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Home safety checklist for 2026

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The document is a Home Safety Checklist for Teleworkers provided by the U.S. Department of State. It aims to assess the safety of an employee's alternate duty station by guiding them through a series of questions related to workplace environment and computer workstation ergonomics. Employees are required to complete the checklist, sign it with their supervisor, and return it to their bureau telework coordinator. The document also includes a Privacy Act Statement regarding the use of the information collected.

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Click ‘Get Form’ to open the home safety checklist in our editor.
Begin by entering your name, organization, and the address of your alternate duty station in the designated fields.
Provide your supervisor's name and the city/state where your alternate duty station is located.
Fill in the phone number for your alternate duty station and briefly describe your designated work area.
Proceed to section A, Workplace Environment. For each statement, select 'Yes' or 'No' based on your assessment of the environment.
Continue to section B, Computer Workstation. Again, answer each question with 'Yes' or 'No', ensuring that your workstation meets ergonomic standards.
Once completed, sign and date the checklist at the bottom. Ensure both you and your supervisor have signed it before submission.

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What is a home fall prevention checklist for older adults?

☐ Clear clutter from the floor, stairs, and walkways. ☐ Remove loose throw rugs and those that buckle or dont lie flat. ☐ Add nonslip mats or treads to each step (for hardwood or tile steps). ☐ Secure stair handrails and make sure they extend the entire length of your staircase.

How to prevent falls at home for the elderly?

To make your home safer: Remove boxes, newspapers, electrical cords and phone cords from walkways. Move coffee tables, magazine racks and plant stands from high-traffic areas. Secure loose rugs with double-faced tape, tacks or a slip-resistant backing or remove loose rugs from your home.

What is a home safety check?

A home safety assessment is an evaluation of your home to identify and eliminate potential hazards. It is typically performed by a licensed health-care professional, such as an occupational therapist or medical social worker.

What are the 5 Ps of falls prevention?

They are: Pain, Potty, Periphery, Position Pump. Pain. Is the patient experiencing any pain? Potty. Does the patient need to use the bathroom? Periphery. Do they have all of their personal belongings within reach? Position. Is the patient comfortable? Pump. Are all the patients pumps and items in their room plugged in?

What is a home safety assessment for the elderly?

The 240-point Comprehensive Home Safety Assessment is performed by a trained advisor and includes the exterior of the home, all entry areas, every room including bathrooms, bedrooms, laundry room, garage, basement, kitchen and dining room, lighting evaluation, fire safety and electrical safety.

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