Division of Family Services

Health and Safety Environmental Observations Minimal Standards Checklist

Case Name: __________________ FACTS No: _______ Completed by: _______________
12. Alcohol/drugs stored out-of-reach of
children.
13. Flame producing devices stored out-ofreach of children.
14. Stairwells/hallways/fire escapes kept
free of (excessive) debris.
15. Infant/toddler beds placed away from
window blind/curtain cords.
16. Infant crib railings no more than 2-3/8
apart.
17. Hot water heater settings no higher than
120 F.
18. Safety gates available at top/bottom of
stairs with toddlers.
19. Swimming pool not (readily) accessible
to children without adult.
20. Family pets have state required
inoculations (current Rabies tags).
21. Floors/walls free of holes/broken
boards.
22. Outside area free of dangerous debris.

HEALTH Observations
1. Spoilable refuse contained in closeable
trash receptacle.
2. Human and/or animal waste contained
in toilet/ animal box/pen.
3. Soiled diapers contained in closeable
trash receptacle.
4. Environment free of unmanaged
(excessive) insect/rodents.
5. Potable water (running or bottled).
6. Toilet in working condition.
7. Environment free of excessive
mold/mildew.
8. Spoilable food chilled or refrigerated.
9. Cleaning agent/soap available for food
preparation area.
10. Observable means of warming/ heating
food.
11. Cleaning agent/soap available for
clothes laundering.
12. Observable (reasonable) means of
laundering clothes.
13. Observable means of (extreme)
temperature control, ie: heat/air
conditioning/fans.

SUSTENANCE Observations
1. Age appropriate, healthy food varieties
available.1
2. Demonstrable ability to maintain food
supply.2

SAFETY Observations
1. External door locking mechanisms in
working order.
2. Windows have no exposed edges or
jagged glass.
3. Smoke detectors in working order.
4. Environment free of exposed electrical
wiring.
5. Firearms/ammunition locked in firearms
safe or have approved locking devices.
6. Home does not have deadman props on
doors, or windows nailed shut.
7. Flammable liquids stored away from
flame/heating units.
8. Space/water heaters have flame/ignition
guards.
9. Railings on staircase are secure.
10. Chemicals secured away from children .
11. Medications/syringes stored out-ofreach of children.

Adapted from:

Recognition of Child Abuse for the Mandated

Reporter, 2nd edition, James Monteleone

Field Guide to Child Welfare, vol. I, Foundations

of Child Protective Services, Judith Rycus &
Ronald Hughes

US Consumer Product Safety Commission

National Safety Council & Child Safety Network

Consider: protein, caloric content, calcium, essential

vitamins/minerals, fat content, food groups, and
childs age.
2
Consider: income availability, transportation to
purchase food, external/community assistance.