Home Safety Risk Assessment for Vulnerable Adults

Client Information

Name Date of Assessment Assessor Address

Living Situation

Who lives in the home? Support Services (if any)

General Safety

Are all internal walkways clear and free of hazards? Yes No Are floor coverings firm and secure? Yes No

Bathroom Safety

Are there grab rails near the toilet, bath or shower? Yes No Non-slip mats present? Yes No

Kitchen Safety

Are frequently used items within easy reach? Yes No Are electrical appliances in good condition? Yes No

Fire Safety

Are smoke detectors installed and working? Yes No Is there a clear evacuation plan? Yes No

Medication Safety

Are medications clearly labelled and stored safely? Yes No Any medication management concerns?

Mobility and Accessibility

Is the home accessible for aids (wheelchair, walker, etc)? Yes No Are there any steps or stairs that could pose a risk?

Additional Notes/Comments