Audit

Mat-Su Regional Medical Center

EOC MOCK TRACER

Infant and Pediatric Security

Select date

Interview of Department Director:

Department:

Interviewee:

(1) Has the organization conducted a risk assessment on infant/pediatric abduction?

Comments/Observations:

(2) What were the results of this risk assessment?

Comments/Observations:

(3) What are your concerns about infant/pediatric security in this area?

Comments/Observations:

(4) How does the organization control access to this area?

Comments/Observations:

(5) What do you do when the electronic system for controlling access fails?

Comments/Observations:

(6) Does the unit have manual systems in place for controlling access?

Comments/Observations:

(7) How does the unit ensure the security of the elevator?

Comments/Observations:

(8) How does the unit identify potentially disruptive family situations – such as estrangement or a custody battle?

Comments/Observations:

(9) How does the unit increase security around a child involved in such situations?

Comments/Observations:

TRAINING

Review of employee's training file - (form 22):

Is employee form 22 complete?

Is employee form 22 complete?

Interview of Department Staff Member:

Department:

Interviewee Name:

Interviewee Job Title:

(1) How do you know if an infant/pediatric patient has been abducted?

Comments/Observations:

(2) What is your responsibility when a Code Pink or Amber is called?

Comments/Observations:

(3) How do you know if the electronic systems in-place are working?

Comments/Observations:

(4) Has the organization ever done an infant/ pediatric abduction drill?

Comments/Observations:

Department:

Interviewee Name:

Interviewee Job Title:

(1) How do you know if an infant/pediatric patient has been abducted?

Comments/Observations:

(2) What is your responsibility when a Code Pink or Amber is called?

Comments/Observations:

(3) How do you know if the electronic systems in-place are working?

Comments/Observations:

(4) Has the organization ever done an infant/ pediatric abduction drill?

Comments/Observations:

Interview of Maintenance Director:

Interviewee:

(1) Has the organization conducted a risk assessment on infant/pediatric abduction?

Comments/Observations:

(2) What were the results of this risk assessment?

Comments/Observations:

(3) Is the security system for OB connected to emergency power?

Comments/Observations:

(4) When was the last abduction drill conducted?

Comments/Observations:

(5) Are drills reported to the Safety Committee?

Comments/Observations:

Overall Comments, Observations and or Recommendations from surveyor:

SIGN OFF

Lead Surveyor:

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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.