Grounds and Building Exterior Safety.

Parking areas are in good repair and free of hazardous cracks, tripping hazards and obstructions, ect.

Walkways are in good repair; and fall hazards are marked and protected.

Traffic and directional signs/markings are appropriate, adequate, unobstructed and in good repair.

Exterior lighting is present, illuminated, and adequate for the area.

A No Firearms Allowed poster is displayed and legible. (AC living areas)

Fenced recreation areas are enclosed and free of debris and sharp objects.

Outdoor furnishings are in good repair.

Front entrance is neat and free of trash.

Electrical Safety - Interior

Electrical cords are protected from damage and do not present a trip hazzard.

Extension cords are not used as permanent wiring.

Area is free of unauthorized plug adapters.

No power strips were found on the floor.

Outlets are free of cracks or loose face plates.

Areas free of other hazardous electrical conditions such as exposed wiring.

Electrical panel are free of obstruction.

Electrical panel doors are closed and locked.

Breakers/switches are properly labeled.

Generators are inspected regularly and are in good repair.

Bio-Med equipment has documentation of current inspection, testing/preventive maintenance.

Bio-Med equipment inventory is current within six months.

Individual owned electrical equipment is free from damage or frayed cords

Fire Safety.

All fire/smoke partition doors are properly marked and free of paint.

All fire/smoke partition doors operate properly.

No penetrations found in fire walls

Exit access doors are accessible at all times.

K-type fire extinguisher is located within 30 feet of any grease producing equipment.

Kitchen Hood Extinguishing system's annual inspection and semi-annual hood cleaning is up to date

Fire extinguishers are in designated cabinets/locations within 75 feet in any directions.

Fire extinguishers are stored with 3 feet of clearance in any directions.

Monthly inspections of portable fire extinguishers are documented on the inspection tag, are inspections are current.

Annual inspection of portable fire extinguishers is documented on the inspection tag, and inspection is current.

Gauge on all portable fire extinguishers indicates proper charge.

Portable fire extinguishers are in good condition (connections tight, no deterioration on hose, pin in place, seal intact, etc.).

Emergency lights are operational.

Exit access corridors are free of obstructions.

Flammable/combustible liquids are properly stored.

Exit doors open in the direction of exit egress.

Exit signs are appropriately placed, illuminated, and indicate the proper direction

Exit signs, sprinkler heads, and pull stations are free from obstructions (e.g. plants, decorations, etc.)

There is 18 inches of clearance between storage and sprinkler heads.

Fire alarm pull stations have 3 ft. of clearance in all directions.

Rooms and offices are free of excessive fire loading

Rooms and offices are free of loosely attached combustible materials that do not exceed 20% of each wall area or are located within four feet of room exit.

All buildings are free of portable heating devices.

Areas where oxygen is used/stored are clearly marked.

Compressed gas cylinders are properly secured with protective caps in place when not in use.

Full and empty oxygen cylinders in storage are segregated and labeled.

Where compressed gas storage exceeds 300 cu. ft., there is a designated, protected storage room.

Less than 12 E-tanks (300 cu. Ft., oxygen) are stored in the smoke compartment.

General Safety.

Stickers are present on telephones showing the telephone #'s of police, fire, ambulance, internal page, Ga. Poison Control, and Safety Data Sheets (SDS) information.

Bomb threat instructions are on or near telephones.

There are no conditions that would put the individual at risk for trips or falls.

Wet floor signs are used appropriately when the floor is wet.

The nurse call system is operational and there is an alternative signaling mechanism such as a bell in the event of failure

All treatment areas are free of suicide risks.

Employee lockers are free of hazardous materials and excessive quantities of combustible materials.

Storage rooms are clean and safe.

No objects are stored within 18 inches of the ceiling.

No holes or penetrations in ceilings, walls, or floors.

No doors are propped open.

Faucets and pipes are in good repair (e.g., no drips).

Washers/dryers are clean and in good repair.

Clean linen is kept covered and separate from soiled linen.

Hand washing signs are above sinks?

Eye wash stations/bottles up to date?

Hazardous Chemicals/Materials

An inventory of chemicals is available.

There is a separate storage area for chemicals.

Chemicals are stored properly on the shelves. Incompatible chemicals are not stored together.

All chemicals, including secondary containers, are properly labeled and labels are legible. Secondary containers are labeled in accordance with applicable regulations

The chemical storage area is free of debris and clutter, which would hamper cleaning of spills or quick exit in an emergency.

The "right to know" poster is posted on the official bulletin board.

Appropriate and adequate personal protective equipment (PPE) is accessible to all employees.

Bloodborne pathogen precaution procedures are in place.

Sharps containers are no more than 2/3 full or as indicated on the container.

All red bag biomedical wastes are properly handled and stored.


There is controlled access to security sensitive areas and confidential information such as medical records.

Medication carts are locked when unattended.

Medication rooms are locked when unattended.

Doors required to be locked can be locked or unlocked easily

Security fences are in good repair.

Employee ID Badges and Employee Knowledge

Staff wears a legible and visible ID badge on the chest of the outer garment.

Staff has keys for locked fire alarm pull station. Staff has keys for all locked exits.

Staff knows the procedures in the event of a tornado watch or warning.

Staff can describe the process for Code Red (RACE) and how to use a fire extinguisher (PASS).

Staff can describe their role in the Emergency Operations Plan.

Emergency Operations Plan is current.

Staff knows the location of their emergency manual "rainbow book"?

Staff can describe how to properly dispose of bio-medical waste.

Staff knows how to report abuse of individuals served in DBHDD hospitals. Staff knows how to report an accident/injury. Staff knows how to or to whom to report a safety hazard.

Environmental Evaluation – Cleanliness of Individual’s Room

Doors are in good repair.

Baseboards/corners are free of wax and/or soil buildup.

Floors are free of dirt/spills. Floors are free of urine/feces. Floors are free of rust, stains and scuff marks.

Walls are free of washable stains and spills.

Light fixtures are clean.

Ceiling lights are illuminated when light switch is turned on.

Vent grilles are clean.

Interior windows, window sills, and screens are clean.

Rooms are free of evidence of insects/rodents.

Ceiling is in good repair and free from evidence of dirt, mold, dust, and stains.

A non-skid material/mat is present in showers and bathtubs where appropriate.

A corner mirror or bubble window is present and in good repair in all seclusion/time out rooms.

Furnishings in all seclusion/time-out rooms are bolted to the floor.

Seclusion rooms are free of other visible hazards (sharp edges, suicide risks, etc.).

Maintenance and Cleanliness of Restroom and Shower

Restrooms and Showers are free of odors.

Walls are in good repair.

Entrance doors are in good repair. Room is numbered and appropriately used.

Restrooms and showers are accessible to individuals

Area is ventilated sufficiently.

Toilets are in good repair. Toilet partitions/doors/grab bars are in good repair.

Soap dispensers are in good repair. Mirrors are in good repair.

Hallways, Lobby Areas, and Day Areas

Floors are free of dirt and spells. Floors are free of urine/feces. Floors are free of rust, stains and scuff marks.

Vent grilles are clean. Light fixtures are clean.

Light fixtures are clean.

Drinking fountains are clean.

Antibacterial gel dispensers are in good repair.

Water fountains are in good repair.

Walls are in good repair.

Doors are in good repair.

Environmental Evaluation - Cleanliness of Food Service / Dining Room

PPE is available

Scoop for ice is stored covered or in scoop holder, no visible sign of rust in machine.

Ice machine cleaning is up to date

There is evidence of food rotation

Food is within the expiration/recommended use date.

Food was found dated and labeled.

Tables are clean

Garbage is kept to a minimum

Refrigerators are labeled to identify staff, individual, or medication use.

Temperature logs for refrigerators are readily available and current.

Refrigerator temp is documented to be below 40 degrees?

Refrigerator and microwave are clean

Counter tops are clean and free of clutter

Sink is kept clean

Floors are kept clean and free of debris

Kitchen areas/Dining room is free of any signs of pest or insects

Environmental Evaluation - Staff Areas

Counter tops, cabinets, book shelves and mail cubbies are neat and clean

Staff refrigerator and microwave are clean

Fingernails are short (1/4 in.); no artificial nails are present

Only hospital approved lotions, soaps, and sanitizers are in use


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.