Use this checklist to spot possible safety problems which may be present in your home. Check YES or NO to answer each question. Then go back over the list and take action to correct those items which may need attention. Keep this checklist as a reminder of safe practices, and use it periodically to re-check your home. This checklist is organized by areas in the home. However, there are some potential hazards that need to be checked in more than just one area of your home. These are highlighted at the beginning of the checklist and short reminders are included in each other section of the checklist.

In all areas of your home, check all electrical and telephone cords; rugs, runners and mats; furniture areas; telephone areas; smoke detectors; electrical outlets and switches; light bulbs; space heaters; wood-burning stoves; and your emergency exit plan.

QUESTION: Are lamp, extension, and phone cords placed out of the flow of traffic? YES ___ NO ___

RECOMMENDATION: Cords stretched across walkways may cause someone to trip.

• Arrange furniture so that outlets are available for lamps and appliances without the use of extension cords.
• If you must use an extension cord, place it on the floor against a wall where people can not trip over it.
• Move the phone so that telephone cords will not lie where people walk.

QUESTION: Are cords out from beneath furniture and rugs or carpeting? YES ___ No ___

RECOMMENDATION: Furniture resting on cords can damage them, creating fire and shock hazards. Electric cords which run under carpeting may cause a fire.

• Remove cords from under furniture or carpeting.
• Replace damaged or frayed cords.

QUESTION: Are cords attached to the walls, baseboards, etc., with nails or staples? YES ___ NO ___

RECOMMENDATION: Nails or staples can damage cords, presenting fire and shock hazards.

• Remove nails, staples, etc.
• Check wiring for damage.
• Use tape to attach cords to walls or floors.

QUESTION: Are electrical cords in good condition, not frayed or cracked? YES ___ NO ___

RECOMMENDATION: Damaged cords may cause a shock or fire.

• Replace frayed or cracked cords.

QUESTION: Do extension cords carry more than their proper load, as indicated by the ratings labeled on the cord and the appliance? YES ___ NO ___

RECOMMENDATION: Overloaded extension cords may cause fires. Standard 18 gauge extension cords can carry 1250 watts.

• If the rating on the cord is exceeded because of the power requirements of one or more appliances being used on the cord, change the cord to a higher rated one or unplug some appliances.
• If an extension cord is needed, use one having a sufficient amp or wattage rating.

QUESTION: Are all small rugs and runners slip-resistant? YES ___ NO ___

RECOMMENDATION: The Consumer Product Safety Commission (CPSC) estimates that in 1982, over 2,500 people 65 and over were treated in hospital emergency rooms for injuries that resulted from tripping over rugs and runners. Falls are also the most common cause of fatal injury for older people.

• Remove rugs and runners that tend to slide.
• Apply double-faced adhesive carpet tape or rubber matting to the backs of rugs and runners.
• Purchase rugs with slip-resistant backing.
• Check rugs and mats periodically to see if backing needs to be replaced.
• Place rubber matting under rugs. (Rubber matting that can be cut to size is available.)
• Purchase new rugs with slip-resistant backing. NOTE: Over time, adhesive on tape can wear away. Rugs with slip-resistant backing also become less effective as they are washed. Periodically, check rugs and mats to see if new tape or backing is needed.

QUESTION: Are emergency numbers posted on or near the telephone? YES ___ NO ___

RECOMMENDATION: In case of emergency, telephone numbers for the Police, Fire Department, and local Poison Control Center, along with a neighbor's number, should be readily available.

• Write the numbers in large print and tape them to the phone, or place them near the phone where they can be seen easily.

QUESTION: Do you have access to a telephone if you fall (or experience some other emergency which prevents you from standing and reaching a wall phone)? YES ___ NO ___

• Have at least one telephone located where it would be accessible in the event of an accident which leaves you unable to stand.

QUESTION: Are smoke detectors properly located? YES ___ NO___

RECOMMENDATION: At least one smoke detector should be placed on every floor of your home.

• Read the instructions that come with the smoke detector for advice on the best place to install it.
• Make sure detectors are placed near bedrooms, either on the ceiling or 6-12 inches below the ceiling on the wall.
• Locate smoke detectors away from air vents.

QUESTION: Do you have properly working smoke detectors? YES ___ NO ___

RECOMMENDATION: Many home fire injuries and deaths are caused by smoke and toxic gases, rather than the fire itself. Smoke detectors provide an early warning and can wake you in the event of a fire.

• Purchase a smoke detector if you do not have one.
• Check and replace batteries and bulbs according to the manufacturer's instructions.
• Vacuum the grillwork of your smoke detector.
• Replace any smoke detectors which can not be repaired. NOTE: Some fire departments or local governments will provide assistance in acquiring or installing smoke detectors.

QUESTION: Are any outlets and switches unusually warm or hot to the touch? YES ___ NO ___

RECOMMENDATION: Unusually warm or hot outlets or switches may indicate that an unsafe wiring condition exists.

• Unplug cords from outlets and do not use the switches.
• Have an electrician check the wiring as soon as possible.

QUESTION: Do all outlets and switches have cover plates, so that no wiring is exposed? YES ___ NO ___

RECOMMENDATION: Exposed wiring presents a shock hazard.

• Add a cover plate.

QUESTION: Are light bulbs the appropriate size and type for the lamp or fixture? YES ___ NO ___

RECOMMENDATION: A bulb of too high wattage or the wrong type may lead to fire through overheating. Ceiling fixtures, recessed lights, and "hooded" lamps will trap heat.

• Replace with a bulb of the correct type and wattage. (If you do not know the correct wattage, use a bulb no larger than 60 watts.)

QUESTION: Are heaters which come with a 3-prong plug being used in a 3-hole outlet or with a properly attached adapter? YES ___ NO ___

RECOMMENDATION: The grounding feature provided by a 3-hole receptacle or an adapter for a 2-hole receptacle is a safety feature designed to lessen the risk of shock.

• Never defeat the grounding feature.
• If you do not have a 3-hole outlet, use an adapter to connect the heater's 3-prong plug. Make sure the adapter ground wire or tab is attached to the outlet.

QUESTION: Are small stoves and heaters placed where they can not be knocked over, and away from furnishings and flammable materials, such as curtains or rugs? YES ___ NO ___

RECOMMENDATION: Heaters can cause fires or serious burns if they cause you to trip or if they are knocked over.

• Relocate heaters away from passageways and flammable materials such as curtains, rugs, furniture, etc.

QUESTION: If your home has space heating equipment, such as a kerosene heater, a gas heater or an LP gas heater, do you understand the installation and operating instructions thoroughly? YES ___ NO ___

RECOMMENDATION: Unvented heaters should be used with room doors open or window slightly open to provide ventilation. The correct fuel, as recommended by the manufacturer, should always be used. Vented heaters should have proper venting, and the venting system should be checked frequently. Improper venting is the most frequent cause of carbon monoxide poisoning, and older persons are at special risk.

• Review the installation and operating instructions.
• Call your local fire department if you have additional questions.

QUESTION: Is wood-burning equipment installed properly? YES ___ NO ___

RECOMMENDATION: Wood-burning stoves should be installed by a qualified person according to local building codes.

• Local building code officials or fire marshals can provide requirements and recommendations for installation. NOTE: Some insurance companies will not cover fire losses if wood stoves are not installed according to local codes.

QUESTION: Do you have an emergency exit plan and an alternate emergency exit plan in case of a fire? YES ___ NO ___

RECOMMENDATION: Once a fire starts, it spreads rapidly. Since you may not have much time to get out and there may be a lot of confusion, it is important that everyone knows what to do.

• Develop an emergency exit plan.
• Choose a meeting place outside your home so you can be sure that everyone is capable of escape quickly and safely.
• Practice the plan from time to time to make sure everyone is capable of escape quickly and safely. Remember periodically to re-check your home.

In the kitchen, check the range area, all electrical cords, lighting, the stool, all throw rugs and mats, and the telephone area.

CHECK THE RANGE AREA

QUESTION: Are towels, curtains, and other things that might catch fire located away from the range? YES ___ NO ___

RECOMMENDATION: Placing or storing non-cooking equipment like potholders, dish towels, or plastic utensils on or near the range may result in fires or burns.

• Store flammable and combustible items away from range and oven.
• Remove any towels hanging on oven handles. If towels hang close to a burner, change the location of the towel rack.
• If necessary, shorten or remove curtains which could brush against heat sources.

QUESTION: Do you wear clothes with short or close-fitting sleeves while cooking? YES ___ NO ___

RECOMMENDATION: The CPSC estimates that 70% of all people who die from clothing fires are over 65 years of age. Long sleeves are more likely to catch fire than are short sleeves. Long sleeves are also more apt to catch on pot handles, overturning pots and pans and causing scalds.

• Roll back long, loose sleeves or fasten them with pins or elastic bands while you are cooking.

QUESTION: Are kitchen ventilation systems or range exhausts functioning properly and are they in use while you are cooking? YES ___ NO ___

RECOMMENDATION: Indoor air pollutants may accumulate to unhealthful levels in a kitchen where gas or kerosene-fire appliances are in use.

• Use ventilation systems or open windows to clear air of vapors and smoke.

QUESTION: Are all extension cords and appliance cords located away from the sink or range areas? YES ___ NO ___

RECOMMENDATION: Electrical appliances and power cords can cause shock or electrocution if they come in contact with water. Cords can also be damaged by excess heat.

• Move cords and appliances away from sink areas and hot surfaces.
• Move appliances closer to wall outlets or to different outlets so you won't need extension cords.
• If extension cords must be used, install wiring guides so that cords will not hang near sink, range, or working areas.
• Consider adding new outlets for convenience and safety; ask your electrician to install outlets equipped with ground fault circuit interrupters (GFCIs) to protect against electric shock. A GFCI is a shock-protection device that will detect electrical fault and shut off electricity before serious injury or death occurs.

QUESTION: Does good, even lighting exist over the stove, sink, and countertop work areas, especially where food is sliced or cut? YES ___ NO ___

RECOMMENDATION: Low lighting and glare can contribute to burns or cuts. Improve lighting by:

• Opening curtains and blinds (unless this causes to much glare).
• Using the maximum wattage bulb allowed by the fixture. (If you do not know the correct wattage for the fixture, use a bulb no larger than 60 watts.)
• Reducing glare by using frosted bulbs, indirect lighting, shades or globes on light fixtures, or partially closing the blinds or curtains.
• Installing additional light fixtures, e.g. under cabinet/over countertop lighting. (Make sure that the bulbs you use are the right type and wattage for the light fixture.)

QUESTION: Do you have a step stool which is stable and in good repair? YES ___ NO ___

RECOMMENDATION: Standing on chairs, boxes, or other makeshift items to reach high shelves can result in falls. The CPSC estimates that in 1982, 1500 people over 65 were treated in hospital emergency rooms when they fell from chairs on which they were standing.

• If you don't have a step stool, consider buying one. Choose one with a handrail that you can hold onto while standing on the top step.
• Before climbing on any step stool, make sure it is fully opened and stable.
• Tighten screws and braces on the step stool.
• Discard step stools with broken parts. Remember: Check all of the product areas mentioned at the beginning of the checklist.

In the living room/family room, check all rugs and runners, electrical and telephone cords, lighting, the fireplace and chimney, the telephone area, and all passageways.

QUESTION: Are chimneys clear from accumulations of leaves, and other debris that can clog them? YES ___ NO ___

RECOMMENDATION: A clogged chimney can cause a poorly-burning fire to result in poisonous fumes and smoke coming back into the house.

• Do not use the chimney until the blockage has been removed.
• Have the chimney checked and cleaned by a registered or licensed professional.

QUESTION: Has the chimney been cleaned within the past year? YES ___ NO ___

RECOMMENDATION: Burning wood can cause a build up of a tarry substance (creosote) inside the chimney. This material can ignite and result in a serious chimney fire.

• Have the chimney checked and cleaned by a registered or licensed professional

QUESTION: Are halls, passages between rooms and other heavy traffic areas well lit? YES ___NO ___

RECOMMENDATION: Shadowed or dark areas can hide tripping hazards.

• Use the maximum wattage bulb allowed by the fixture. (If you do not know the correct wattage, use a bulb no larger than 60 watts.)
• Install night lights.
• Reduce glare by using frosted bulbs, indirect lighting, shades or globes on light fixtures, or partially closing blinds or curtains.
• Consider using additional lamps or light fixtures. Make sure that the bulbs you use are the right type and wattage for the light fixture.

QUESTION: Are exits and passageways kept clear? YES ___ NO ___

RECOMMENDATION: Furniture, boxes, or other items could be an obstruction or tripping hazard, especially in the event of an emergency or fire.

• Rearrange furniture to open passageways and walkways.
• Remove boxes and clutter. Remember: Check all of the product areas mentioned at the beginning of the checklist.

In the bathroom, check bathtub and shower areas, water temperature, rugs and mats, lighting, small electrical appliances, and storage areas for medications.

QUESTION: Are bathtubs and showers equipped with non-skid mats, abrasive strips, or surfaces that are not slippery? YES ___ NO ___

RECOMMENDATION: Wet soapy tile or porcelain surfaces are especially slippery and may contribute to falls.

• Apply textured strips or appliques on the floors of tubs and showers.
• Use non-skid mats in the tub and shower, and on the bathroom floor.

QUESTION: Do bathtubs and showers have at least one (preferably two) grab bars? YES ___ NO ___

RECOMMENDATION: Grab bars can help you get into and out of your tub or shower, and can help prevent falls.

• Check existing bars for strength and stability, and repair if necessary.
• Attach grab bars, through the tile, to structural supports in the wall, or install bars specifically designed to attach to the sides of the bathtub. If you are not sure how it is done, get someone who is qualified to assist you.

QUESTION: Is the temperature 120 degrees or lower? YES ___ NO ___

RECOMMENDATION: Water temperature above 120 degrees can cause tap water scalds.

• Lower the setting on your hot water heater to "Low" or 120 degrees. If you are unfamiliar with the controls of your water heater, ask a qualified person to adjust it for you. If your hot water system is controlled by the landlord, ask the landlord to consider lowering the setting. NOTE: If the water heater does not have a temperature setting, you can use a thermometer to check the temperature of the water at the tap.
• Always check water temperature by hand before entering bath or shower.
• Taking baths, rather than showers, reduces the risk of a scald from suddenly changing water temperatures.

QUESTION: Is a light switch located near the entrance to the bathroom? YES ___ NO ___

RECOMMENDATIONS: A light switch near the door will prevent you from walking through a dark area.

• Install a night light. Inexpensive lights that plug into outlets are available.
• Consider replacing the existing switch with a "glow switch" that can be seen in the dark.

QUESTION: Are small electrical appliances such as hair dryers, shavers, curling irons, etc., unplugged when not in use? YES ___ NO ___

RECOMMENDATION: Even an appliance that is not turned on, such as a hairdryer, can be potentially hazardous if it is left plugged in. If it falls into water in a sink or bathtub while plugged in, it could cause a lethal shock.

• Unplug all small appliances when not in use.
• Never reach into water to retrieve an appliance that has fallen in without being sure the appliance is unplugged.
• Install a ground fault circuit interrupter (GFCI) in your bathroom outlet to protect against electric shock.

QUESTION: Are all medicines stored in the containers that they came in and are they clearly marked? YES ___ NO ___

RECOMMENDATION: Medications that are not clearly and accurately labeled can be easily mixed up. Taking he wrong medicine or missing a dosage of medicine you need can be dangerous.

• Be sure that all containers are clearly marked with the contents, doctor's instructions, expiration date, and patient's name.
• Dispose of outdated medicines properly.
• Request non-child-resistant closures from your pharmacist only when you cannot use child-resistant closures. NOTE: Many poisonings occur when children visiting grandparents go through the medicine cabinet or grandmother's purse. In homes where grandchildren or other youngsters are frequent visitors, medicines should be purchased in containers with child-resistant caps, and the caps properly closed after each use. Store medicines beyond the reach of children. Remember: Check all of the product areas mentioned at the beginning of the checklist.

In the bedroom, check all rugs and runners, electrical and telephone cords, and areas around beds.

QUESTION: Are lamps or light switches within reach of each bed? YES ___ NO ___

RECOMMENDATION: Lamps or switches located close to each bed will enable people getting up at night to see where they are going.

• Rearrange furniture closer to switches or move lamps closer to beds.
• Install night lights.

QUESTION: Are ash trays, smoking materials, or other fire sources (heaters, hot plates, teapots, etc.) located away from beds or bedding? YES ___ NO ___

RECOMMENDATION: Burns are a leading cause of accidental death among seniors. Smoking in bed is a major contributor to this problem. Among mattress and bedding fire related deaths in a recent year, 42% were to persons 65 or older.

• Remove sources of heat or flame from areas around beds.
• Don't smoke in bed.

QUESTION: Is anything covering your electric blanket when in use? YES ___ NO ___

RECOMMENDATION: "Tucking in" electric blankets, or placing additional coverings on top of them can cause excessive heat buildup which can start a fire.

• Use electric blankets according to the manufacturer's instructions.
• Don't allow anything on top of the blanket while it is in use. (This includes other blankets or comforters, even pets sleeping on top of the blanket.)
• Don't set electric blankets so high that they could burn someone who falls asleep while they are on.

QUESTION: Do you ever go to sleep with a heating pad which is turned on? YES ___ NO ___

RECOMMENDATION: Never go to sleep with a heating pad if it is turned on because it can cause serious burns even at relatively low settings.

QUESTION: Is there a telephone close to your bed? YES ___ NO ___

RECOMMENDATION: In case of an emergency, it is important to be able to reach the telephone without getting out of bed. Remember: Check all of the product areas mentioned at the beginning of the checklist.

In the basement, garage, workshop, and storage areas, check lighting, fuse boxes or circuit breakers, appliances and power tools, electrical cords, and flammable liquids.

QUESTION: Are work areas, especially areas where power tools are used, well lit? YES ___ NO ___

RECOMMENDATION: Power tools were involved in over 5,200 injuries treated in hospital emergency rooms to people 65 and over in 1982. Three fourths of these were finger injuries. Good lighting can reduce the chance that you will accidentally cut your finger.

• Either install additional light, or avoid working with power tools in the area.

QUESTION: Can you turn on lights without first having to walk through a dark area? YES ___ NO ___

RECOMMENDATION: Basement, garages, and storage areas can contain many tripping hazards and sharp or pointed tools that can make a fall even more hazardous.

• Keep an operating flashlight handy.
• Have an electrician install switches at each entrance to a dark area.

QUESTION: If fuses are used, are they the correct size for the circuit? YES ___ NO ___

RECOMMENDATION: Replacing a correct size fuse with a larger size fuse can present a serious fire hazard. If the fuse in the box is rater higher than that intended for the circuit, excessive current will be allowed to flow and possibly overload the outlet and house wiring to the point that a fire can begin.

• Be certain that correct-size fuses are used. (If you do not know the correct sizes, consider having an electrician identify and label the sizes to be used.) NOTE: If all, or nearly all, fuses used are 30-amp fuses, there is a chance that some of the fuses are rated too high for the circuit.

QUESTION: Are power tools equipped with a 3-prong plug or marked to show that they are double insulated? YES ___ NO ___

RECOMMENDATION: These safety features reduce the risk of an electric shock.

• Use a properly connected 3-prong adapter for connecting a 3- prong plug to a 2-hole receptacle.
• Consider replacing old tools that have neither a 3-prong plug nor are double insulated.

QUESTION: Are power tools guards in place? YES ___ NO ___

RECOMMENDATION: Power tools used with guards removed pose a serious risk of injury from sharp edges or moving parts.

• Replace guards that have been removed from power tools.

QUESTION: Has the grounding feature on any 3-prong plug been defeated by removal of the grounding pin or by improperly using an adapter? YES ___ NO ___

RECOMMENDATION: Improperly grounded appliances can lead to electric shock.

• Check with your service person or an electrician if you are in doubt.

QUESTION: Are containers of volatile liquids tightly capped? YES ___ NO ___

RECOMMENDATION: If not tightly closed, vapors may escape that may be toxic when inhaled.

• Check containers periodically to make sure they are tightly closed. NOTE: The CPSC has reports of several cases in which gasoline, stored as much as 10 feet from a gas water heater, exploded. Many people are unaware that gas fumes can travel that far.

QUESTION: Are gasoline, paints, solvents, or other products that give off vapors or fumes stored away from ignition sources? YES ___ NO ___

RECOMMENDATION: Gasoline, kerosene, and other flammable liquids should be stored out of living areas in properly labeled, non-glass safety containers.

• Remove these products from the areas near heat or flame such as heaters, furnaces, water heaters, ranges, and other gas appliances.

For all stairways, check lighting, handrails, and the conditionof the steps and coverings.

QUESTION: Are stairs well lighted? YES ___ NO ___

RECOMMENDATION: Stairs should be lighted so that each step, particularly the step edges, can be clearly seen while going up and down stairs. The lighting should not produce glare or shadows along the stairway.

• Use the maximum wattage bulb allowed by the light fixture. (If you do not know the correct wattage, use a bulb no larger than 60 watts.)
• Reduce glare by using frosted bulbs, indirect lighting, shades or globes on light fixtures, or partially closing blinds and curtains.
• Have a qualified person add additional light fixtures. Make sure that the bulbs you use are the right type and wattage for the light fixture.

QUESTION: Are light switches located at both the top and bottom of the stairs. YES ___ NO ___

RECOMMENDATION: Even if you are very familiar with the stairs, lighting is an important factor in preventing falls. You should be able to turn on the lights before you use the stairway from either end.

• If no other light is available, keep an operating flashlight in a convenient location at the top and bottom of the stairs.
• Install night lights at nearby outlets.
• Consider installing switches at the top and bottom of the stairs.

QUESTION: Do the steps allow secure footing? YES ___ NO ___

RECOMMENDATION: Worn treads or worn or loose carpeting can lead to insecure footing, resulting in slips or falls.

• Try to avoid wearing only socks or smooth-soled shoes or slippers when using stairs.
• Make certain the carpet is firmly attached to the steps all along the stairs.
• Consider refinishing or replacing worn treads, or replacing worn carpeting.
• Paint outside steps with paint that has a rough texture, or use abrasive strips.

QUESTION: Are steps even and of the same size and height? YES ___ NO ___

RECOMMENDATION: Even a small difference in step surfaces or riser heights can lead to falls.

• Mark any steps which are especially narrow or have risers that are higher or lower than the others. Be especially careful of these steps when using the stairs.

QUESTION: Are the coverings on the steps in good condition? YES ___ NO ___

RECOMMENDATION: Worn or torn coverings or nails sticking out from coverings could snag your foot or cause you to trip.

• Repair coverings.
• Remove coverings.
• Replace coverings.

QUESTION: Can you clearly see the edges of the steps? YES ___ NO ___

RECOMMENDATION: Falls may occur if the edges of the steps are blurred or hard to see.

• Paint edges of outdoor steps white to see them better at night.
• Add extra lighting.
• If you plan to carpet your stairs, avoid deep pile carpeting or patterned or dark colored carpeting that can make it difficult to see the edges of the steps clearly.

QUESTION: Is anything stored on the stairway, even temporarily? YES ___ NO ___

RECOMMENDATION: People can trip over objects left on stairs, particularly in the event of an emergency or fire.

• Remove all objects from the stairway.