Template

Home Visiting Risk Assessment Form

by Tim Rees, from the Community

20+

Create a thorough home visiting risk assessment before staff attend a clients home. This checklist guides pre-visit screening, access and parking checks, hazards in yards and entryways, room-by-room safety (kitchen, bathroom, laundry, bedroom), infection control, electrical and equipment risks, emergency readiness, and chemical exposure. Capture decisions on whether visits proceed and record controls to protect home support workers and clients.

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With SafetyCulture you can

Digitize any process, procedure or policy

Eliminate mistakes made by paper-based processes

Create and share professional reports instantly

Confirm accountability and compliance with a digital log

About author

Community

This community page makes available free workplace checklists and templates created by other users within the SafetyCulture community. SafetyCulture has re-published this content and where possible, has credited the original author. SafetyCulture has not verified the accuracy, reliability or suitability of any community content. You agree that your use of any of this content is in accordance with SafetyCulture’s Terms and Conditions.

Template
Home Visiting by Program Staff Checklist
This home visiting checklist helps program staff plan and document safe, effective client visits. Capture visit schedules and reasons, employee details and vehicle, apply risk controls, confirm lone worker device usage, and complete a pre-visit risk assessment. Record client contact information, notes and observations, visit completion time, and signatures to ensure clear documentation, safety compliance, and accountability across community service operations.
by Ralph Parker, from the Community
Downloads: 10+
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Template
Home Health and Safety Inspection Checklist
Use this Home Health and Safety Inspection checklist to evaluate risks and compliance in residential or care home settings. Cover maintenance records, accident reporting and RIDDOR, COSHH controls and PPE, clinical waste and sharps disposal, moving and handling assessments and training, first aid readiness, environmental hazards and accessibility, smoking policy, laundry and chemical storage, grounds and lighting, electrical safety, and fire risk assessment and reviews. Capture findings, assign actions, and keep audits on record.
by John Crockett, from the Community
Downloads: 10+
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Template
QLD QCSS Safety Assessment: Client Home and Transport
This QLD QCSS safety assessment template helps community care providers identify and manage hazards in client homes and during transport. It guides pre-visit screening, home and access checks, internal premises review, equipment and chemical safety, manual handling, mobility equipment verification, and transport safety considerations. It also supports emergency evacuation planning, risk assessment using a risk matrix, and implementing control measures to protect clients and staff. Use it to document hazards, assign actions, and keep records up to date for safer service delivery.
by Bruce Russell, from the Community
Downloads: 0
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Template
Home Healthcare Client Location Hazard Assessment
Use this hazard assessment checklist to evaluate risks in a client residence before or during home healthcare visits. It guides staff through general safety conditions, fire and life safety, slip, trip and fall hazards, sanitation, infection control and PPE, sharps handling, and patient handling ergonomics. It also covers pets, security concerns, firearms, hoarding, environmental factors, wandering behaviors, and transportation safety. Record findings, identify controls, and plan corrective actions to protect caregivers and clients.
by MYRA GRAYSON, from the Community
Downloads: 0
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Home Visiting by Program Staff Checklist

This home visiting checklist helps program staff plan and document safe, effective client visits. Capture visit schedules and reasons, employee details and vehicle, apply risk controls, confirm lone worker device usage, and complete a pre-visit risk assessment. Record client contact information, notes and observations, visit completion time, and signatures to ensure clear documentation, safety compliance, and accountability across community service operations.

by Ralph Parker, from the Community

10+

Get

Template

Home Health and Safety Inspection Checklist

Use this Home Health and Safety Inspection checklist to evaluate risks and compliance in residential or care home settings. Cover maintenance records, accident reporting and RIDDOR, COSHH controls and PPE, clinical waste and sharps disposal, moving and handling assessments and training, first aid readiness, environmental hazards and accessibility, smoking policy, laundry and chemical storage, grounds and lighting, electrical safety, and fire risk assessment and reviews. Capture findings, assign actions, and keep audits on record.

by John Crockett, from the Community

10+

Get

Template

QLD QCSS Safety Assessment: Client Home and Transport

This QLD QCSS safety assessment template helps community care providers identify and manage hazards in client homes and during transport. It guides pre-visit screening, home and access checks, internal premises review, equipment and chemical safety, manual handling, mobility equipment verification, and transport safety considerations. It also supports emergency evacuation planning, risk assessment using a risk matrix, and implementing control measures to protect clients and staff. Use it to document hazards, assign actions, and keep records up to date for safer service delivery.

by Bruce Russell, from the Community

Get

Template

Home Healthcare Client Location Hazard Assessment

Use this hazard assessment checklist to evaluate risks in a client residence before or during home healthcare visits. It guides staff through general safety conditions, fire and life safety, slip, trip and fall hazards, sanitation, infection control and PPE, sharps handling, and patient handling ergonomics. It also covers pets, security concerns, firearms, hoarding, environmental factors, wandering behaviors, and transportation safety. Record findings, identify controls, and plan corrective actions to protect caregivers and clients.

by MYRA GRAYSON, from the Community

Get

Home Visiting Risk Assessment Form

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Home Visiting by Program Staff Checklist

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QLD QCSS Safety Assessment: Client Home and Transport

Home Healthcare Client Location Hazard Assessment

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Home Visiting by Program Staff Checklist

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