Have you checked the temperature of your tap water at home with a thermometer in the past 2 months? | Check water temperature | ⩽120°F | >120°F |
Do you have smoke detectors on each floor of your house? | Is there a smoke alarm on each floor? | Yes | No |
In the past 6 months, have you replaced the batteries in the smoke detectors? | Do(es) smoke alarm(s) work? | Yes | No |
Does [child’s name] own a helmet? | Does child have a bike helmet? | Yes | No |
In the past 2 months have you checked to see if [child’s name]’s helmet fits snugly? | Check the helmet fit. Is it snug? | Yes | No |
What type of car seat did [child name] use on his last car trip? | Forward facing car seat | Yes | No |
Booster facing car seat | Yes | No |
Adult seat belt | Yes | No |