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2023 Malibu Senior Center Facility Inspection Form

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1. Malibu Senior Center Facility Inspection This section is complete This section is incomplete
2. Inspection Information This section is complete This section is incomplete

Malibu Senior Center Facility Inspection

Instructions
Inspect each area of the park carefully and fill out the entirety of this form.
Staff Member Information
First Name
Last Name
Date and Time
Date and Time
Date and Time
Continue

Inspection Information

1. Malibu Senior Center
1. Chairs Stacked Against Wall (Max 6)
2. Tables Against Wall
3. Chairs in Use
4. Tables in Use
5. Exterior Doors Closed
Activity / Notes
2. Multi-Purpose Room
1. Chairs Stacked Against Wall (Max 6)
2. Tables Against Wall
3. Chairs in Use
4. Tables in Use
5. Exterior Doors Closed
6. Not in Use by Senior Programs
Activity / Notes
3. Kitchen
1. Senior Center Dishes Cleaned
2. Senior Center Dishes Put Away
3. Coffee Maker in Working Condition
Additional Supplies Needed / Notes
Activity / Notes
4. Computer Lab
1. Window Blinds Open
2. Open Door for Patrons
Notes / Action Taken
5. AV System
1. Projector Powers On
2. Screen in Working Condition
Notes / Action Taken
6. Senior Center Office
1. First Aid Kit Stocked
2. AED Inspected (Battery)
Notes / Actions Taken
7. Exterior Patio
1. Tables Cleaned for Senior Programs
2. Not in Use by Senior Programs
8. Were there any coffee or food spills during your inspection that need immediate attention?
1. Yes, due to Senior programs
2. Yes, due to non-Senior related programs
3. No coffee or food spills
If yes, please document the location below and notify a supervisor.
9. Were there any safety issues or vandalism observed during your inspection that needs immediate attention?
1. Yes
2. No
Please document below and notify a supervisor immediately.

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23825 Stuart Ranch Road
Malibu, California 90265-4861

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