Playground Inspection Attestation Form



Early Childhood Education (ECE) Service PLAYGROUND INSPECTION ATTESTATION FORMIn exceptional circumstances, when an ECE service cannot provide the required evidence for compliance with the playground safety standard described in NZS5828:2015 this form is to be completed by the person responsible for inspecting the installation of the playground structures and equipment for that service.I, ______________________________________, attest that I (Printed name of person doing the inspection) completed an inspection of the playground structures and equipment at ____________________________________________________________________, (Name of ECE service) located at________________________________________________________ ,(Physical location of playground) on ___/___/______.(date)I confirm that the structures, equipment and surfacing are safe for use by children and to the best of my knowledge comply with the requirements set out in the NZS5828:2015 __________________________________/___/______ (signature) (date) ................
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