Office of Developmental Disabilities
Stabilization and Crisis Unit
Stabilization and Crisis Unit
Client Room Inspection
Client Name:
Date of Inspection:
Staff completing room inspection: (2 staff are required)
1).
2).
Guidelines: Staff will inspect client room for items that are hazardous, can pose a health and safety
concern and items that may be stolen. Staff is required to conduct the search with another staff present. If
items are removed from the client room, items found should be placed in the managers’ office or
designated place, and labeled until management can inspect them. Items such as food / beverages
should be removed and discarded. Check with the Site Manager for guidelines regarding whether client
should be present or not.
Examples of hazardous items:
Glass – Mirrors, compacts, pictures and frames with glass, perfume bottles, fingernail polish, bottles, etc.
Aerosol and Sprays – Hairspray, deodorant, perfume, cologne, body sprays, air fresheners, etc.
Miscellaneous – Pens, lighters, matches, knives, pencils, paperclips, nail clippers, metal nail files, razors,
rat-tail combs, tools, thumb tacks, sharp or pointed objects and broken objects (CD’s, CD & cassette
cases, knick-knacks and hard plastic items), play jewelry/belts. No cowboy or work boots.
These items post safety hazards for both staff and clients and are not to be kept in the client’s room. They
are to be stored in locked cupboards and only used under strict staff supervision. If these or other items
are discovered in a client’s room and staff feel that clients or staff may be at potential risk of harm, remove
the item from the client’s room until the ISP team can meet and review. Be alert when families visit, they
frequently bring gifts that may include a hazardous item. If this occurs, ensure that the items is properly
stored in a locked cupboard and only used with strict staff supervision, and that the manager is made
aware.
Food & Drink – No food or drink is allowed in the client’s room at any time for any reason. This is a health
and safety hazard.
***Note – Staff may remove any item of concern due to being used as a weapon or for safety issues at
their discretion.
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DHS 4635 (09/14)
Stabilization and Crisis Unit
Office of Developmental Disabilities
Stabilization and Crisis Unit
Client Room Inspection
Some examples of places to search
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Pockets of clothes hanging, in drawers or on the floor
Items taped to the bottom & backs of drawers
Window sills / edging
Books / magazines – between the pages
Behind dressers, beds, nightstands
Cracks / crevices of upholstered furniture
In the hems of curtains, valances
CD cases
CD compartments of stereos, walkmans, etc
Under lids of containers, boxes, bottles of hygiene supplies
In mattresses, upholstered furniture (check for small holes, splits in seams)
Under & inside the underside of furniture (i.e. recliners, chairs)
The following items require an incident report (IR) to be completed (DHS 4595):
Lighters, matches, knives, silverware, metal nail files, tools
Or anything that is considered a weapon.
If you are unsure about an item, notify the manager.
List the items removed from the clients’ room due to health and safety reasons or theft.
Where items are stored:
Site Manager Signature:
Date of Review:
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DHS 4635 (09/14)
Stabilization and Crisis Unit
Office of Developmental Disabilities
Stabilization and Crisis Unit
Client Room Inspection
Documentation Sheet
Removal of Items from Bedroom (per BSP)
Client Name:
Date:
Time:
Signature of staff removing item:
List of items removed:
Reason items are being removed:
Where items are stored (locked location):
IR Completed (DHS 4595)?
Yes
No
Hourly assessment of client’s behavior to determine whether safe enough to return items. Initial that
assessment was completed. State below when items were returned.
0100
0700
1300
1900
0200
0800
1400
2000
0300
0900
1500
2100
0400
1000
1600
2200
0500
1100
1700
2300
0600
1200
1800
2400
Date:
Time:
Signature of staff returning items to client possession:
This form is to be kept in the front of the client program book for staff documentation. When items are
returned, please ensure form is turned into Behavior Specialist or Site Manager.
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DHS 4635 (09/14)