Title Page
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Facility Name
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Conducted on
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Prepared by
FBUS Facility Audit
Fire Extinguishers Inspection
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How many Fire Extinguishers are located in this facility?
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Are the Fire Extinguishers in good working order?
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What is not in compliance with the FE?
- Expired
- Missing Inspection Tag
- Broken/Missing Cotter Pin
- Breakaway tie missing/ Non-compliant
- Gauge in Red/ Empty
- Broken Hose/Handle
- Missing from location
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What Fire Extinguisher #s are not in compliance?
- FE #1
- FE #2
- FE #3
- FE #4
- FE #5
- FE #6
- FE #7
- FE #8
- FE #9
- FE #10
- FE #11
- FE #12
- FE #13
- FE #14
- FE #15
- FE #16
- FE #17
- FE #18
- FE #19
- FE #20
AED Inspection
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How many AEDs are located in this facility?
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Are the AED(s) in good working order?
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What is not in compliance with the AED?
- Expired Adult Pads
- Dead Batteries
- Missing from location
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What AED # is not in compliance?
- AED #1
- AED #2
- AED #3
- AED #4
First Aid Kit Inspection
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How many First Aid Kits are located in this facility?
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Are the First Aid Kits in compliance?
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What is out of compliance with the First Aid Kit?
- Missing Items
- Expired Items
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What Items are missing or Expired?
- Band-Aids
- Gauze
- Guaze Bandage Roll
- Burn Spray
- Burn Dressing
- Eye Wash
- Antibiotic
- Ibueprofen
- Aspirin
- Extra Strength Non-Aspirin
- Antibiotic Ointment
- First Aid/Burn Cream
- Antiseptic Wipes
- First Aid Tape
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What First Aid Kit number is out of compliance?
- First Aid Kit #1
- First Aid Kit #2
- First Aid Kit #3
- First Aid Kit#4
- First Aid Kit #5
- First Aid Kit #6
Eye Wash Inspection
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How many Eye Wash Stations are located in this facility?
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Is the Eye wash station clear for use?
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Is the Eye wash station in good working order?
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What is out of compliance with the Eye Wash station?
- Empty Eye Wash
- Expired Solution
- Dirty Eye Wash Station
- Blocked from proper use
- Broken
- Dirty
