Information

  • Audit Title

  • Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

FHMMC 12th Floor Administration

  • 40" / 31.5g Exec Console Conf Doc -restroom lobby

  • 40" / 31.5g Exec Console- Conf. Doc.- Copy Room

  • "0" containers larger than 32 gallons

  • Containers not closer than 8'

FHMMC 11th Floor Classroom

  • "0" containers larger than 32 gallons

FHMMC 10th Floor - Education

  • 40" / 31.5g Exec Console- Conf. Doc.- Reception Area

  • "0" containers larger than 32 gallons

FHMMC 10th Floor Nursing Unit

  • 40" / 31.5g Exec Console- Nurses Station

  • 40" / 31.5g Exec Console- Conf. Doc.- Equipment Room

  • Containers not closer than 8'

  • 24"/ 15g Exec Console- Conf. Doc.- Nurse Station 2ea

  • Large Soiled Carts- trash, linen & bio waste- located in properly rated rooms only

FHMMC 9th Floor Department of Clinical Effectiveness

  • 40" / 31.5g Exec Console Conf Doc 1

  • 40" / 31.5g Exec Console Conf Doc 2

  • Containers not closer than 8'

  • "0" containers larger than 32 gallons

FHMMC 9th Floor Mother Baby Unit

  • 40" / 31.5g Exec Console Conf Doc - Nurse Station

  • Large Soiled Carts- trash, linen & bio waste- located in properly rated rooms only

FHMMC 9th Floor Hospice

  • 40" / 31.5g Exec Console Conf Doc - Nurse Station

  • Large Soiled Carts- trash, linen & bio waste- located in properly rated rooms only

FHMMC 8th Floor Employee Health/Diabetes

  • 40" / 31.5g Exec Console Conf Doc - Workroom

  • "0" containers larger than 32 gallons

FHMMC 8th Floor Rehab Office

  • 40" / 31.5g Exec Console Conf Doc

  • "0" containers larger than 32 gallons

FHMMC 8th Floor Nursing Unit

  • 24"/ 15g Exec Console- Conf. Doc.- Nurse Station 1

  • 24"/ 15g Exec Console- Conf. Doc.- Nurse Station 2

  • 24"/ 15g Exec Console- Conf. Doc.- Nurse Station 3

  • 40" / 31.5g Exec Console Conf Doc

  • Containers not closer than 8'/ or 32g within 64 sq.ft. In non protected space

  • Large Soiled Carts- trash, linen & bio waste- located in properly rated rooms only

FHMMC 7th Floor Nursing Admin

  • 40" / 31.5g Exec Console Conf Doc 1

  • 40" / 31.5g Exec Console Conf Doc 2

  • 40" / 31.5g Exec Console Conf Doc 3

FHMMC 7th Floor Nursing Unit

  • 40" / 31.5g Exec Console Conf Doc 1 Nurse Station

  • 40" / 31.5g Exec Console Conf Doc 2 Nurse Station

  • 24"/ 15g Exec Console- Conf. Doc.- Nurse Station 1

  • 24"/ 15g Exec Console- Conf. Doc.- Nurse Station 2

  • Containers not closer than 8'/ or 32g within 64 sq.ft. In non protected space

  • Large Soiled Carts- trash, linen & bio waste- located in properly rated rooms only

FHMMC 6th Floor Nursing Unit

  • 40" / 31.5g Exec Console Conf Doc 1 Nurse Station

  • 40" / 31.5g Exec Console Conf Doc Equipment Room

  • 24"/ 15g Exec Console- Conf. Doc.- Nurse Station 1

  • 24"/ 15g Exec Console- Conf. Doc.- Nurse Station 2

  • Containers not closer than 8'/ or 32g within 64 sq.ft. In non protected space

  • Large Soiled Carts- trash, linen & bio waste- located in properly rated rooms only

FHMMC 5th Floor Case Management

  • 40" / 31.5g Exec Console Conf Doc

  • "0" containers larger than 32 gallons

FHMMc 5th Floor Nursing Unit ICU

  • 40" / 31.5g Exec Console Conf Doc - Nurse Mgr Office

  • 24"/ 15g Exec Console- Conf. Doc.- Nurse Station 1

  • 24"/ 15g Exec Console- Conf. Doc.- Nurse Station 2

  • Large Soiled Carts- trash, linen & bio waste- located in properly rated rooms only

FHMMC 4th Floor Information Svcs

  • 40" / 31.5g Exec Console Conf Doc 1

FHMMC 4th Floor Nursing Unit Birth Care

  • 40" / 31.5g Exec Console Conf Doc 1- Front Desk

  • 40" / 31.5g Exec Console Conf Doc 2- Nurse Station

  • 24"/ 15g Exec Console- Conf. Doc.- Nursery

  • Large Soiled Carts- trash, linen & bio waste- located in properly rated rooms only

FHMMC 3rd Floor Nursing Unit CSDU

  • 95g Wheeled Container conf doc.- Soiled Holding by Central Monitor Room

  • 40" / 31.5g Exec Console- Conf. Doc.- Central Monitor Rm

  • 40" / 31.5g Exec Console- Conf. Doc. 1 - Nurse Station

  • 40" / 31.5g Exec Console- Conf. Doc. 2 - Nurse Station

  • 24"/ 15g Exec Console- Conf. Doc.- Nurse Station

  • "0" containers larger than 32 gallons

  • Large Soiled Carts- trash, linen & bio waste- located in properly rated rooms only

  • Containers not closer than 8'/ or 32g within 64 sq.ft. In non protected space

FHMMC Nursing Unit Cardio- CVICU, CPU, Cath Lab, Admin

  • 40" / 31.5g Exec Console- Conf. Doc. CVOR Holding

  • 40" / 31.5g Exec Console- Conf. Doc. CVICU Nurse Station

  • 40" / 31.5g Exec Console- Conf. Doc. - Dr Lounge

  • 40" / 31.5g Exec Console- Conf. Doc. 1 CPU Nurse Station#1

  • 40" / 31.5g Exec Console- Conf. Doc. 2 CPU Nurse Station #2

  • 24"/ 15g Exec Console- Conf. Doc. - Admin Rob Grant Ofc.

  • 24"/ 15g Exec Console- Conf. Doc. - Office next to CV Education classroom

  • 24"/ 15g Exec Console- Conf. Doc. 1 Cath Lab

  • 24"/ 15g Exec Console- Conf. Doc. 2 Cath Lab

  • 24"/ 15g Exec Console- Conf. Doc. 3 Cath Lab

  • 24"/ 15g Exec Console- Conf. Doc. 4 Cath Lab

  • 24"/ 15g Exec Console- Conf. Doc. .?

  • 24"/ 15g Exec Console- Conf. Doc. ?

  • Containers not closer than 8'/ or 32g within 64 sq.ft. In non protected space

  • Large Soiled Carts- trash, linen & bio waste- located in properly rated rooms only

FHMMC 2nd Floor Pharmacy

  • 40" / 31.5g Exec Console- Conf. Doc. 1

  • 40" / 31.5g Exec Console- Conf. Doc. 2

  • 40" / 31.5g Exec Console- Admin Office

  • 24"/ 15g Exec Console- Conf. Doc. . Coordinator Office

  • Containers not closer than 8'/ or 32g within 64 sq.ft. In non protected space

  • "0" containers larger than 32 gallons

FHMMC 2nd Floor SPD

  • 40" / 31.5g Exec Console- Conf. Doc.

  • Large Soiled Carts- trash, linen & bio waste- located in properly rated rooms only

FHMMC 2nd Floor PreOp Testing

  • 95g Wheeled Container - doc. Soiled Holding

  • Large Soiled Carts- trash, linen & bio waste- located in properooms only

FHMMC 2nd Floor ASU

  • 95g Wheeled Container/ conf doc.- Soiled Holding

  • 40" / 31.5g Exec Console- Conf. Doc. Nurse Station

  • Large Soiled Carts- trash, linen & bio waste- located in properly rated rooms only

FHMMC 2nd Floor Recovery

  • 40" / 31.5g Exec Console- Conf. Doc. Nurse Station

  • 24"/ 15g Exec Console- Conf. Doc. 1 Nurse Station

  • 24"/ 15g Exec Console- Conf. Doc. 2 Nurse Station by Docs

  • 24"/ 15g Exec Console- Conf. Doc. PreOp Holding

  • Large Soiled Carts- trash, linen & bio waste- located in properly rated rooms only

  • Containers not closer than 8'/ or 32g within 64 sq.ft. In non protected space

FHMMC 2nd Floor OR

  • 95g Wheeled Container- conf. doc.

  • Large Soiled Carts- trash, linen & bio waste- located in properly rated rooms only

FHMMC 1st Floor Admitting- Registration

  • 40" / 31.5g Exec Console- Conf. Doc. Behind main registration

  • 40" / 31.5g Exec Console- Conf. Doc. Behind ED registration

  • 40" / 31.5g Exec Console- Conf. Doc. Office by ED registration

  • "0" containers larger than 32 gallons

  • Containers not closer than 8'/ or 32g within 64 sq.ft. In non protected space

FHMMC 1st Floor ED

  • 40" / 31.5g Exec Console- Conf. Doc. Admin Suite Conf Room

  • 40" / 31.5g Exec Console- Conf. Doc. Doctors Lounge

  • 24"/ 15g Exec Console- Conf. Doc. Fast Track

  • 24"/ 15g Exec Console- Conf. Doc. Triage workroom

  • 24"/ 15g Exec Console- Conf. Doc. Nurse Station Main

  • 24"/ 15g Exec Console- Conf. Doc. Nurse Station #2

  • Large Soiled Carts- trash, linen & bio waste- located in properly rated rooms only

FHMMC 1st Floor Cardio

  • 95g Wheeled Container- conf. doc. Clean Utility

  • Large Soiled Carts- trash, linen & bio waste- located in properly rated rooms only

FHMMC 1st Floor Imaging

  • 40" / 31.5g Exec Console- Conf. Doc. Reception

  • 40" / 31.5g Exec Console- Conf. Doc. Rad Workroom Ultrasound

  • 40" / 31.5g Exec Console- Conf. Doc. Rad Workroom Nuc Med

  • 40" / 31.5g Exec Console- Conf. Doc. Rad Workroom CT

  • 40" / 31.5g Exec Console- Conf. Doc. Radiologists Reading Room

  • Large Soiled Carts- trash, linen & bio waste- located in properly rated rooms only

FHMMC 1st Floor LAB

  • 40" / 31.5g Exec Console- Conf. Doc. 1

  • 40" / 31.5g Exec Console- Conf. Doc. 2

  • 40" / 31.5g Exec Console- Conf. Doc. 3

  • 40" / 31.5g Exec Console- Conf. Doc. 4

  • 24"/ 15g Exec Console- Conf. Doc.- Supervisor office Blood Draw

  • Containers not closer than 8'/ or 32g within 64 sq.ft. In non protected space

  • "0" containers larger than 32 gallons

FHMMC 1st Floor Med Staff, Mail rm

  • 40" / 31.5g Exec Console- Conf. Doc. - Mail Room

  • 40" / 31.5g Exec Console- Conf. Doc. - Doctors Lounge

  • 40" / 31.5g Exec Console- Conf. Doc. - Physician Workroom

  • Containers not closer than 8'/ or 32g within 64 sq.ft. In non protected space

  • "0" containers larger than 32 gallons

FHMMC 1st Floor MED Records

  • 95g Wheeled Container- conf. doc. 1 Storage

  • 95g Wheeled Container- conf. doc. 2 Storage

  • 95g Wheeled Container- conf. doc. 3 Storage

  • 40" / 31.5g Exec Console- Conf. Doc. 1- Near Main Entry

  • 40" / 31.5g Exec Console- Conf. Doc. 2 - Center Hall

  • 40" / 31.5g Exec Console- Conf. Doc. 3 - Near Main Entry

  • Containers not closer than 8'/ or 32g within 64 sq.ft. In non protected space

  • Large Soiled Carts- trash, linen & bio waste- located in properly rated rooms only

FHMMC 1st Floor MM, Engineering

  • 40" / 31.5g Exec Console- Conf. Doc. Materials Mgt

  • 40" / 31.5g Exec Console- Conf. Doc. Security Office

  • 40" / 31.5g Exec Console- Conf. Doc. Engineering office

  • 40" / 31.5g Exec Console- Conf. Doc. FANS Kitchen

  • 24"/ 15g Exec Console- Conf. Doc.- EVS Supervisor office

  • 24"/ 15g Exec Console- Conf. Doc.- EVS AsstD office

  • "0" containers larger than 32 gallons

  • Containers not closer than 8'/ or 32g within 64 sq.ft. In non protected space

Starr Rehab

  • 95g Wheeled Container- conf. doc.

  • Large Soiled Carts- trash, linen & bio waste- located in properly rated rooms only

  • "0" containers larger than 32 gallons outside properly rated storage area

FHO 3rd Floor

  • 95g Wheeled Container- conf. doc. - Copier closet

  • 64g Wheeled Container- conf. doc. - Case Mgrs Office

  • 40" / 31.5g Exec Console- Conf. Doc. Nurse Station

  • 24"/ 15g Exec Console- Conf. Doc. - doctors office

  • "0" containers larger than 32 gallons outside properly rated storage area

  • Large Soiled Carts- trash, linen & bio waste- located in properly rated rooms only

FHO 2nd Floor

  • 40" / 31.5g Exec Console- Conf. Doc. Rehab Gym

  • "0" containers larger than 32 gallons outside properly rated storage area

FHO 1st Floor

  • 95g Wheeled Container- conf. doc. 1 Med Records

  • 95g Wheeled Container- conf. doc. 2- Med Records

  • 95g Wheeled Container- conf. doc. 3- Med Records

  • 95g Wheeled Container- conf. doc. FANS- kitchen

  • 40" / 31.5g Exec Console- Conf. Doc. - Health Care Partners

  • 40" / 31.5g Exec Console- Conf. Doc. - Pharmacy

  • 40" / 31.5g Exec Console- Conf. Doc. 1- ED

  • 40" / 31.5g Exec Console- Conf. Doc. 2- ED

  • 40" / 31.5g Exec Console- Conf. Doc. 1- LAB

  • 40" / 31.5g Exec Console- Conf. Doc. 2- LAB

  • 40" / 31.5g Exec Console- Conf. Doc. - Cardio

  • "0" containers larger than 32 gallons outside properly rated storage area

  • Large Soiled Carts- trash, linen & bio waste- located in properly rated rooms only

  • Containers not closer than 8'/ or 32g within 64 sq.ft. In non protected space

FH Imaging

  • Need info:

Additional Comments

  • Additional Comments

  • Signature of person completing report

  • Type name of person completing report

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. Any ratings or scores displayed in our Public Library have not been verified by SafetyCulture for accuracy. Users of our platform may provide a rating or score that is incorrect or misleading. You should independently determine whether the template is suitable for your circumstances. You can use our Public Library to search based on criteria such as industry and subject matter. Search results are based on their relevance to your search and other criteria. We may feature checklists based on subject matters we think may be of interest to our customers.