Information
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Audit Title
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Document No.
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
ENVIRONMENT OF CARE
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Area is clean and sanitary <br> No bugs in lights<br> Surfaces free of dust<br> No clutter
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No items stored under sinks?
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Equipment / Furniture:<br> * No broken equipment or furniture stored on the patient care units.<br> * Coverings are intact - no rips or repairs needed.
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Hazardous rooms are locked: EVS closets, supply closets, mechanical rooms and electrical panels.
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Hazardous chemicals and flammable agents are labeled and stored properly.
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Eyewash stations: Inspection tags are present and up to date.
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Refrigerators: Contain only those items designed for that refrigerator (specimen, medications or patient food)
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Refrigerators: If manually monitored, logs are complete. Both manual and temp track-documentation is present for actions taken to correct out of range temps.
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Plugs and elective receptacles are in good condition
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Electrical cords in good condition
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No evidence of daisy chain
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No outer shipping carton boxes in patient care areas.
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No expired items.
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Preventative Maintenance:<br> * Equipment checked with up to date bio-med sticker.
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No evidence of trip hazards
LIFE SAFETY
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Sprinkler heads are free of dust
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Sprinkler heads have escutcheons or guards as needed
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Smoke detectors are 36 inches from intake or exhaust
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No fire wall penetrations
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Alcohol foam is at least 6 inches from ignition source and at least 4 feet apart
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Appropriate storage of boxes and pt care items:<br> * Not directly on floor.<br> * 18" clearance from ceiling<br> * Boxes stored on shelves close to floor must have solid bottom and high enough to not incur water damage from mopping.<br> * Volume of combustible material is not stored in large quantity as to create a fire hazard.
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Oxygen or other combustible compressed gas cylinders are stored properly:<br> * Secured in floor stand, carrier or secured to the wall by a mount. (not laying on the floor or against wall)<br> * Limited to 12 E-cylinders per smoke compartment.<br> * Greater than 12 stored in a secured room.
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Fire exits and hallways are cleared:<br> * Egress corridors must have 4 ft clearance.<br> * Equipment in corridors must be actively accessed to be in use.
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Fire alarm pull stations, fire extinguishers, medical gas shutoff valves are not blocked.
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Fire extinguishers have been inspected monthly.
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Fire doors are not blocked or propped
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Fire doors close properly
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Exit signs are illuminated.
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Evacuation route posted & current.
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Ceiling tiles are in place, no cracks, holes, misaligned or visible stains.
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Floors, ceilings, walls, and other surfaces intact and free from holes.
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There is 36 inch clearance around electrical panels
