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Volunteer Home Assessment - Big Brothers Big Sisters of Peel York
  • About Us
    • Mission and Vision
    • OUR BOARD
    • Our Partners
    • Annual Report & Strategy
    • YOUTH ADVISORY COUNCIL
    • E-Newsletter
    • FAQ
    • Contact Us
    • Land Acknowledgement
    • CAREER OPPORTUNITIES
    • Student Placement Opportunities
  • What we do
    • Our Programs
    • Enrol a Young Person
    • Stories
      • Share your Story
  • Ways to Support
    • Agency Signature Fundraising Events
    • Other Agency Events
    • Corporate Team Building Opportunities
    • Host An Event
  • Resources
    • Activity Ideas
    • Big Ideas for Match Activities
    • Resources for Parents
    • Resources for Mentors
    • Resources for Mentees
Donate Volunteer

Volunteer Home Assessment

Volunteer Home Assessment: Self-Report Form

This form is intended to help ensure a safe and welcoming environment for youth participating in our Community-Based 1:1 Mentorship Programs. While it is not mandatory for matches to meet at the volunteer Mentor’s home, this information is required in the event that the Mentor, Mentee, and the Mentee’s caregiver mutually agree to hold match activities in the volunteer’s home or on their property. Please answer all questions honestly and thoroughly. A member of our team may follow up to confirm or clarify your responses.

Name(Required)
Address(Required)

General Home Safety

1. Do you have working smoke detectors installed on every floor of your home?(Required)
2. Do you have a working carbon monoxide detector?(Required)
3. Are there railings on all staircases inside and outside the home?(Required)
4. Are all entryways/exits easily accessible in case of emergency?(Required)
5. Is your home free of any heavy machinery or industrial tools?(Required)
6. Are there any hazards in the home (e.g., exposed wiring, broken steps, cluttered walkways)?(Required)

Presence of Potential Risks

7. Are there any pets in the home?(Required)
8. Is your property near a body of open water (e.g., pond, lake, river, creek)?(Required)
9. Do you have a swimming pool, hot tub, or similar water feature on the property?(Required)
Is it fenced and secured?(Required)
10. Are there any print or digital materials (i.e. posters, art, magazines, etc.) of a mature or inapproriate nature that would be visible to a child?(Required)
11. Are there any weapons or firearms in the home?(Required)
Are they stored unloaded and locked in a secure location?(Required)
12. If present in the home, are alcohol and prescription medications out of reach and out of sight of youth?(Required)
13. Are any illicit/illegal substances present or used in the home?(Required)
14. Is smoking or vaping permitted in the home?(Required)

People and Spaces

15. Please list all individuals currently living your home, including their name, age, and relation to you.(Required)
Name
Age
Relation to Volunteer
 
16. Please list the rooms or areas in the home where match activities may take place (e.g., living room, kitchen, backyard).

Final Considerations

17. Is there anything in the home that would need to change before a youth is welcomed in?(Required)
18. Do you have any other concerns or notes regarding your home environment?(Required)
Attestation(Required)
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To Reach Us
Head Office
71 West Drive, Unit 23 Brampton, ON L6T 5E2
Email: info.peelyork@bigbrothersbigsisters.ca Telephone: 905.457.7288 Contact us York Office: 350 Industrial Parkway S. Aurora ON Canada L4G 3V7 Email: info.peelyork@bigbrothersbigsisters.ca Telephone: 905.457.7288
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© 2025, Big Brothers Big Sisters of Peel York

Charitable Business Number: 118809482RR0001

Start Something™ Reg. CIPO Big Brothers Big Sisters of Canada.
Go Girls! Healthy Bodies, Healthy Minds™Reg. CIPO Big Brothers Big Sisters of Canada.
Game On! Eat Smart, Play Smart, Live Smart™Reg. CIPO Big Brothers Big Sisters of Canada.

 

We recognize the importance of language and its impact on inclusivity and representation.  We acknowledge that our organizational name reflects the gender binary and does not fully honor the experiences of trans, non-binary, and gender-diverse individuals. However, BBBSPY is deeply committed to creating an inclusive and affirming environment where all identities are reflected in the work we do. We proudly welcome 2SLGBTQIA+ Mentors, Mentees, and staff members, and we are dedicated to advancing the development of PRISM—a service created by and for the 2SLGBTQIA+ community.

 

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