Form Center

2. CLIMBING AND UPPER BODY EQUIPMENT
4. Location*

   1. Aycock
   2. Lions
   3. Oak
   4. Discovery
8. Playground Location
   Describe location of playground at the facility.
9. Surface
10. Age of Intended Users
12. Location of piece
    Describe location of broken piece in detail.
14. Height
18. Are all footings stable and buried below ground level or covered by protective surfacing?*

    1. yes
    2. no
20. Comments (Explain in detail)
22. Actions Taken
26. Is there any visible corrosion or rotting?*

    1. yes
    2. no
27. Do any climbers have climbing bars or structural compontents in the interior of the stucture onto which a chilld may fall more than 18 inches? Note: Climbing devices intended for 2-5 year olds offer an easy way out.*

    1. yes
    2. no
28. Are there any flexible access devices that are used as sole access to other components?*

    1. yes
    2. no
30. Comments (Explain in detail)
32. Actions Taken
36. Are all ropes, cables, and chain within the climbing grids securely fixed?*

    1. yes
    2. no
37. Does the spacing between the horizontal and vertical climbing grid satify all entrapment criteria?*

    1. yes
    2. no
38. Are all flexible climbing devices achored at both ends?*

    1. yes
    2. no
40. Is the bottom anchoring device below the level of the playing surface?*

    1. yes
    2. no
41. Are preschool users able to bring both feet to the same level before ascending to the next level?*

    1. yes
    2. no
43. Comments (Explain in detail)
45. Actions Taken
49. Are there freestanding arch climbers in any area recommended for ages 2-5 year olds?*

    1. yes
    2. no
50. Are all hand and foot rung diameters .95-1.55 inches?*

    1. yes
    2. no
51. Do all spacings of rungs on arch climbers foolow the recommendations for rung ladders?*

    1. yes
    2. no
53. Does all spacing between horizontal and vertical components satisfy all entrapment criteria?*

    1. yes
    2. no
54. Are there any arch climbers that are the sole access to any equipment?*

    1. yes
    2. no
55. Do all arch ladders have hand supports?*

    1. yes
    2. no
57. Comments (please explain in detail)
59. Actions Taken
63. Are all horizontal ladders and overhead rings only used in area the are recommended for ages 4-12 (CPSC) or 2-12 years (ASTMI)?*

    1. yes
    2. no
64. I the space between adjacent rings or overhead ladders greater than 9 inches?*

    1. yes
    2. no
65. Does center to center spacing on the rungs exceed 15 inches? (this does not apply to the spacing of overhead rings)*

    1. yes
    2. no
67. Is the first hanhold placed directly above the platform or climbing rungs?*

    1. yes
    2. no
69. Comments (Explain in detail)
71. Actions Taken
75. Comments (Please explain in detail)
77. Actions Taken
81. Are all hand gripping components a minumun of 64 inches?*

    1. yes
    2. no
82. Are all elevated landings a minumum of 36 inches long and 32 inches wide?*

    1. yes
    2. no
83. Are all center to center distances between adjacent tracks 48 inches or more?*

    1. yes
    2. no
85. Are there any sharp points, corners or edges? *

    1. yes
    2. no
86. Is all wood smooth with no splinters?*

    1. yes
    2. no
87. Are there any protrusions? (test all projections.)*

    1. yes
    2. no
89. Are all angles greater than 55 degrees, unless the lower leg is horizontal or projects downwards?*

    1. yes
    2. no
90. Are all interior surfaces less tahn 3 1/2 inches or greater than 9 inches at a depth of 4 inches or greater?*

    1. yes
    2. no
91. Have all openings been tested?*

    1. yes
    2. no
93. Are all fasteners tight?*

    1. yes
    2. no
94. Are all fasteners tight enough you have to use tools to remove or loosen them?*

    1. yes
    2. no
95. Is there adequate drainage provided?*

    1. yes
    2. no
97. Do each of the depth of surfacing material agree with critical height of equiptment?*

    1. yes
    2. no
98. Does the use zone comply with the measurement of six feet from the side perimeters of the equiptment?*

    1. yes
    2. no
100. Comments (Please explain in detail)
102. Actions Taken
106. Inspection Completed by:*
107. Date:*
108. Time:*
110. Follow Up Inspection
     If a follow up inspection is required, please list date, time and inspector's name here.
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112. 1. Receive an email copy of this form.
113. Email address

     This field is not part of the form submission.

114. Submit

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