Unit Issues - Supervisor/Manager is responsible for correcting all “NO” answers in this Unit section. For any Procedural Changes with your environment (staff knowledge, improper storage, etc.) - Correct the situation AND Conduct applicable training to prevent re occurrence of noted issues.

1) Are all commercial exhaust hoods inspected?

2) Are space heaters the approved type, and in appropriate areas?

3) Is all cooking equipment the proper type and in designated cooking areas?

4) Are wet floors clearly marked with signage, to reduce slipping hazards?

5) Is the area free of door chocks?

6) Is the area free of electrical hazards (no damaged cords, extension cords or daisy-chaining surge protectors, etc.)?

7) Are Relocatable Power Taps (power strips) the correct type in the correct locations?
RPTs must be listed UL 1363A or UL 60601-1 for patient care areas,
or UL 1363 for non-patient care equipment outside of patient care areas.

8) Are medical inspection tags current?

9) Are corridors and passageways free of obstructions?

10) Are all stairwells clean, free of storage and obstructions?

11) Are fire doors, fire extinguishers, gas cut-off valves and other emergency equipment unobstructed?

12) Are fire and smoke doors free of posters and combustible decorations?

13) Are all materials stored a minimum of 18 inches from sprinklers heads?

14) Are Emergency Telephone Number stickers on telephones?

15) Are the medications properly secured?

16) Are trash rooms properly secured?

17) Are storage & equipment rooms free of clutter and unsafe conditions?

18) Are chemicals properly stored, labeled, and separated from patient contact/other clean items?

19) Are chemical spill kits available?

20) Is Chemical Inventory list updated annually and accessible to employees?

21) Is Personal Protective Equipment available?

22) Are all records maintained for weekly testing of eyewash units?

23) Are the number of compressed gas cylinders within maximum limits?

24) Are all compressed gas cylinders properly secured and segregated? (Green rack FULL, Red rack Used/Empty)

25) Is the "Unit/Department Specific Emergency Preparedness Plan" complete, posted, and updated annually?

26) Does staff know location and proper use of fire extinguishers?

27) Does staff know location and proper use of medical gas shut-off valves?

28) Do the employees observed have RACER & Identification cards?

29) Does staff know how to report a lost Identification Card?

30) Does the staff know how to access the Safety Manual and EOP?

31) Does staff know how to access the SDS (Safety Data Sheet) for chemicals?

32) Does staff know how to report an unsafe condition?

33) Does staff know how to report safety and security incidents involving patients, visitors or staff?

34) Does staff know how handle/report medical equipment malfunctions/incidents, including when someone is injured?

35) Does staff know the roles & responsibilities of their specific unit/department during a disaster or emergency exercise?

36) Does staff know of the emergency preparedness exercises that the facility has participated in the past 12 months?

37) Have all Unit/Department concerns been addressed?

Life Safety Department / Plant Ops are responsible for correcting all "NO" answers in this section.

38) Are hazards properly safeguarded for any renovations or construction projects underway?

Are documents (construction & hot-works permits, barrier checklist, etc.) posted?

39) Are all hazardous areas properly identified with signage?

40) Are Exit and stairwell doors properly identified and illuminated?

41) Are doors, including fire doors, in good repair and free to open, close and latch properly?

42) Are sprinkler heads free from damage, corrosion, foreign materials and paint?

43) Are all electrical panels free of open gaps and improperly connected breakers in panels?

44) Are all panels in public areas properly secured?

45) Are all mechanical/electrical areas free of combustible storage/debris?

46) Are electrical outlets and junction boxes undamaged, and have covers?

47) Is no smoking policy posted and being followed? Is the area free from evidence of smoking?

48) Are all fire extinguishers inspected and tagged?

49) Have fire drills been conducted and critiqued?

50) Are there records of all required fire protection and detection systems’ inspections and tests?

51) Have all facility concerns been addressed?

Appropriate Environment - Life Safety Department / Plant Ops are responsible for correcting all "NO" answers in this section.

52) Is lighting suitable for the care, treatment, and services provided?

53) Is the floor (tile / carpet) clean and in good condition?

54) Are ceiling tiles and HVAC grilles clean and intact?

55) Are electrical tamper-proof receptacles installed in the areas where children may be present?

56) Are grab bars and handrails installed and in good condition, where required?

57) Are all furnishing and equipment safe and in good repair?

58) Are areas used by patients safe, clean, and free of offensive odors?

59) Environment appropriate to the care, treatment, and services provided, in relation to the age & needs of patients?

60) Is there an area for physicians or other healthcare professionals to speak to patients, visitors, or family that ensures privacy?

61) Is the waiting area ADA compliant and located to minimize the impact of noise/activity on patient areas and staff functions?

62) Are there adequate way-finding markings to assist patients and visitors in locating specific areas or service?

63) Is the exterior of the building safe and free of hazards?

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.