Care visits
Home Safety Check (Care) template
Record visible trip hazards, access, heating and alarms during a home visit. The checklist supports a practical handover and does not assess medical needs or replace a specialist assessment.
Blank printable PDF: Classic style with the JobForms badge. No sign-up needed.
What's on this sheet
JobForms
Home Safety Check (Care)
Job ref: __________
Details
Date
Date
Person supported
Short answer
Address
Short answer
Checks
Floors clear of trip hazards
Pass / Fail / N/A · note on Fail
Lighting working in hall and stairs
Pass / Fail / N/A · note on Fail
Heating working
Pass / Fail / N/A · note on Fail
Smoke alarm tested
Pass / Fail / N/A · note on Fail
Key safe / access working
Pass / Fail / N/A · note on Fail
Fridge food in date
Pass / Fail / N/A · note on Fail
Notes
Actions and who was told
Notes
Sign off
Checked by name
Short answer
Checked by signature
Signature
Classic printable sheet · Powered by JobForms
Who uses it
Care visits teams and UK businesses keeping a clear visit or check record. Simple walk-round of trip hazards, heating, alarms and access at the person's home.
Explore this industry’s formsCommon questions
Is this care visits sheet a certificate?
Keep factual observations and follow your organisation’s care plan and reporting procedures. These forms do not give clinical advice.
Can I print it or fill it on my phone?
Download the blank Classic PDF without signing up, or fill a copy in guest mode on your phone. Photos and signatures are available when filling digitally.
What is included on the Free plan?
Free includes Classic PDFs with the JobForms badge, up to 3 custom templates, 20 jobs per calendar month and 1 shared form. Other PDF styles and custom PDF branding are paid features.