Date: ___________________ Name: _____________________

Household Floor Safety Plan

Instructions:
1, Measure the dimensions of each room in the main living area of your house and clearly record
them in feet and inches.
2. On graph paper, use a pencil and ruler to accurately draw the dimensions of your home. (one
block = 1 foot)
3. Outside walls should be one block thick and include window and door spaces.
4. Balconies or decks should be included they simply jut out from living space.
5. Draw in the rooms within your home creating walls, doors and stairs as needed
6. Label and identify the dimensions properly for each room
7. Include all requirements listed in number #8 following identifying them using the proper
symbols and appropriate sizes for large furniture and permanent items.

** Alternatively if you prefer a technology option; you may use websites such as
http://www.homestyler.com/designer or http://planner.roomsketcher.com or
http://www.floorplanner.com (some of these may require that you sign-up; please use school
email and NO personal info)

Bedroom #1 Bathroom Bedroom #2

12 x 12 8 x 6 12 x 18

Kitchen Living Room

13 x 11.5 13 x 12
Entry
6 x 6.5
8. A smoke detector SD Carbon Monoxide Detector CO

Fire Extinguisher FE Stove Fridge

Sinks Toilet Shower

Bath Tub Electrical Outlet Ceiling Light

ANY large furniture placements couch, kitchen table, etc.

Fire Escape Route for all main living areas:

i) Red Arrow for BEST choice
ii) Dotted Red Arrow for secondary exit

9. Determine five (5) categories of safety concerns within your floor plan. Using a colour
coded system, shade the locations of these safety concerns on your floor plan.
ie. Fall Prone areas blue
Hazardous materials area green

10. Include a legend on the bottom right corner of your floor plan to indicate safety
concerns.

11. Separately identify any person or pets that may need assistance and the gathering local.

12. When everyone is finished you will act as a Safety Inspector for another
persons floor plan. Attach this sheet to your floor plan when submitting.

Assessment Checklist for Safety Floor Plan

Criteria Level 1 Level 2 Level 3 Level 4

Floor Plan
Floor plan is titled; neatly drawn (pencil/ruler/erasures);
measurements are accurate & properly placed; rooms
labelled properly, proper symbols used 10

All required elements have been included; fire escape

route & secondary; gathering local and help needed; home
safety items, permanent & large fixtures 10

A variety of household safety concerns have been

realistically considered (5) legend included 5

Inspection:
Inspection was fully completed; identified additional
concerns chart, identified sufficient ways home is safe,
provided relative feedback 5