Audit

Fire Safety - (FS 1-10) physical inspection/utilities

FS 1. Are exit doors and stairwells clear?
Main, corridor, and stairwell exits cannot be blocked by any means.

FS 2. Are exit doors clearly marked "exit" and illuminated?
Check for burnt out bulbs.

FS 3. Do fire doors latch properly?
Close the fire doors to see if they latch properly and see that there is no gap<1/8 inch in the middle.

FS 6. Are doors closed with no props / held open?
Doorstops or homemade held open devices are not allowed.

FS 9. Do fire extinguishers have monthly and yearly checks?

FS 5. Are pull stations or fire extinguishers unobstructed?
There must be nothing to obstruct access.

FS 4. Are corridors and passageways free of obstructions?
The corridors can have mobile items (wheels on them) that are emergency needed items and are in use.

SS 5. Are ceiling tiles in place, clean, stain free, and in good condition?
Indicate where these bad tiles are located in the comments.

FS 7. Are materials stored a minimum of 18 inches from sprinkler deflectors?
The distance between sprinkler deflector and stored items is 18 inches for sprinkled buildings.

FS 10. Sprinkler heads clean and free from debris?

SS 11. Are all mechanical, electrical, janitorial, and communications rooms locked?

UT 11. Are all mechanical, electrical, janitorial, communications rooms clean with no storage?

UT 7. Circuit breaker boxes are unobstructed and properly labeled?

FS 8. Are stored rooms and equipment rooms free from clutter and unsafe conditions?
Make sure that items are not falling down or overstocked.

ME 4. The equipment storage room doors will self close and latch?

IC 9. Clean supplies are stored appropriately in clean area?

IC 11. Supplies are not found under sinks?

UT 3. Plumbing lines under sinks adequately sealed (no evidence of leakage)?

IC 12. Sinks are functioning properly?

IC 22. Supplies stocked have not reached their expiration date?

SS 6. Are heavy items stored at low levels or mid levels in storage?
Make sure heavy items are stored at waist level or lower shelves.

Are boxes and patient care items off floor?

SS 2. Are floors and hallways in good condition?

UT 4. All penetrations in the walls and ceilings have been appropriately filled?

UT 6. All electrical outlets have cover plates?

UT 5. Drawer / cabinet handles function properly ( no loose handles )?

UT 9. Door hinges are working properly ( no loose hinges )?

SS 12. Are punch code doors working properly?

SS 4. Wires are in good physical condition (no cracks, tears, or exposed wires)?

UT 8. There are no extension cords being used?

UT 10. Are telephone cords out of the way?

UT 1. All lighting is operational?

SS 18. Are general areas clean and free of clutter?

SS 3. Walls are free from damage (chips, scuffs, or gouges) and clean?

IC 32. High dust areas, computer carts are dust free, top of monitors are dust free?

Is furniture clean and free of tears, broken parts etc.?

SS 19. Are compressed gases stored properly?

Employee checks - (SS 1-20)

IC 8. Lounge area is maintained in a clean sanitary condition?

IC 8a. Is microwave clean?

IC 8b. Is refrigerator clean?

SS 9. Are staffs personal items properly secured?

SS 10. Are all employees wearing their I.D badges properly?

HM 8. Does staff know how to get to MSDS?

IC 15. PPE-gloves, face masks, protective eyewear, and gowns are worn as required when exposed to blood or other potentially infectious materials is reasonably anticipated?

IC 16. PPE are removed at the end of the task/procedure?

IC 29. Hand hygiene is performed according to policy?

Only hospital lotion being used?

IC 17. Sharps and instruments are placed in approved containers as soon as possible?

IC 30. Behavior - eating, drinking, applying cosmetics in work areas where there is reasonable likelihood of exposure to blood/body fluid?

Hazardous Materials & Waste - (HM 1-7)

HM 1. Is medical waste kept in red biohazard bags or containers?

HM 5. Regular and infectious waste trash are separated?

IC 1. Linen containers for contaminated linens are readily accessible?

IC 14. Bottoms of waste and linen containers are free of debris?

IC 13. Pest control-area is free of insects, rodents, and all other vermin?

HM 6. An eyewash station is readily available and functioning properly?

HM 7. All chemicals contain a manufactures label?

HM 4. A spill kit is available for chemical spills?

Medical Equipment Physical Inspection - and medications. ME 1-6)

ME 3. Does the equipments cleanliness, paint, wiring, and covers appear satisfactory?

ME 5. Does medical equipment have an asset tag and current maintenance sticker?

ME 6. Are temperature and other logs current, and are there notes for actions taken if device is operating outside of parameters?

Test strips and controls are dated?

Crash cart checks are documented daily?

SS 17. Are medications kept in locked rooms?

Pill splitters or mortar and pestles are clean?

IC 23a. Open medications are labeled with date and initials?

IC 24. Infusing IV bag, tubing, and tube feeding administration set-ups are labeled?

IC 25. Medication stock have not reached their expiration date?

IC 23. Open medication/supply expiration open multi-use vials/containers dated and irrigation fluid have not reached their expiration dates?

Infection Control Physical Inspection - (IC 1-32)

IC 2. Sharps containers are readily accessible?

IC 17a. Sharps containers are <2/3 full?

IC 3. Hand-washing soap dispensers are in place and filled?

IC 4. Alcohol hand sanitizers are in place and not expired?

Hand sanitizer at correct height and distance from electrical source?

IC 5. Hand-washing towels are in place and filled?

IC 6. PPE (gloves, gowns, face masks, protective eyewear, and respirators are readily accessible?

IC 28. Precaution signs are posted clearly on patient doors?

IC 19. Blanket and fluid warmers are at appropriate temperatures? Are fluids labeled with use by date?

IC 10. Clean linen is stored in clean area?

IC 10a. Clean linen is covered?

IC 18. Patient Refrigerator/freezer are at appropriate temperatures?

Pt and employee food are not stored together?

Pt fridge is clean?

IC 20. Food items in refrigerators/cabinets/freezers are not opened or uncovered?

IC 20a. Foods are not outdated?

IC 21. Food items are not stored in areas where blood or other infectious material is present?

Are disinfecting wipes available with lids closed when not in use?

Notes Section

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.