Uninstructed fire exits, fire extinguishers, or pull stations.
Storage no higher than 18" from a sprinkler head.
Unobstructed electrical panels.
Gray bins for paper located in a room not in corridor.
Hand rail is unobstructed.
No doors propped open.
No patient care items stored on floor.
Food cart in dirty utility room.
Bottom shelves on storage shelves have protective covering if open.
All decorations meet policy requirements.
Unobstructed fire/smoke doors.
No space heaters in patient care areas.
No fans in patient care areas.
Staff know the evacuation route and the meeting point outside of the building.
Fire doors closing and latching.
Electrical cords and computer cable not a tripping hazard.
Broken equipment properly labeled.
Patient care equipment-preventive maintenance (PM) label not expired.
Critical care equipment plugged into red outlets.
Code carts checked and results documented daily.
WOWs are dust free.
Patient care equipment charging when not being used.
Med and food refrigerator temps recorded daily; action documented on out of range temperatures.
Open food in patient refrigerator labeled and dated.
Refrigerator clean and defrosted.
Housekeeping cart not left unattended.
Sharps container less than 2/3 full.
Med Rooms locked; unused sharps secured.
Ceiling tiles in place and without stains.
Alcohol gel containers not mounted over electrical outlets; not mounted within 6" of container.
Hand hygiene being performed before and after contact with patient.
Patient personal items or gloves not located under paper towel dispenser or soap dispenser on sinks in patient rooms.
No outdated medications.
All Multi-use medications dated when opened.
No patient care items stored under sinks.
All lighting working properly.
All electrical outlets have covers.
Personnel Protective Equipment (PPE) available for all staff.
Proper isolation techniques being used by staff.
Proper isolation signage used on patient doors.
Ae additional glove boxes needed?
No open food or drink at nursing station.
All linen is covered.
Chemicals labeled properly.
Staff can find MSDS for hazardous materials in department.
Staff know the location of spill kits and how to clean up a hazardous spill (if applicable).
Is regular trash in biohazard bag?
Oxygen tanks secured in a holder.
Oxygen tanks transported in a holder not on a patient bed or stretcher.
No more than 6 oxygen tanks in storage area.
All chemicals and cleaners are labeled properly.
Patient information secured and disposed properly.
All staff wearing ID badges above waist.
Staff know where to find safety and security policies.
Staff know where to find the department specific emergency response plan and where to report in an emergency.
Pharmaceutical waste guidelines being followed appropriately for vials with significant medication remaining.
Empty medication vials in regular trash.
Other Concerns Noted:
Manager Signature: Date: