Information

  • Audit Title

  • Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

EOC Rounds

  • Equipment in Corridors is in use and not stationary > 30 minutes?

  • Corridors and open alcoves are free from trash and linen carts?

  • Fire exit, cross-corridor and stairwell doors are equipped with panic hardware and self-closing devices (Close completely and automatically)?

  • Corridors, fire exits and stairwell are clear and unobstructed?

  • Exit signs are illuminated and at least two are always visible (all lights burning)?

  • Doors are held open only with magnetic hold open devices (no wedges, paper card boards, etc)?

  • "Stairs" signs are displayed at stairs entrances and elevators lobbies?

  • Corridor, cross-corridor and stairwell doors close and positive latching?

  • Electrical panels are locked and properly labeled?

  • No penetrations or separations in walls?

  • All light fixtures are protected, not damaged or burnt out?

  • There is no excessive trash or linen in the room?

  • All hazardous and proprietary doors are locked?

  • Biohazard signs on doors?

  • Biohazard bag usage acceptable?

  • Fire extinguishers have been checked monthly and have a current annual inspection tag?

  • 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?

  • No materials are blocking/hindering access to or hanging off the fire extinguisher, fire pull, or emergency shut off (3 foot rule)?

  • There are no materials stored within 18 inches of any sprinkler head or 12 inches of lights if non-sprinkled?

  • Storage area clean, free of dust and clutter?

  • Shelves and stored items off floor?

  • Extension cords are not in use?

  • Power strips are not plugged into power strips?

  • Electrical cords do not run under carpets, through walls or doors, or into cabinets?

  • All junction boxes, electrical switches and plugs must have covers (not broken)?

  • Appropriate bags are in use [red-biohazard, blue-recycle, yellow-chemotherapy]?

  • Sharps containers less than ¾ full?

  • Sharps container in appropriate rack or dog bowl on counter?

  • Appropriate disposal of fluid waste. [Solidifier or Hopper with protective glasses within reach]?

  • Eye wash stations operational and checked appropriately?

  • All portable gas cylinders in racks/stands and separated full/empty?

  • All rooms in the facility are numbered and labeled?

  • Area free of fall potentials?

  • All employees are wearing ID badges?

  • Ceiling tiles clean and undamaged?

  • Furnishings/pads, matresses safe and in good repair with no cuts?

  • Patient.OR/Treatment rooms free of dust/dirt/biohazard?

  • Do all clinical equipment items have current inspection tag?

  • Alternative waterless agent available and hung appropriately?

  • No items underneath sink and area dry/clean?

  • No cleaning agent accessible left unattended?

  • Work surfaces clean, free of dust, clutter and hazards?

  • Floors clean and free of clutter?

  • No environmental or personal heating devices?

  • Patient equipment found with no visible signs of soil of contamination?

  • Baseboards intact and in good repair?

  • Emergency pull cords hanging 6" from floor; no wrapping of cord around hand rail?

  • Floor tiles/vinyl in OR/flooring without evidence of cracks or seperation?

  • Type any special instruction, work requests, & calculated score:

  • Inspectors Signature

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.