Safety Management

- Compressed gas cylinders properly secured, categorized full vs empty, and do not exceed q’ty limits

- Flammable liquids properly stored

Flooring/Ceiling Surfaces are intact, undamaged, and free of stains

- Chemicals labeled and properly stored

- Walking surfaces in good repair

- Tripping hazards are not present

- Adequate precautions taken during remodeling or construction

- Radiation, laser, biological hazards clearly identified

Pt care and medication refrigerators are labeled, clean, and logs current

Pt foods are dated and within expiration ranges

Cabinets under sinks are clean and not used for storage

Proper hand hygiene is followed

Fire Safety Management

- Fire doors, pull stations, and egress routes are clear

Trash/Linen Chutes are secured and properly close & latch

- Storage at least 18” below sprinkler heads

Stored supplies are elevated off the floor with solid shelving

- Fire extinguishers inspected monthly

Fire Extinguishers are mounted properly and at within appropriate heights

Sprinkler heads are clean and unobstructed

Fire doors latch and close properly w/ < 1/8” gap

- Patient rooms doors close and latch properly

- Satisfactory housekeeping/sanitation

- Exhaust ventilation system functioning

- Stairway, ramps, handrails in good condition, free of obstacles and storage

- No flammable decorations

- No doors propped open

- Electrical panels are closed, latched, and unobstructed

Hand foam canisters are within expiration date


- Personal belongings secure

- Medication room secure

- Co-workers wearing identification badges

Staff can explain security process for forensic patients

Access control properly functions

Staff can explain their role in an infant abduction

Hazmat & Waste

Staff can demonstrate SDS

Hazardous waste is properly stored

Janitors closets are secured

Eyewash station is current on logs

There is appropriate PPE in area

Infection Control

- Soiled linen covered and not overflowing

Medical equipment is clean (sticker free) and in good repair

- Sharps containers not overfilled

Clean utility is segregated from dirty

Proper Air pressure is maintained

Utilities Management

- Lights in good working order

- Extension cords not in use for permanent power

- Multistrip outlets are hospital-grade

- Air supply and returns clean

- Medical gas zone valves in good condition, properly labeled, clean, and unobstructed

- Emergency lighting for exit signs operable and arrows pointed correctly

- Air pressure relationships are correct (clean rooms are positively pressured, dirty rooms are negative)

HIPPA Concerns

- Inappropriate staff discussion of PHI overheard in area

- Documents containing PHI concealed from public access and view

- Pt info boards include minimum pt information

Water Management Optional

Water Sample Location 1


Water Sample Location 2


Water Sample Location 3


Water Sample Location 4


Water Sample Location 5


Other Deficiencies Noted

Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.