Form Center

2. FACILITY INSPECTION FORM
4. Location*

   1. Baker Community Center
   2. Millington Gym
8. Security - Were all doors and windows secured?*

   1. Yes
   2. No
9. Fire Extinguishers - Are all fire extinguishers in place and fully charged?*

   1. Yes
   2. No
10. Emergency Lighting - Are all emergency lights working and EXIT lights illuminated?*

    1. Yes
    2. No
11. Interior Lighting - Are all interior lights working?*

    1. Yes
    2. No
13. HVAC - Is the inside temperature comfortable? Thermostats should be set at 74 in summer and 70 in winter.*

    1. Yes
    2. No
14. Plumbing - Are all toilets, sinks & water fountains operational? *

    1. Yes
    2. No
15. Interior Cleanliness - Is the general cleanliness of the facility acceptable?*

    1. Yes
    2. No
19. Exterior Lighting - Are all exterior lights working?*

    1. Yes
    2. No
20. Exterior Cleanliness - Is the general cleanliness of the exterior areas acceptable?*

    1. Yes
    2. No
21. Flag - Is the American Flag in good condition and properly lit and displayed?*

    1. Yes
    2. No
23. If you answered NO to anything above, please describe. If not, answer NA.*
25. Other*
    If there are any other issues, please identify here.
29. Inspection Completed by:*
30. Date:*
31. Time:*
33. Follow Up Inspection
    If a follow up inspection is required, please list date, time and inspector's name here.
Leave This Blank:


35. 1. Receive an email copy of this form.
36. Email address

    This field is not part of the form submission.

37. Submit

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