HEALTH, FIRE AND SAFETY INSPECTION REPORT
Office of Residential Life ~ Assumption College
You are required to correct the following unsafe
conditions that were present during an inspection of your room/apartment
immediately. In addition to the
described fines, failure to comply may result in College judicial action.
YOUR ROOM/APARTMENT WILL BE FINED $25.00 PER PERSON
Common Bedroom
Area (specific)
____ ____ Blocked
Room Access: please remove ______________________ from blocking the exit
____ ____ Wardrobes: Please make sure all wardrobes remain upright at all
times and the back of them remains against a wall at all times. (Not to block egress and/or vision)
____ ____ Candles/Incense/Potpourri Burners: have been confiscated and will not be returned.
____ ____ Ceiling:
tapestries, posters, etc. can be hung on the walls only.
____ ____ Cleanliness: the room/apartment is a health concern and must be
cleaned immediately.
____ ____ Electrical
Concerns: overloaded outlets, extension cords. Please use a surge
protected power strip. Only 1 extension
cord, plugged into that power strip will be acceptable.
____ ____ Garbage Outside Room/Apt: must be removed immediately and placed in a dumpster.
____ ____ Halogen Lamps: have been confiscated and will not be returned.
____ ____ Hazardous
Appliances: hotplate, toaster/toaster
oven, electric heater, George Foreman grill, etc.
____ ____ Lounge Furniture: must be placed back in the lounge immediately.
____ ____ Pets: only fish are allowed.
____ ____ Stacked Furniture (desks): only beds, which are designed for stacking,
may be stacked.
____ ____ Cinder Blocks: can not be
used to stack beds.
____ ____ Storage: improper storage of food, bottles/cans, etc.
____ ____ Smoke: evidence of smoking in the room, ie: ashes, cigarette
butts, actual smell of smoke.
____ ____ Smoke Detector/Fire Alarm: evidence of tampering with and/or disarming.
____ ____ Security Screen Tabs: evidence of tampering with and /or removing.
____ ____ Other:
Students are required to correct items noted on this
form or take home items for which you have been fined. This is NOT a bill. You will be receiving a formal bill in your
mailbox within 5 days. Should you
not receive a bill, please contact our office x-7505. Further, items for which you have been warned about may be subject
to further disciplinary action. For
your information: Health, Fire, and Safety guidelines are outlined in your
Campus Calendar/Student Handbook, and Housing Contract.
Signed:
__________________________________________________ Date:
______________
White
Copy: Residents Yellow
Copy: RD Pink Copy: Public Safety