Since our children sometimes play with yours, and in order to really help keep kids safe, we would appreciate it if you would take a few moments to answer the following questions. For your convenience, you can write the answers in the spaces below each question and return the questionnaire to our mailbox. Thanks so much for your commitment to keeping children safe.
1) Is there a gun in your home?
2) If so, is it kept unloaded and locked up separately from its ammunition, where kids absolutely can't get to it, and nobody else can quickly access it either?
3) Do you have any pepper spray in your home? Did you know that pepper spray can be dangerous for children, being potentially carcinogenic?
4) Are there any other potentially cancer-chemicals in your home? How are they stored?
5) Do you keep any dangerous household cleansers or bleaches where children might access them, or are they safely locked away?
6) Do you have any water-filled containers in your yard that a kid might drown in? Did you know more small children are killed by water-filled buckets each year than are killed by gun accidents?
7) Do you keep gasoline in your garage? If so, is it stored in a plastic can or a metal one? Is the garage kept locked up, or is the can kept in a locked container where kids couldn't get it and play with it?
8) Do you have any chain saws, power saws, or other dangerous tools lying about? Are they locked up?
9) Do you have prescription medications in your house? If so, are they stored in a locked cabinet? What about acetaminophen? Did you know that acetaminophen is an extremely deadly medication?
10) Does your home have a swimming pool?
11) If so, will there be a lifeguard on duty at all times?
12) Are your sharp kitchen knives kept locked up, safely away from the hands of little ones?
13) Do you keep a fire extinguisher in your home?
14) If you are taking our children out in a vehicle, will they be in a proper car seat? Will you obey all speed limits and stop signs?
15) Does anybody in your home smoke? If so, is there an adequate ventilation system set up to protect our children from the dangers of second hand smoke?
16) Is your home free of lead paint and radon?
17) Do you have any spikes sticking up in your yard, or boards with rusty nails in them?
18) Are stairs in your home equipped with proper safety rails in good condition? Do any decks in your home have rails which would prevent children from falling off?
19) Do all vehicles at your home have easy-to-find internal releases on the trunks? Were you aware that 5 little girls were killed in a single accident when they became locked in a car trunk on a warm day?
20) Do you watch television programs or movies that might be psychologically damaging to our children if they were to view them? If so, are these videos kept locked up and are there parental controls on the TV? Do children have free access to R-rated videos?
21) Does anybody in your home have a history of pedophilia or other deviant sexual behavior? Have you, your spouse or any of your children ever had any sexual thoughts or fantasies involving children?
22) Does anybody in your home have a history of mental illness? If so, have they ever had inpatient care or been considered to possibly be a danger to other people?
23) Has anybody in your home ever been convicted of, or charged with, a violent crime? If so, please provide details.
24) Regardless of the above, does anybody in your home have dangerous, violent, or anti-government tendencies?
25) Have there ever been any domestic disturbances in your home? Have the police ever been called to your house for a domestic dispute?
26) Do you have any heavy bookshelves that are not secured to the wall?
27) Does anybody in your house have any contagious diseases? Has anybody in your house been exposed to HIV or AIDS?
28) Do you, your spouse, or any teenager keep any pornography in your home? If so, is it soft-core or hard-core? And do you keep it locked up, rather than just hidden away?
29) Do you, or any member of your house, ever use illicit drugs, or abuse prescription medications? Have you ever done so in the presence of a child?
30) And one final question: Is anybody in your home intimately involved (that is, sexually) with someone outside the home? If so, is this person only allowed in at hours when my children won't be there? Are children in your home exposed to explicit sexual behavior?
Thanks, neighbor, for answering these questions. I'm sure you appreciate our commitment to keep our kids safe. It's better to be safe than sorry!
(sign your name here)