To be completed by Operation Dept. | ||||||
Pre Move-Out Inspection Checklist | Reviewer Initials: | |||||
Circle one: PH or CTH | Room Number: | Date: | If an item fails, note is required | |||
Shared Common Area Check: | Pass | Fail | Notes | |||
General Cleanliness of shared kitchen and restroom |
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Removed belonging from fridge section |
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Removed belonging from cupboards |
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Individual Room Check | Pass | Fail | Notes | |||
Ceiling: |
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Ceiling Tile/ Hard Lid - Intact |
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HVAC/ Fans - Intact and functioning |
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Light fixtures & Smoke Detector - Intact and functioning |
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Ceiling System - Clean |
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Walls: |
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Walls – Clean and Intact |
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All cover plates - Intact |
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Windows: |
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Window System - Intact and functioning |
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Window System - Clean |
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Blinds - Clean and Intact |
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Floors: |
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Surface - Intact |
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Clean, free of debris |
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Doors: |
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Intact, Clean |
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Doorknob and lock function properly |
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General Conditions: |
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All non-SMC belonging have been removed |
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Free of garbage and debris |
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No sign of pest infestation |
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No accumulated food or food storage |
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Interior Air Quality |
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Furniture in good condition: |
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Mattress |
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Bed Frame |
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Nightstand |
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Wardrobe |
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Dresser |
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Air Purifier (If applicable) |
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Other SMC provided furniture (Specify) |
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Additional Questions for Case Manager: | ||||||
Specify final move-out date and time: |
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Will the client require support moving into their new residence? | Yes | No |
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Specify the move-in support needed by the client to get into their new residence. (ex. Furniture assembly or moving boxes.) | ||||||
Additional Notes: | ||||||