Form Center

Malibu High School Facility Inspection Form

2. Instructions

   Inspect each area of either tennis court or basketball court carefully and fill out the entirety of this form.

4. Staff Member Information
6. First Name*
7. Last Name*
8. Date and Time*
   Date and Time

   Date and Time
10. Continue

Inspection Information

2. 1. Aquatics/Sports Office*

   1. Disinfect First Aid Kit
   2. Disinfect iPad

   1. Disinfect Credit Card Reader
   2. Disinfect Keys
4. Notes / Actions Taken
6. Are you working a gym shift?*

   1. Yes
   2. No
8. Upload Photos of Gymnasium, before setting up

   Standing by the entrance, please take a photo of the gymnasium.

   If not working in the gymnasium, please skip.

10. 2. Gymnasium*

    1. Garage Door in proper working order
    2. Garage Door Needs Maintenance
11. Are the exterior lights working properly?*

    1. Yes
    2. No
13. Are the interior lights working properly?*

    1. Yes
    2. No
15. Wet Moped if needed? *

    1. Yes
    2. No
    3. Not Needed
17. Floors Swept? *

    1. Yes
    2. No
19. Notes/Actions Taken
21. Garage Picture

    Please upload a picture of the Small Gym Garage.

23. Are you working a Tennis Shift? *

    1. Yes
    2. No
25. Upload Photos of Tennis Court, before setting up

    From the entrance, take a photo of the tennis court, including where the check-in table sits.

    If not working at the tennis courts, please skip.

27. 3. Tennis Court*

    1. Tennis Court in Working Condition
    2. Tennis Court Needs Maintenance
29. Notes/Actions Taken
30. Image
32. 4. Check-In Table*

    1. Disinfect Table and Set-Up

    1. Disinfect Chair and Set-Up
34. Notes/Actions Taken
36. 5. Condition of Restroom*

    1. N/A (not opened)
    2. Fully Stocked
    3. Restocked by Recreation Staff
    4. Closed for Maintenance
    5. Cleaned by Recreation Staff (Disinfect Handles & High Touch Surface Areas)
    6. SMMUSD Maintenance Needed
38. Notes / Actions Taken
39. Image
41. 6. Was the facility unlocked before the inspection was conducted?*

    1. Yes
    2. No
43. 7. Emergency Supplies*

    1. First Aid Kit Needs to be Restocked
    2. Ice Packs Need to be Restocked
    3. AED Battery Needs Replacement

    1. Fire Extinguisher Needs Maintenance
    2. All Equipment in Working Condition
45. Notes / Maintenance Concerns
47. 8. Were there any safety issues or vandalism observed during your inspection that needs immediate attention?*

    1. Yes
    2. No
49. If Yes, please document below and notify a supervisor immediately.
50. Image
Leave This Blank:


51. Submit | Go Back

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.