Facility Check Report
Facility checks are completed in the Residence Halls to ensure that everything is in good working order. Any items that are not working perfectly should be work ordered using templates found on our resource webpage. Please complete a Facility Check Form for each of your assigned rooms. Ask residents about all items on the check list. Also ask if the resident knows of anything else in the room that needs to be work ordered.
RA Name
*
First Name
Last Name
Residence Hall
*
Anderson
Jorgenson
Rimview
Widenhouse
Room Number
*
Rimview Bedroom Letter
*
A
B
C
D
Main Area
Not a Rimview Room
Check List (ALL ITEMS ON THIS LIST MUST VISUALLY &/OR PHYSICALL INSPECTED AND CONFIRMED FUNCTIONAL)
*
Smoke Detectors (visual inspection)
Sprinklers (visual inspection)
Window and Locks (visual inspection and physically tested)
Door Security (visual inspection and physically tested)
Drains (visual inspection and physically tested)
Appliances (visual inspection and physically tested)
Heater (visual inspection and physically tested)
Other
If Other Please Explain
Work Orders Entered (include photos)
*
Yes
No
Jorgenson Rented Furniture
*
NOT A JORGENSON ROOM
1 dresser
2 dressers
1 bed (frame and mattress)
2 beds (frames and mattresses)
1 desk
2 desks
1 desk chair
2 desk chairs
1 living room chair (with cushions)
2 living room chairs (with cushions)
1 living room love seat (with cushions)
2 living room love seats (with cushions)
1 living room couch (with cushions)
No RMC issued furniture
Staff Notes
*
Comments from Students
*
File Upload
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Submit
Should be Empty: