IHC Home Safety Update

Educator First Name*
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Educator Last Name*
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Educator Email*
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Client First Name*
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Client Last Name*
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In conjunction with your client, please discuss and fill out the following regarding safety in the client's home

Is the first aid kit stored in a locked cupboard or out of reach of children?*
Please answer the question.
Is all medication stored in a locked cupboard or out of reach of children?*
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Are all medication stored in their original containers or labelled clearly?*
Please answer the question.
For more info about medicine safety, click here.
Is all poison stored in a locked cupboard or out of reach of children?*
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Are all poisons stored in their original containers or labelled clearly?*
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Is all alcohol stored in a locked cupboard or out of reach of children?*
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Are all cleaning products stored in a locked cupboard or out of reach of children?*
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Are all cleaning products stored in their original containers or labelled clearly?*
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Are all matches, oil burners, incense and lighters out of reach of children?*
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Are all knives, razors, scissors and other sharp cut objects out of reach of children?*
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Are all kitchen appliances (toaster, kettle etc.) out of reach of young children?*
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Are all plastic bags or similar out of reach of young children?*
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Are all toiletries, perfumes, jewellery or similar out of reach of young children?*
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Are all curtain and blind cords out of reach of young children?*
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Are all garden/pool/tool sheds securely locked and inaccessible by children?*
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Are all pool gates child-locked?*
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For more info about pool safety, click here.
I have checked all of the above and discussed the importance of the above with my client*
Please confirm.
Are there any improvements that were made to the safety of the client’s home during this process?*
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Are there any improvements that need to be made to the safety of the client’s home?*
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If yes, detail an action plan for these improvements (when will they be made, and by who etc.)
Field is required!
I confirm that all information provided is true, accurate and current.*
Please confirm.