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Cooperative Extension Service |
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Agricultural
Experiment Station |
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U of A Board Policies
Division Home
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Cooperative Extension Service Departments
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| ___ | ___ | ___ | 1. | Are all stairways clear of objects which could cause a person to trip? |
| ___ | ___ | ___ | 2. | Do all stairways have a firmly anchored handrail? |
| ___ | ___ | ___ | 3. | Are all stairways well-lighted? |
| ___ | ___ | ___ | 4. | If you have small children, do you keep safety gates closed across the entrances to stairwells? |
| ___ | ___ | ___ | 5. | Are stair coverings securely anchored? |
| ___ | ___ | ___ | 6. | Do you have a safe step ladder for home use? |
| ___ | ___ | ___ | 7. | Do you have a safe step stool with a hand rail for reaching high shelves? |
| ___ | ___ | ___ | 8. | Are all scatter rugs skid-proof, and do they lay flat? |
| ___ | ___ | ___ | 9. | Are all carpets securely anchored? |
| ___ | ___ | ___ | 10. | Are all entrance ways, exits, halls and walks well-lighted? |
| ___ | ___ | ___ | 11. | Are night lights used to prevent stumbling around in the dark? |
| ___ | ___ | ___ | 12. | Are all walks, porches and doorways clear of obstacles? |
| ___ | ___ | ___ | 13. | Are all hard-surfaced floors clean, are spills wiped up immediately? |
| ___ | ___ | ___ | 14. | Is non-skid wax used on all polished floors? |
| ___ | ___ | ___ | 15. | Is proper footwear worn to prevent slips, trips, falls and other fall injuries? |
| ___ | ___ | ___ | 16. | Do bath tubs and showers have non-skid strips or suction mats in them? |
| ___ | ___ | ___ | 17. | Are grab bars installed in bathtubs and showers? |
| ___ | ___ | ___ | 18. | Are lamp, extension and telephone cords placed out of traffic areas? |
| ___ | ___ | ___ | 19. | Are all chairs, tables and beds safe to use? |
| Yes | NA | No | ||
| ___ | ___ | ___ | 1. | Are all electric receptacles of the three-prong grounded type? |
| ___ | ___ | ___ | 2. | Are all bathroom, kitchen and outdoor circuits protected by a ground fault circuit interrupter? |
| ___ | ___ | ___ | 3. | Do you know how to shut off the electrical, water and gas sources to your home? |
| ___ | ___ | ___ | 4. | Are all fuses of correct amperage? |
| ___ | ___ | ___ | 5. | Are fuses or circuit breakers labeled to identify outlets and appliances they protect? |
| ___ | ___ | ___ | 6. | Does your home have adequate electrical power in all areas to safely operate all your electrical appliances? |
| ___ | ___ | ___ | 7. | Do all light switches work correctly? |
| ___ | ___ | ___ | 8. | Do all wall switches and outlets have safe coverplates? |
| ___ | ___ | ___ | 9. | Are all appliance and extension cords in good condition? |
| ___ | ___ | ___ | 10. | Is the ground prong still on all electric plugs which came equipped with one? |
| ___ | ___ | ___ | 11. | Are all electrical appliances Underwriters Laboratories (UL) approved? Check both the appliance and the cord? |
| ___ | ___ | ___ | 12. | Are small electrical appliances such as hair dryers, shavers, electric knives, coffee pots, etc., unplugged when not in use? |
| ___ | ___ | ___ | 13. | Do you purchase "flame retardant" sleepwear for your children? |
| ___ | ___ | ___ | 14. | If smoking is permitted in your home, do you provide deep, wide-rimmed ashtrays and prohibit smoking in bed or while lying down? |
| ___ | ___ | ___ | 15. | Is the furnace cleaned and serviced yearly? |
| ___ | ___ | ___ | 16. | Are areas around the furnace clear of boxes and other combustible materials? |
| ___ | ___ | ___ | 17. | Are the chimney and smoke pipe cleaned yearly? |
| ___ | ___ | ___ | 18. | Does the fireplace function properly and is it adequately screened? |
| ___ | ___ | ___ | 19. | Is the space around the hot water heater clear of combustible materials? |
| ___ | ___ | ___ | 20. | Does the hot water heater have a pressure and temperature relief valve? |
| ___ | ___ | ___ | 21. | Is the hot water temperature 120 degrees or less to prevent burns? (It may need to be set at 140 degrees for the dishwasher to wash dishes properly.) |
| ___ | ___ | ___ | 22. | Are portable heaters in good condition, is adequate ventilation provided, and is it positioned in a safe location away from flammable materials? |
| ___ | ___ | ___ | 23. | Are portable electric fans and heaters adequately screened to prevent contact with the fan blades or heating elements? |
| ___ | ___ | ___ | 24. | Do you keep matches where young children cannot reach them? |
| ___ | ___ | ___ | 25. | Are small children supervised when in the kitchen while you are cooking, baking and handling hot objects? |
| ___ | ___ | ___ | 26. | Are charcoal grills used only outdoors, never in the house, garage or enclosed porch? |
| ___ | ___ | ___ | 27. | Has your family developed and practiced a fire escape plan for your home? |
| ___ | ___ | ___ | 28. | Are the smoke and/or fire detectors installed in the house, at least one per floor? |
| ___ | ___ | ___ | 29. | Are the smoke and/or fire detectors tested monthly? |
| ___ | ___ | ___ | 30. | Do you have a charged ABC fire extinguisher of at least the 21/2-pound size conveniently located in your home? |
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University of Arkansas • Division of Agriculture |
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