Information
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Audit Title
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Document No.
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Location
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Conducted on
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Prepared by
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Location
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Personnel
EOC Rounds
Fire
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Fire extinguishers have been checked monthly and have a current annual inspection tag?
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Extinguishers less than 40 lbs must be no higher than 5 ft (measured from the floor to the top of the extinguisher), extinguishers greater than 40 lbs must be no higher than 3.5 ft (measured from the floor to the top of the extinguisher). Note: the clearance between the bottom of the extinguisher and the floor shall not be less than 4 inches?
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Corridors and open alcoves are free from trash and linen carts?
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Fire exit, cross-corridor and stairwell doors are equipped with panic hardware and self-closing devices (Close completely and automatically)?
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Corridors, fire exits and stairwell are clear and unobstructed?
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Corridor, cross-corridor and stairwell doors close and positive latching?
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Doors are held open only with magnetic hold open devices (no wedges, paper card boards, etc)?
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Exit signs are illuminated and at least two are always visible (all lights burning)?
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There are no materials stored within 18 inches of any sprinkler head or 12 inches of lights if non-sprinkled?
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"Stairs" signs are displayed at stairs entrances and elevators lobbies?
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No penetrations or separations in walls?
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There is no excessive trash or linen in the room?
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No materials are blocking/hindering access to or hanging off the fire extinguisher, fire pull, or emergency shut off (3 foot rule)?
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No environmental or personal heating devices?
Hazardous Materials
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All hazardous and proprietary doors are locked?
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Biohazard signs on doors?
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Appropriate bags are in use [red-biohazard, blue-recycle, yellow-chemotherapy]?
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Sharps containers less than ¾ full?
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Sharps container in appropriate rack or dog bowl on counter?
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Appropriate disposal of fluid waste. [Solidifier or Hopper with protective glasses within reach]?
Electrical
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Electrical cords do not run under carpets, through walls or doors, or into cabinets?
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Electrical panels are locked and properly labeled?
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Extension cords are not in use?
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Power strips are not plugged into power strips?
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All light fixtures are protected, not damaged or burnt out?
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All junction boxes, electrical switches and plugs must have covers (not broken)?
General Safety
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Storage area clean, free of dust and clutter?
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Shelves and stored items off floor?
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Eye wash stations operational and checked appropriately?
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All portable gas cylinders in racks/stands and separated full/empty?
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All rooms in the facility are numbered and labeled?
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Area free of fall potentials?
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Do all employees have ID badges?
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Ceiling tiles clean and undamaged?
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Furnishings/pads, mattresses safe and in good repair with no cuts?
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Patient Treatment rooms free of dust/dirt/biohazard?
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Do all clinical equipment items have current inspection tag?
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Alternative waterless agent available and hung appropriately?
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No items underneath sink and area dry/clean?
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No cleaning agent accessible left unattended?
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Work surfaces clean, free of dust, clutter and hazards?
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Floors clean and free of clutter?
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Patient equipment found with no visible signs of soil or contamination?
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Baseboards intact and in good repair?
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Emergency pull cords hanging 6" from floor; no wrapping of cord around hand rail?
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Flooring without evidence of cracks or seperation?
Non-Listed Findings:
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Inspectors Signature
