Photograph of Building
Additional photograph
Specific workplace hazards

Are any recognizable hazards present?

Choose one or more as needed
Routine Employee Health

How are immunization booster services handled?

How are flu shots administered?

How is TB Testing done???

Fire Prevention

Fire doors close and latch?

Smoke doors close?

Doors wedged?

Exit signs illuminated?

Fire alarms accessible?

Fire extinguishers accessible?

Flammables stored appropriately?

Medical gas stored appropriately?

Smoke detectors unobstructed?

Sprinklers unobstructed?

Appropriate use of decorations?

Security Management

Medications secured?

Syringes and needles secured?

Medical records secured?

Staff wearing IDs?

Belongings secured?

Log Sheet Documentation


Crash carts - daily?

Refrigerators - daily?

Fire Extinguishers - monthly?

Safety Management

Electrical cords and plugs in a safe condition?

Extension cords are not in use?

GFI outlet within 6' of water source?

Electrical panels accessible (3')?

Corridors unobstructed?

Emergency reference guides available?

Flashlights available?

Lifting equipment available?

Stairwells clear?

Step stools available?

Utilities Management

Building in good repair?

Ceiling tiles stained?

Clinical Equipment

Current PM sticker?

Alarms disabled?

Hazardous Materials

Appropriate use of utility rooms?

Sharps containers overfilled?

PPE available?

Products properly labeled and stored?

Infection Control

Respiratory Hygiene Protocol in place?

Hand-washing observed?

Linen covered?

Waste Management

Appropriate items in general trash?

Appropriate items in red bags?

Appropriate items in RCRA cans?

Appropriate items in sharps container?

Recommended Follow-up?

Follow-up for manager?

Follow-up for Facilities?

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.