Completing the following checklist provides you with a safety assessment of your home. The nurse can help you determine which questions are applicable to your home and situation. Safety hazards in a home can usually be remedied very easily. If you answer “no” to any applicable question, the nurse can teach you what you have to do to answer “yes” and increase your home’s safety.

Miscellaneous

  • Are the following items in secured areas out of the reach of children and confused individuals?
    • Medications?
    • Poisons (bug killer, weed killer, etc.)?
    • Cleaning substances?
    • Dangerous tools
    • Sharp objects (knives, axes, etc.)
  • Is wheeled furniture secured by caster plates?
  • Are sidewalks, curbs and outside stairs maintained?
  • Is snow and ice removal adequate and efficient?
  • Is the water heater temperature kept under 120°F?

Stairwells

  • Are handrails present and securely fastened?
  • Are different colors used to mark changes in level?
  • Are there nonskid treads on steps?

Lighting

  • Are nightlights used along routes/areas traveled after dark?
  • Are burned-out light bulbs replaced?
  • Is lighting adequate throughout the hours?

Heating System

  • Are examinations/cleanings done on a regular basis by a utility expert?

Floors

  • Are pathways and hallways cleared of toys, excess furniture, etc.?
  • Are large rugs anchored at the edges?
  • Are scatter rugs secured by nonskid backing?
  • Is nonskid wax used on floors?

Fire

  • Do the following areas have smoke alarms?
    • Basement?
    • Attic? Yes No o Bedrooms?
    • Kitchen? Yes No o Hallways?
  • Does the fireplace have n smoke screen?
  • Is maintenance for the fireplace/woodstove scheduled completed on a regular basis?
  • Are curtains and other flammable items kept away from the stove and other open flame areas?
  • Are there an adequate number of glass or ceramic ashtrays?
  • Are exits available from all locations in the house?
  • Is there a home fire safety/drill plan?

Electric Outlets and Devices

  • Are all electric devices protected from and not exposed to moisture?
  • Do electric cords run along walls?
  • Do all electric plugs fit snugly into their sockets?
  • Are all electric cords free from fraying or cracking?
  • Are appliances disconnected when not in use?
  • Are unused outlets covered?

Bathroom

  • Does the toilet have n high-rise seat?
  • Is there a seat by the sink?
  • Is there a seat in the tub/shower?
  • Is there a nonskid mat in the tub/shower?
  • Are there Agrippa by the toilet?
  • Are there Agrippa by the tub/shower?