subject_line
Fields marked with an
*
are required
Date
*
+
Resident's Name
*
Room Number
*
Residential Life Staff Member Completing Inspection
*
Inspection Type
*
Standard Inspection
Spring Break Health and Safety Inspection
Winter Break Health and Safety Inspection
Thanksgiving Health and Safety Inspection
Violations
Unclean living conditions
Yes
Room damage (walls, furniture and other equipment)
Yes
Trash in room
Yes
Fire safety equipment tampering
Yes
Items hung from ceiling or sprinkler system
Yes
Multiple cords/strips plugged together
Yes
Overloaded outlets
Yes
Cords routed under rugs or doors
Yes
Candles/incense
Yes
Prohibited items
Yes
Foul Odor
Yes
Blocked doorways
Yes
Non-surge protected power strip
Yes
Multiple appliances on one outlet
Yes
Shades NOT Down
Yes
Refrigerator NOT cleaned and perishable items removed
Yes
Food left out on counters.
Yes
Personal Refrigerator NOT empty and Unplugged
Yes
Personal electronics NOT unplugged.
Yes
Inspection Comments
Upload 1
Upload 2
Upload 3
Upload 4