1.0 Previous Inspection

Has the last Inspection been reviewed?

No outstanding work orders?

2.0 fire Prevention

Alcohol Based Hand Rub (ABHR) containers in proper location? One inch to the right, left and below ignition source. NFPA 101:

Fire extinguisher signs six feet off floor?

Is fire extinguisher four inches off floor and 60 inches to top of extinguisher? NFPA (2010)

Are "K" extinguishers properly labeled? NFPA (2010) 5.5.5

A restraining device is correctly installed on caster equipped natural gas appliances? NFPA 54 (2012) Z223.1

Exit doors open easily?


3.0 General Lighting

Lights working and in good condition?

Light lens cover in place and not damaged?

Egress lights working?

Exit lights working?


4.0 Building Maintenance

Base cove not loose,damaged or missing?

Hand rails not damaged or missing parts?

No visible wall damage?

Doors not damaged or missing parts?

Door locks and handles working correctly?

Doors not held open by devices other than those that release when the door is pushed or pulled? NFPA 101 (2012)

Signage not damaged or missing?

Room description and ID number present? (AutoCad Department)

No water leaks?

Faucets shut-off completely, no drips?

Toilet does not leak and is properly sealed?

Plastic laminate in good condition?

Counter tops properly caulked?

Ceiling grid in good condition and intact?

Ceiling tile in good condition, not stained and not missing?

Wall paper not torn or with loose seams?

Cabinet hinges and pulls in working condition?

Room conditions comfortable?

Eye wash in correct position? 33-45 inches off floor and 6 inches from nearest obstruction. ANSI Z358.1

Sharps box at correct height? 50-56 inches off floor to opening.

Exhaust grills secure and clean?

Thermostat/ sensor in good condition?

Supply and return grills in place?

Refrigerator / freezer seals and doors in good condition?

Is room air flow correct?

Room air flow correct.

Are exterior door air curtains working and clean?

Are ice machines clean and serviced on time?

Nurse call cord 4 inches off floor but not more than 6 inches off floor? Is call cord cleanable?


5.0 General Housekeeping

Mechanical, electrical and communication rooms clean?

Oily rags and combustibles in covered or closed metal containers?


6.0 Mechanical Rooms

Are machine guards in place?

Drip pans in place and no spills?

Is lighting adequate?

Noise levels controlled?

Air ducts in good repair?

Are compressed gas bottles secured?


7.0 Electrical Safety

No open "J" boxes?

Breaker box legends complete?

Flexible cords not run through ceiling tiles or doorways? NFPA 70 (2011) 400.8

Portable equipment tested and tagged?

No broken plugs, sockets or switches?

GFIC and tamper resistant receptacles installed?

No extension cords in use?

No exposed wiring?

Line Isolation Monitor (LIM) cabinets unlocked?

Electrical panels locked in public areas? NFPA 99(2012)

Power strips not used in patient care area. Special Purpose Relocatable Power Taps (UL 1363A or UL 60601-1) or Relocatable Power Taps (UL 1363) in use.

36 inch clearance around electrical equipment and controls? NFPA 70 (2011) 110.26


8.0 Ladders

Are ladders industrial strength? Non-household rated, check label.

Are ladders in good condition?

Are ladders properly secured?

9.0 Medical Gas

Medical gas alarms and zone valves labeled?

Do gauges have indicators with the normal pressure in the middle third of the range? NFPA 99 (2012)

Are gauges working?

Oxygen storage room with over 300 cubic feet has appropriate sign "Caution: Oxidizing Gas(es) Stored Within. No Smoking". NFPA 99 (2012)

Oxygen storage room with over 300 cubic feet has electrical fixtures five feet off the floor, a lockable door, one hour rated room, and cylinders secured from falling. NFPA 99 (2012)


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.