This Register is maintained for each Resident from the date of admission to the date of discharge. It records every item of personal property declared on admission, every item brought onto the premises during the stay, every item placed into Facility safekeeping, every item issued or returned to the Resident, every item lost, damaged or removed, and the handover of personal property on discharge.
The Facility accepts no responsibility for cash, valuables, jewellery, watches, electronic devices, clothing, documents or personal items belonging to the Resident, whether such loss or damage arises from theft, negligence, accident or any other cause. The completion of this Register does not impose any liability on the Facility for property listed.
RESIDENT IDENTIFICATION
PART A — PROPERTY DECLARED ON ADMISSION
Every item of personal property brought onto the premises on admission must be declared and recorded below. The Resident is encouraged not to bring items of significant monetary or sentimental value onto the premises.
| Item | Description / Make / Model | Colour | Serial Number / IMEI / Identifying Mark | Condition on Receipt | Estimated Value (R) | Stored With Resident / In Facility Safe | Staff Initial | Resident Initial |
|---|---|---|---|---|---|---|---|---|
PART B — ITEMS PLACED IN FACILITY SAFEKEEPING
Where the Facility holds an item in safekeeping at the request of the Resident, the item must be sealed in a tamper-evident bag in the presence of the Resident, labelled with the Resident's name, the date and the staff member's initials, and stored in the Facility safe.
| Date Placed | Item Description | Serial / Identifying Mark | Sealed Bag Reference | Resident Sign | Staff 1 Sign | Staff 2 Sign |
|---|---|---|---|---|---|---|
PART C — ITEMS ISSUED FROM SAFEKEEPING
| Date Issued | Time | Item | Reason for Issue | Returned (Y/N) | Date Returned | Resident Sign | Staff Sign |
|---|---|---|---|---|---|---|---|
PART D — ITEMS BROUGHT ONTO THE PREMISES DURING THE STAY
Items brought onto the premises after admission, including items brought by visitors, items received by delivery, items returned with the Resident after leave, and items purchased while on outings, must be declared and recorded below. The Facility may decline entry of any item that, in its reasonable opinion, is unsuitable for the residence.
| Date Received | Item | Description / Identifying Mark | Source (Visitor / Delivery / Other) | Searched (Y/N) | Accepted (Y/N) | Staff Initial | Resident Initial |
|---|---|---|---|---|---|---|---|
PART E — CONFISCATED OR PROHIBITED ITEMS
Record any item confiscated under the House Rules or identified as prohibited. State the action taken (destruction, return to Responsible Person, handover to the South African Police Service) and the witnesses.
| Date | Item | Where Found | Reason for Confiscation | Action Taken | Authorised By | Staff 1 Sign | Staff 2 Sign |
|---|---|---|---|---|---|---|---|
PART F — LOST, DAMAGED OR MISSING ITEMS REPORTED
Record any property reported as lost, damaged or missing. Acknowledge that the Facility accepts no responsibility for personal property, save where the loss or damage arises from the gross negligence or wilful misconduct of the Facility.
| Date Reported | Item | Date Last Seen | Last Known Location | Circumstances Reported | Resident Sign | Staff Sign |
|---|---|---|---|---|---|---|
PART G — VEHICLE OR MOTORCYCLE ON THE PREMISES
Where the Resident has a vehicle or motorcycle on the premises, complete the record below. The Facility may search the vehicle at any time. The Resident accepts that the vehicle is parked on the premises at his own risk.
PART H — HANDOVER OF PROPERTY ON DISCHARGE
On discharge, the property listed in this Register is reconciled and handed over to the Resident or to the Responsible Person.
| Item | Returned to Resident (Y/N) | Returned to Responsible Person (Y/N) | Not Located (Y/N) | Comments |
|---|---|---|---|---|
RESIDENT ACKNOWLEDGEMENT
I, the Resident, acknowledge that:
- I bring personal property onto the premises at my own risk.
- The Facility accepts no responsibility for any loss of or damage to my personal property, whether arising from theft, negligence, accident or any other cause.
- I have been advised not to bring items of significant monetary or sentimental value onto the premises.
- I will declare every item of personal property brought onto the premises on admission and during my stay.
- I will report any loss, damage or theft to the staff on duty without delay.
- I am liable for any damage to the property of the Facility, the property of other residents, the property of staff, or the property of visitors, caused through negligence, recklessness or intentional misconduct.