Home Visiting Risk Assessment Form Name of client: ____________________________________________________________ Address of assessment: _____________________________________________________ _________________________________________________________________________ Date assessment conducted: ____________ By: _________________________________ Signed: ______________________________________ Premises risk assessment Identified risk or Risk management or hazard control hazard Access to home easy – access and exit, more than one exit from the home. Doors easily opened, – unobstructed Pathways level surface, – uncluttered, adequate width Steps /stairs non slip, level – surface, solid Pets adequately restrained – Lighting well-lit, dark hiding – places NB. If any home visits need to be carried out dark ensure neighbourhood lighting is assessed after dark prior to first visit. Neighbourhood general – safety Is there safe, well-lit parking available close to the home? Are any safety concerns regarding the route from public transport stops to the home.
Home Visiting Risk Assessment Form Name of client: ____________________________________________________________ Address of assessment: _____________________________________________________ _________________________________________________________________________ Date assessment conducted: ____________ By: _________________________________ Signed: ______________________________________ Premises risk assessment Identified risk or hazard Risk management or hazard control Access to home – easy access and exit, more than one exit from the home. Doors – easily opened, unobstructed Pathways – level surface, uncluttered, adequate width Steps /stairs – non slip, level surface, solid Pets – adequately restrained Lighting – well-lit, dark hiding places NB. If any home visits need to be carried out dark ensure neighbourhood lighting is assessed after dark prior to first visit. Neighbourhood – general safety Is there safe, well-lit parking available close to the home? Are any safety concerns regarding the route from public transport stops to the home.
auks%20home%20visiting%20risk%20assessment%20form%20july%202013.docx