First Aid & Eye Wash Audit

• Site conducted

  Select

• Date of Inspection

  Date

• Inspection Completed By

• Have any incident reports been submitted since the last audit?

  Yes

  No

EYEWASH STATION

• Locate the EYEWASH STATION

• Is the EYEWASH STATION easily ACCESSIBLE ? (No obstructions, is well lit, easy to reach)

  Yes

  No

• Is the EYEWASH STATION CLEAN ? (no dust, rust, water leaking or dirt in or on top of the station)

  Yes

  No

• Is the TAMPER SEAL intact and IN DATE (within the next 2 months) ?

  Yes

  No

EYEWASH BOTTLES

• Locate the EYEWASH BOTTLES

  

• How many EYEWASH BOTTLES are available ?

• Do the EYEWASH BOTTLES appear to be in GOOD CONDITION ? (Not tampered with, opened, dirty, ect.)

  Yes

  No

• Use the eyewash bottle with the expiry date closest to the current date of inspection for reference when answering the questions below

• Are the EYEWASH BOTTLES in date ?

  Yes

  No

• What is the EXPIRY DATE on the EYEWASH BOTTLE

  Date

• Is the EXPIRY DATE within the next 2 MONTHS ?

  Yes

  No

• Do the EYEWASH BOTTLES appear to have been used ?

  Yes

  No

EYEWASH PODS

• Locate the EYEWASH PODS

  

• How many EYEWASH PODS are available ?

• Do the EYEWASH PODS appear to be in GOOD CONDITION ? (Not tampered with, opened, dirty, ect.)

  Yes

  No

• Use the eyewash pods with the expiry date closest to the current date of inspection for reference when answering the questions below

• Are the EYEWASH PODS in date ?

  Yes

  No

• What is the EXPIRY DATE on the EYEWASH POD ?

  Date

• Is the EXPIRY DATE within the next 2 MONTHS ?

  Yes

  No

EYE PAD DRESSINGS

• Locate the EYE PAD DRESSINGS

  

• How many EYE PAD DRESSINGS are available ?

• Do the EYE PAD DRESSINGS appear to be in GOOD CONDITION ? (Not tampered with, opened, dirty, ect.)

  Yes

  No

• Use the eye pad dressings with the expiry date closest to the current date of inspection for reference when answering the questions below

• Are the EYE PAD DRESSINGS in date ?

  Yes

  No

• What is the EXPIRY DATE on the EYE PAD DRESSING ?

  Date

• Is the EXPIRY DATE within the next 2 MONTHS ?

  Yes

  No

MIRROR

• Is the MIRROR in GOOD CONDITION ? (Clean of dirt and fingerprints, no cracks)

  Yes

  No

• Please add any additional notes from your inspection below

FIRST AID KIT STATION

• Locate the FIRST AID KIT STATION

  

• Is the FIRST AID KIT STATION easily ACCESSIBLE ? (No obstructions, is well lit, easy to reach)

  Yes

  No

• Is the FIRST AID KIT STATION CLEAN ? (no dust, rust, no dirt in or on top of the station)

  Yes

  No

• Is the TAMPER SEAL intact and IN DATE (within the next 2 months) ?

  Yes

  No

WASHPROOF PLASTERS

• Locate the WASHPROOF PLASTERS

  

• How many WASHPROOF PLASTERS are available ?

• Do the WASHPROOF PLASTERS appear to be in GOOD CONDITION ? (Not tampered with, not opened, dirty, ect.)

  Yes

  No

• Use the washproof plaster packet with the expiry date closest to the current date of inspection for reference when answering the questions below

• Are the WASHPROOF PLASTERS in date ?

  Yes

  No

• What is the EXPIRY DATE on the WASHPROOF PLASTERS ?

  Date

• Is the EXPIRY DATE within the next 2 MONTHS ?

  Yes

  No

EYE PAD DRESSINGS

• Locate the EYE PAD DRESSINGS

  

• How many EYE PAD DRESSINGS are available ?

• Do the EYE PAD DRESSINGS appear to be in GOOD CONDITION ? (Not tampered with, not opened, dirty, ect.)

  Yes

  No

• Use the eye pad dressing with the expiry date closest to the current date of inspection for reference when answering the questions below

• Are the EYE PAD DRESSINGS in date ?

  Yes

  No

• What is the EXPIRY DATE on the EYE PADS WITH BANDAGES ?

  Date

• Is the EXPIRY DATE within the next 2 MONTHS ?

  Yes

  No

TRIANGULAR BANDAGES

• Locate the TRIANGULAR BANDAGES

  

• How many TRINAGULAR BANDAGES are available ?

• Do the TRIANGULAR BANDAGES appear to be in GOOD CONDITION ? (Not tampered with, not opened, dirty, ect.)

  Yes

  No

• Use the triangular bandage with the expiry date closest to the current date of inspection for reference when answering the questions below

• Are the TRIANGULAR BANDAGES in date ?

  Yes

  No

• What is the EXPIRY DATE on the TRIANGULAR BANDAGES ?

  Date

• Is the EXPIRY DATE within the next 2 MONTHS ?

  Yes

  No

SAFETY PINS

• Locate the SAFETY PINS

  

• How many SAFETY PINS are available ?

• Do the SAFETY PINS appear to be in GOOD CONDITION ? (clean, free of rust, working condition, ect.)

  Yes

  No

MEDIUM STERILE DRESSINGS (12 X 12 CM)

• Locate the MEDIUM STERILE DRESSINGS (12 X 12 CM)

  

• How many MEDIUM STERILE DRESSINGS are available ?

• Do the MEDIUM STERILE DRESSINGS appear to be in GOOD CONDITION ? (Not tampered with, not opened, dirty, ect.)

  Yes

  No

• Use the medium sterile dressing with the expiry date closest to the current date of inspection for reference when answering the questions below

• Are the MEDIUM STERILE DRESSINGS in date ?

  Yes

  No

• What is the EXPIRY DATE on the SMALL STERILE DRESSINGS ?

  Date

• Is the EXPIRY DATE within the next 2 MONTHS ?

  Yes

  No

LARGE STERILE DRESSINGS (18 X 18 CM)

• Locate the LARGE STERILE DRESSINGS (18 X 18 CM)

  

• How many LARGE STERILE DRESSINGS are available ?

• Do the LARGE STERILE DRESSINGS appear to be in GOOD CONDITION ? (Not tampered with, not opened, dirty, ect.)

  Yes

  No

• Use the large sterile dressing with the expiry date closest to the current date of inspection for reference when answering the questions below

• Are the LARGE STERILE DRESSINGS in date ?

  Yes

  No

• What is the EXPIRY DATE on the LARGE STERILE DRESSINGS ?

  Date

• Is the EXPIRY DATE within the next 2 MONTHS ?

  Yes

  No

MOIST WIPES

• Locate the MOIST WIPES

  

• How many MOIST WIPES are available ?

• Do the MOIST WIPES appear to be in GOOD CONDITION ? (Not tampered with, not opened, dirty, ect.)

  Yes

  No

DISPOSABLE GLOVES

• Locate the DISPOSABLE GLOVES

  

• How many DISPOSABLE GLOVES are available ?

• Do the DISPOSABLE GLOVES appear to be in GOOD CONDITION ? (Not tampered with, damages, dirty, ect.)

  Yes

  No

• Please add any additional notes from your inspection below

EYEWASH STATION

• Locate the EYEWASH STATION

• Is the EYEWASH STATION easily ACCESSIBLE ? (No obstructions, is well lit, easy to reach)

  Yes

  No

• Is the EYEWASH STATION CLEAN ? (no dust, rust, water leaking or dirt in or on top of the station)

  Yes

  No

• Is the TAMPER SEAL intact and IN DATE (within the next 2 months) ?

  Yes

  No

EYEWASH BOTTLES

• Locate the EYEWASH BOTTLES

  

• How many EYEWASH BOTTLES are available ?

• Do the EYEWASH BOTTLES appear to be in GOOD CONDITION ? (Not tampered with, opened, dirty, ect.)

  Yes

  No

• Use the eyewash bottle with the expiry date closest to the current date of inspection for reference when answering the questions below

• Are the EYEWASH BOTTLES in date ?

  Yes

  No

• What is the EXPIRY DATE on the EYEWASH BOTTLE

  Date

• Is the EXPIRY DATE within the next 2 MONTHS ?

  Yes

  No

• Do the EYEWASH BOTTLES appear to have been used ?

  Yes

  No

EYEWASH PODS

• Locate the EYEWASH PODS

  

• How many EYEWASH PODS are available ?

• Do the EYEWASH PODS appear to be in GOOD CONDITION ? (Not tampered with, opened, dirty, ect.)

  Yes

  No

• Use the eyewash pods with the expiry date closest to the current date of inspection for reference when answering the questions below

• Are the EYEWASH PODS in date ?

  Yes

  No

• What is the EXPIRY DATE on the EYEWASH POD ?

  Date

• Is the EXPIRY DATE within the next 2 MONTHS ?

  Yes

  No

EYE PAD DRESSINGS

• Locate the EYE PAD DRESSINGS

  

• How many EYE PAD DRESSINGS are available ?

• Do the EYE PAD DRESSINGS appear to be in GOOD CONDITION ? (Not tampered with, opened, dirty, ect.)

  Yes

  No

• Use the eye pad dressings with the expiry date closest to the current date of inspection for reference when answering the questions below

• Are the EYE PAD DRESSINGS in date ?

  Yes

  No

• What is the EXPIRY DATE on the EYE PAD DRESSING ?

  Date

• Is the EXPIRY DATE within the next 2 MONTHS ?

  Yes

  No

MIRROR

• Is the MIRROR in GOOD CONDITION ? (Clean of dirt and fingerprints, no cracks)

  Yes

  No

• Please add any additional notes from your inspection below

FIRST AID KIT STATION

• Locate the FIRST AID KIT STATION

  

• Is the FIRST AID KIT STATION easily ACCESSIBLE ? (No obstructions, is well lit, easy to reach)

  Yes

  No

• Is the FIRST AID KIT STATION CLEAN ? (no dust, rust, no dirt in or on top of the station)

  Yes

  No

• Is the TAMPER SEAL intact and IN DATE (within the next 2 months) ?

  Yes

  No

WASHPROOF PLASTERS

• Locate the WASHPROOF PLASTERS

  

• How many WASHPROOF PLASTERS are available ?

• Do the WASHPROOF PLASTERS appear to be in GOOD CONDITION ? (Not tampered with, not opened, dirty, ect.)

  Yes

  No

• Use the washproof plaster packet with the expiry date closest to the current date of inspection for reference when answering the questions below

• Are the WASHPROOF PLASTERS in date ?

  Yes

  No

• What is the EXPIRY DATE on the WASHPROOF PLASTERS ?

  Date

• Is the EXPIRY DATE within the next 2 MONTHS ?

  Yes

  No

EYE PAD DRESSINGS

• Locate the EYE PAD DRESSINGS

  

• How many EYE PAD DRESSINGS are available ?

• Do the EYE PAD DRESSINGS appear to be in GOOD CONDITION ? (Not tampered with, not opened, dirty, ect.)

  Yes

  No

• Use the eye pad dressing with the expiry date closest to the current date of inspection for reference when answering the questions below

• Are the EYE PAD DRESSINGS in date ?

  Yes

  No

• What is the EXPIRY DATE on the EYE PADS WITH BANDAGES ?

  Date

• Is the EXPIRY DATE within the next 2 MONTHS ?

  Yes

  No

TRIANGULAR BANDAGES

• Locate the TRIANGULAR BANDAGES

  

• How many TRINAGULAR BANDAGES are available ?

• Do the TRIANGULAR BANDAGES appear to be in GOOD CONDITION ? (Not tampered with, not opened, dirty, ect.)

  Yes

  No

• Use the triangular bandage with the expiry date closest to the current date of inspection for reference when answering the questions below

• Are the TRIANGULAR BANDAGES in date ?

  Yes

  No

• What is the EXPIRY DATE on the TRIANGULAR BANDAGES ?

  Date

• Is the EXPIRY DATE within the next 2 MONTHS ?

  Yes

  No

SAFETY PINS

• Locate the SAFETY PINS

  

• How many SAFETY PINS are available ?

• Do the SAFETY PINS appear to be in GOOD CONDITION ? (clean, free of rust, working condition, ect.)

  Yes

  No

MEDIUM STERILE DRESSINGS (12 X 12 CM)

• Locate the MEDIUM STERILE DRESSINGS (12 X 12 CM)

  

• How many MEDIUM STERILE DRESSINGS are available ?

• Do the MEDIUM STERILE DRESSINGS appear to be in GOOD CONDITION ? (Not tampered with, not opened, dirty, ect.)

  Yes

  No

• Use the medium sterile dressing with the expiry date closest to the current date of inspection for reference when answering the questions below

• Are the MEDIUM STERILE DRESSINGS in date ?

  Yes

  No

• What is the EXPIRY DATE on the SMALL STERILE DRESSINGS ?

  Date

• Is the EXPIRY DATE within the next 2 MONTHS ?

  Yes

  No

LARGE STERILE DRESSINGS (18 X 18 CM)

• Locate the LARGE STERILE DRESSINGS (18 X 18 CM)

  

• How many LARGE STERILE DRESSINGS are available ?

• Do the LARGE STERILE DRESSINGS appear to be in GOOD CONDITION ? (Not tampered with, not opened, dirty, ect.)

  Yes

  No

• Use the large sterile dressing with the expiry date closest to the current date of inspection for reference when answering the questions below

• Are the LARGE STERILE DRESSINGS in date ?

  Yes

  No

• What is the EXPIRY DATE on the LARGE STERILE DRESSINGS ?

  Date

• Is the EXPIRY DATE within the next 2 MONTHS ?

  Yes

  No

MOIST WIPES

• Locate the MOIST WIPES

  

• How many MOIST WIPES are available ?

• Do the MOIST WIPES appear to be in GOOD CONDITION ? (Not tampered with, not opened, dirty, ect.)

  Yes

  No

DISPOSABLE GLOVES

• Locate the DISPOSABLE GLOVES

  

• How many DISPOSABLE GLOVES are available ?

• Do the DISPOSABLE GLOVES appear to be in GOOD CONDITION ? (Not tampered with, damages, dirty, ect.)

  Yes

  No

• Please add any additional notes from your inspection below

FIRST AID KIT STATION

• Locate the FIRST AID KIT STATION

  

• Is the FIRST AID KIT STATION easily ACCESSIBLE ? (No obstructions, is well lit, easy to reach)

  Yes

  No

• Is the FIRST AID KIT STATION CLEAN ? (no dust, rust, no dirt in or on top of the station)

  Yes

  No

• Is the TAMPER SEAL intact and IN DATE (within the next 2 months) ?

  Yes

  No

WASHPROOF PLASTERS

• Locate the WASHPROOF PLASTERS

  

• How many WASHPROOF PLASTERS are available ?

• Do the WASHPROOF PLASTERS appear to be in GOOD CONDITION ? (Not tampered with, not opened, dirty, ect.)

  Yes

  No

• Use the washproof plaster packet with the expiry date closest to the current date of inspection for reference when answering the questions below

• Are the WASHPROOF PLASTERS in date ?

  Yes

  No

• What is the EXPIRY DATE on the WASHPROOF PLASTERS ?

  Date

• Is the EXPIRY DATE within the next 2 MONTHS ?

  Yes

  No

EYE PAD DRESSINGS

• Locate the EYE PAD DRESSINGS

  

• How many EYE PAD DRESSINGS are available ?

• Do the EYE PAD DRESSINGS appear to be in GOOD CONDITION ? (Not tampered with, not opened, dirty, ect.)

  Yes

  No

• Use the eye pad dressing with the expiry date closest to the current date of inspection for reference when answering the questions below

• Are the EYE PAD DRESSINGS in date ?

  Yes

  No

• What is the EXPIRY DATE on the EYE PADS WITH BANDAGES ?

  Date

• Is the EXPIRY DATE within the next 2 MONTHS ?

  Yes

  No

TRIANGULAR BANDAGES

• Locate the TRIANGULAR BANDAGES

  

• How many TRINAGULAR BANDAGES are available ?

• Do the TRIANGULAR BANDAGES appear to be in GOOD CONDITION ? (Not tampered with, not opened, dirty, ect.)

  Yes

  No

• Use the triangular bandage with the expiry date closest to the current date of inspection for reference when answering the questions below

• Are the TRIANGULAR BANDAGES in date ?

  Yes

  No

• What is the EXPIRY DATE on the TRIANGULAR BANDAGES ?

  Date

• Is the EXPIRY DATE within the next 2 MONTHS ?

  Yes

  No

SAFETY PINS

• Locate the SAFETY PINS

  

• How many SAFETY PINS are available ?

• Do the SAFETY PINS appear to be in GOOD CONDITION ? (clean, free of rust, working condition, ect.)

  Yes

  No

MEDIUM STERILE DRESSINGS (12 X 12 CM)

• Locate the MEDIUM STERILE DRESSINGS (12 X 12 CM)

  

• How many MEDIUM STERILE DRESSINGS are available ?

• Do the MEDIUM STERILE DRESSINGS appear to be in GOOD CONDITION ? (Not tampered with, not opened, dirty, ect.)

  Yes

  No

• Use the medium sterile dressing with the expiry date closest to the current date of inspection for reference when answering the questions below

• Are the MEDIUM STERILE DRESSINGS in date ?

  Yes

  No

• What is the EXPIRY DATE on the SMALL STERILE DRESSINGS ?

  Date

• Is the EXPIRY DATE within the next 2 MONTHS ?

  Yes

  No

LARGE STERILE DRESSINGS (18 X 18 CM)

• Locate the LARGE STERILE DRESSINGS (18 X 18 CM)

  

• How many LARGE STERILE DRESSINGS are available ?

• Do the LARGE STERILE DRESSINGS appear to be in GOOD CONDITION ? (Not tampered with, not opened, dirty, ect.)

  Yes

  No

• Use the large sterile dressing with the expiry date closest to the current date of inspection for reference when answering the questions below

• Are the LARGE STERILE DRESSINGS in date ?

  Yes

  No

• What is the EXPIRY DATE on the LARGE STERILE DRESSINGS ?

  Date

• Is the EXPIRY DATE within the next 2 MONTHS ?

  Yes

  No

MOIST WIPES

• Locate the MOIST WIPES

  

• How many MOIST WIPES are available ?

• Do the MOIST WIPES appear to be in GOOD CONDITION ? (Not tampered with, not opened, dirty, ect.)

  Yes

  No

DISPOSABLE GLOVES

• Locate the DISPOSABLE GLOVES

  

• How many DISPOSABLE GLOVES are available ?

• Do the DISPOSABLE GLOVES appear to be in GOOD CONDITION ? (Not tampered with, damages, dirty, ect.)

  Yes

  No

• Please add any additional notes from your inspection below

EYEWASH STATION

• Locate the EYEWASH STATION

• Is the EYEWASH STATION easily ACCESSIBLE ? (No obstructions, is well lit, easy to reach)

  Yes

  No

• Is the EYEWASH STATION CLEAN ? (no dust, rust, water leaking or dirt in or on top of the station)

  Yes

  No

• Is the TAMPER SEAL intact and IN DATE (within the next 2 months) ?

  Yes

  No

EYEWASH BOTTLES

• Locate the EYEWASH BOTTLES

  

• How many EYEWASH BOTTLES are available ?

• Do the EYEWASH BOTTLES appear to be in GOOD CONDITION ? (Not tampered with, opened, dirty, ect.)

  Yes

  No

• Use the eyewash bottle with the expiry date closest to the current date of inspection for reference when answering the questions below

• Are the EYEWASH BOTTLES in date ?

  Yes

  No

• What is the EXPIRY DATE on the EYEWASH BOTTLE

  Date

• Is the EXPIRY DATE within the next 2 MONTHS ?

  Yes

  No

• Do the EYEWASH BOTTLES appear to have been used ?

  Yes

  No

EYEWASH PODS

• Locate the EYEWASH PODS

  

• How many EYEWASH PODS are available ?

• Do the EYEWASH PODS appear to be in GOOD CONDITION ? (Not tampered with, opened, dirty, ect.)

  Yes

  No

• Use the eyewash pods with the expiry date closest to the current date of inspection for reference when answering the questions below

• Are the EYEWASH PODS in date ?

  Yes

  No

• What is the EXPIRY DATE on the EYEWASH POD ?

  Date

• Is the EXPIRY DATE within the next 2 MONTHS ?

  Yes

  No

EYE PAD DRESSINGS

• Locate the EYE PAD DRESSINGS

  

• How many EYE PAD DRESSINGS are available ?

• Do the EYE PAD DRESSINGS appear to be in GOOD CONDITION ? (Not tampered with, opened, dirty, ect.)

  Yes

  No

• Use the eye pad dressings with the expiry date closest to the current date of inspection for reference when answering the questions below

• Are the EYE PAD DRESSINGS in date ?

  Yes

  No

• What is the EXPIRY DATE on the EYE PAD DRESSING ?

  Date

• Is the EXPIRY DATE within the next 2 MONTHS ?

  Yes

  No

MIRROR

• Is the MIRROR in GOOD CONDITION ? (Clean of dirt and fingerprints, no cracks)

  Yes

  No

• Please add any additional notes from your inspection below

FIRST AID KIT STATION

• Locate the FIRST AID KIT STATION

  

• Is the FIRST AID KIT STATION easily ACCESSIBLE ? (No obstructions, is well lit, easy to reach)

  Yes

  No

• Is the FIRST AID KIT STATION CLEAN ? (no dust, rust, no dirt in or on top of the station)

  Yes

  No

• Is the TAMPER SEAL intact and IN DATE (within the next 2 months) ?

  Yes

  No

WASHPROOF PLASTERS

• Locate the WASHPROOF PLASTERS

  

• How many WASHPROOF PLASTERS are available ?

• Do the WASHPROOF PLASTERS appear to be in GOOD CONDITION ? (Not tampered with, not opened, dirty, ect.)

  Yes

  No

• Use the washproof plaster packet with the expiry date closest to the current date of inspection for reference when answering the questions below

• Are the WASHPROOF PLASTERS in date ?

  Yes

  No

• What is the EXPIRY DATE on the WASHPROOF PLASTERS ?

  Date

• Is the EXPIRY DATE within the next 2 MONTHS ?

  Yes

  No

EYE PAD DRESSINGS

• Locate the EYE PAD DRESSINGS

  

• How many EYE PAD DRESSINGS are available ?

• Do the EYE PAD DRESSINGS appear to be in GOOD CONDITION ? (Not tampered with, not opened, dirty, ect.)

  Yes

  No

• Use the eye pad dressing with the expiry date closest to the current date of inspection for reference when answering the questions below

• Are the EYE PAD DRESSINGS in date ?

  Yes

  No

• What is the EXPIRY DATE on the EYE PADS WITH BANDAGES ?

  Date

• Is the EXPIRY DATE within the next 2 MONTHS ?

  Yes

  No

TRIANGULAR BANDAGES

• Locate the TRIANGULAR BANDAGES

  

• How many TRINAGULAR BANDAGES are available ?

• Do the TRIANGULAR BANDAGES appear to be in GOOD CONDITION ? (Not tampered with, not opened, dirty, ect.)

  Yes

  No

• Use the triangular bandage with the expiry date closest to the current date of inspection for reference when answering the questions below

• Are the TRIANGULAR BANDAGES in date ?

  Yes

  No

• What is the EXPIRY DATE on the TRIANGULAR BANDAGES ?

  Date

• Is the EXPIRY DATE within the next 2 MONTHS ?

  Yes

  No

SAFETY PINS

• Locate the SAFETY PINS

  

• How many SAFETY PINS are available ?

• Do the SAFETY PINS appear to be in GOOD CONDITION ? (clean, free of rust, working condition, ect.)

  Yes

  No

MEDIUM STERILE DRESSINGS (12 X 12 CM)

• Locate the MEDIUM STERILE DRESSINGS (12 X 12 CM)

  

• How many MEDIUM STERILE DRESSINGS are available ?

• Do the MEDIUM STERILE DRESSINGS appear to be in GOOD CONDITION ? (Not tampered with, not opened, dirty, ect.)

  Yes

  No

• Use the medium sterile dressing with the expiry date closest to the current date of inspection for reference when answering the questions below

• Are the MEDIUM STERILE DRESSINGS in date ?

  Yes

  No

• What is the EXPIRY DATE on the SMALL STERILE DRESSINGS ?

  Date

• Is the EXPIRY DATE within the next 2 MONTHS ?

  Yes

  No

LARGE STERILE DRESSINGS (18 X 18 CM)

• Locate the LARGE STERILE DRESSINGS (18 X 18 CM)

  

• How many LARGE STERILE DRESSINGS are available ?

• Do the LARGE STERILE DRESSINGS appear to be in GOOD CONDITION ? (Not tampered with, not opened, dirty, ect.)

  Yes

  No

• Use the large sterile dressing with the expiry date closest to the current date of inspection for reference when answering the questions below

• Are the LARGE STERILE DRESSINGS in date ?

  Yes

  No

• What is the EXPIRY DATE on the LARGE STERILE DRESSINGS ?

  Date

• Is the EXPIRY DATE within the next 2 MONTHS ?

  Yes

  No

MOIST WIPES

• Locate the MOIST WIPES

  

• How many MOIST WIPES are available ?

• Do the MOIST WIPES appear to be in GOOD CONDITION ? (Not tampered with, not opened, dirty, ect.)

  Yes

  No

DISPOSABLE GLOVES

• Locate the DISPOSABLE GLOVES

  

• How many DISPOSABLE GLOVES are available ?

• Do the DISPOSABLE GLOVES appear to be in GOOD CONDITION ? (Not tampered with, damages, dirty, ect.)

  Yes

  No

• Please add any additional notes from your inspection below

EYEWASH STATION

• Locate the EYEWASH STATION

• Is the EYEWASH STATION easily ACCESSIBLE ? (No obstructions, is well lit, easy to reach)

  Yes

  No

• Is the EYEWASH STATION CLEAN ? (no dust, rust, water leaking or dirt in or on top of the station)

  Yes

  No

• Is the TAMPER SEAL intact and IN DATE (within the next 2 months) ?

  Yes

  No

EYEWASH BOTTLES

• Locate the EYEWASH BOTTLES

  

• How many EYEWASH BOTTLES are available ?

• Do the EYEWASH BOTTLES appear to be in GOOD CONDITION ? (Not tampered with, opened, dirty, ect.)

  Yes

  No

• Use the eyewash bottle with the expiry date closest to the current date of inspection for reference when answering the questions below

• Are the EYEWASH BOTTLES in date ?

  Yes

  No

• What is the EXPIRY DATE on the EYEWASH BOTTLE

  Date

• Is the EXPIRY DATE within the next 2 MONTHS ?

  Yes

  No

• Do the EYEWASH BOTTLES appear to have been used ?

  Yes

  No

EYEWASH PODS

• Locate the EYEWASH PODS

  

• How many EYEWASH PODS are available ?

• Do the EYEWASH PODS appear to be in GOOD CONDITION ? (Not tampered with, opened, dirty, ect.)

  Yes

  No

• Use the eyewash pods with the expiry date closest to the current date of inspection for reference when answering the questions below

• Are the EYEWASH PODS in date ?

  Yes

  No

• What is the EXPIRY DATE on the EYEWASH POD ?

  Date

• Is the EXPIRY DATE within the next 2 MONTHS ?

  Yes

  No

EYE PAD DRESSINGS

• Locate the EYE PAD DRESSINGS

  

• How many EYE PAD DRESSINGS are available ?

• Do the EYE PAD DRESSINGS appear to be in GOOD CONDITION ? (Not tampered with, opened, dirty, ect.)

  Yes

  No

• Use the eye pad dressings with the expiry date closest to the current date of inspection for reference when answering the questions below

• Are the EYE PAD DRESSINGS in date ?

  Yes

  No

• What is the EXPIRY DATE on the EYE PAD DRESSING ?

  Date

• Is the EXPIRY DATE within the next 2 MONTHS ?

  Yes

  No

MIRROR

• Is the MIRROR in GOOD CONDITION ? (Clean of dirt and fingerprints, no cracks)

  Yes

  No

• Please add any additional notes from your inspection below

FIRST AID KIT STATION

• Locate the FIRST AID KIT STATION

  

• Is the FIRST AID KIT STATION easily ACCESSIBLE ? (No obstructions, is well lit, easy to reach)

  Yes

  No

• Is the FIRST AID KIT STATION CLEAN ? (no dust, rust, no dirt in or on top of the station)

  Yes

  No

• Is the TAMPER SEAL intact and IN DATE (within the next 2 months) ?

  Yes

  No

WASHPROOF PLASTERS

• Locate the WASHPROOF PLASTERS

  

• How many WASHPROOF PLASTERS are available ?

• Do the WASHPROOF PLASTERS appear to be in GOOD CONDITION ? (Not tampered with, not opened, dirty, ect.)

  Yes

  No

• Use the washproof plaster packet with the expiry date closest to the current date of inspection for reference when answering the questions below

• Are the WASHPROOF PLASTERS in date ?

  Yes

  No

• What is the EXPIRY DATE on the WASHPROOF PLASTERS ?

  Date

• Is the EXPIRY DATE within the next 2 MONTHS ?

  Yes

  No

EYE PAD DRESSINGS

• Locate the EYE PAD DRESSINGS

  

• How many EYE PAD DRESSINGS are available ?

• Do the EYE PAD DRESSINGS appear to be in GOOD CONDITION ? (Not tampered with, not opened, dirty, ect.)

  Yes

  No

• Use the eye pad dressing with the expiry date closest to the current date of inspection for reference when answering the questions below

• Are the EYE PAD DRESSINGS in date ?

  Yes

  No

• What is the EXPIRY DATE on the EYE PADS WITH BANDAGES ?

  Date

• Is the EXPIRY DATE within the next 2 MONTHS ?

  Yes

  No

TRIANGULAR BANDAGES

• Locate the TRIANGULAR BANDAGES

  

• How many TRINAGULAR BANDAGES are available ?

• Do the TRIANGULAR BANDAGES appear to be in GOOD CONDITION ? (Not tampered with, not opened, dirty, ect.)

  Yes

  No

• Use the triangular bandage with the expiry date closest to the current date of inspection for reference when answering the questions below

• Are the TRIANGULAR BANDAGES in date ?

  Yes

  No

• What is the EXPIRY DATE on the TRIANGULAR BANDAGES ?

  Date

• Is the EXPIRY DATE within the next 2 MONTHS ?

  Yes

  No

SAFETY PINS

• Locate the SAFETY PINS

  

• How many SAFETY PINS are available ?

• Do the SAFETY PINS appear to be in GOOD CONDITION ? (clean, free of rust, working condition, ect.)

  Yes

  No

MEDIUM STERILE DRESSINGS (12 X 12 CM)

• Locate the MEDIUM STERILE DRESSINGS (12 X 12 CM)

  

• How many MEDIUM STERILE DRESSINGS are available ?

• Do the MEDIUM STERILE DRESSINGS appear to be in GOOD CONDITION ? (Not tampered with, not opened, dirty, ect.)

  Yes

  No

• Use the medium sterile dressing with the expiry date closest to the current date of inspection for reference when answering the questions below

• Are the MEDIUM STERILE DRESSINGS in date ?

  Yes

  No

• What is the EXPIRY DATE on the SMALL STERILE DRESSINGS ?

  Date

• Is the EXPIRY DATE within the next 2 MONTHS ?

  Yes

  No

LARGE STERILE DRESSINGS (18 X 18 CM)

• Locate the LARGE STERILE DRESSINGS (18 X 18 CM)

  

• How many LARGE STERILE DRESSINGS are available ?

• Do the LARGE STERILE DRESSINGS appear to be in GOOD CONDITION ? (Not tampered with, not opened, dirty, ect.)

  Yes

  No

• Use the large sterile dressing with the expiry date closest to the current date of inspection for reference when answering the questions below

• Are the LARGE STERILE DRESSINGS in date ?

  Yes

  No

• What is the EXPIRY DATE on the LARGE STERILE DRESSINGS ?

  Date

• Is the EXPIRY DATE within the next 2 MONTHS ?

  Yes

  No

MOIST WIPES

• Locate the MOIST WIPES

  

• How many MOIST WIPES are available ?

• Do the MOIST WIPES appear to be in GOOD CONDITION ? (Not tampered with, not opened, dirty, ect.)

  Yes

  No

DISPOSABLE GLOVES

• Locate the DISPOSABLE GLOVES

  

• How many DISPOSABLE GLOVES are available ?

• Do the DISPOSABLE GLOVES appear to be in GOOD CONDITION ? (Not tampered with, damages, dirty, ect.)

  Yes

  No

• Please add any additional notes from your inspection below

EYEWASH STATION

• Locate the EYEWASH STATION

• Is the EYEWASH STATION easily ACCESSIBLE ? (No obstructions, is well lit, easy to reach)

  Yes

  No

• Is the EYEWASH STATION CLEAN ? (no dust, rust, water leaking or dirt in or on top of the station)

  Yes

  No

• Is the TAMPER SEAL intact and IN DATE (within the next 2 months) ?

  Yes

  No

EYEWASH BOTTLES

• Locate the EYEWASH BOTTLES

  

• How many EYEWASH BOTTLES are available ?

• Do the EYEWASH BOTTLES appear to be in GOOD CONDITION ? (Not tampered with, opened, dirty, ect.)

  Yes

  No

• Use the eyewash bottle with the expiry date closest to the current date of inspection for reference when answering the questions below

• Are the EYEWASH BOTTLES in date ?

  Yes

  No

• What is the EXPIRY DATE on the EYEWASH BOTTLE

  Date

• Is the EXPIRY DATE within the next 2 MONTHS ?

  Yes

  No

• Do the EYEWASH BOTTLES appear to have been used ?

  Yes

  No

EYEWASH PODS

• Locate the EYEWASH PODS

  

• How many EYEWASH PODS are available ?

• Do the EYEWASH PODS appear to be in GOOD CONDITION ? (Not tampered with, opened, dirty, ect.)

  Yes

  No

• Use the eyewash pods with the expiry date closest to the current date of inspection for reference when answering the questions below

• Are the EYEWASH PODS in date ?

  Yes

  No

• What is the EXPIRY DATE on the EYEWASH POD ?

  Date

• Is the EXPIRY DATE within the next 2 MONTHS ?

  Yes

  No

EYE PAD DRESSINGS

• Locate the EYE PAD DRESSINGS

  

• How many EYE PAD DRESSINGS are available ?

• Do the EYE PAD DRESSINGS appear to be in GOOD CONDITION ? (Not tampered with, opened, dirty, ect.)

  Yes

  No

• Use the eye pad dressings with the expiry date closest to the current date of inspection for reference when answering the questions below

• Are the EYE PAD DRESSINGS in date ?

  Yes

  No

• What is the EXPIRY DATE on the EYE PAD DRESSING ?

  Date

• Is the EXPIRY DATE within the next 2 MONTHS ?

  Yes

  No

MIRROR

• Is the MIRROR in GOOD CONDITION ? (Clean of dirt and fingerprints, no cracks)

  Yes

  No

• Please add any additional notes from your inspection below

FIRST AID KIT STATION

• Locate the FIRST AID KIT STATION

  

• Is the FIRST AID KIT STATION easily ACCESSIBLE ? (No obstructions, is well lit, easy to reach)

  Yes

  No

• Is the FIRST AID KIT STATION CLEAN ? (no dust, rust, no dirt in or on top of the station)

  Yes

  No

• Is the TAMPER SEAL intact and IN DATE (within the next 2 months) ?

  Yes

  No

WASHPROOF PLASTERS

• Locate the WASHPROOF PLASTERS

  

• How many WASHPROOF PLASTERS are available ?

• Do the WASHPROOF PLASTERS appear to be in GOOD CONDITION ? (Not tampered with, not opened, dirty, ect.)

  Yes

  No

• Use the washproof plaster packet with the expiry date closest to the current date of inspection for reference when answering the questions below

• Are the WASHPROOF PLASTERS in date ?

  Yes

  No

• What is the EXPIRY DATE on the WASHPROOF PLASTERS ?

  Date

• Is the EXPIRY DATE within the next 2 MONTHS ?

  Yes

  No

EYE PAD DRESSINGS

• Locate the EYE PAD DRESSINGS

  

• How many EYE PAD DRESSINGS are available ?

• Do the EYE PAD DRESSINGS appear to be in GOOD CONDITION ? (Not tampered with, not opened, dirty, ect.)

  Yes

  No

• Use the eye pad dressing with the expiry date closest to the current date of inspection for reference when answering the questions below

• Are the EYE PAD DRESSINGS in date ?

  Yes

  No

• What is the EXPIRY DATE on the EYE PADS WITH BANDAGES ?

  Date

• Is the EXPIRY DATE within the next 2 MONTHS ?

  Yes

  No

TRIANGULAR BANDAGES

• Locate the TRIANGULAR BANDAGES

  

• How many TRINAGULAR BANDAGES are available ?

• Do the TRIANGULAR BANDAGES appear to be in GOOD CONDITION ? (Not tampered with, not opened, dirty, ect.)

  Yes

  No

• Use the triangular bandage with the expiry date closest to the current date of inspection for reference when answering the questions below

• Are the TRIANGULAR BANDAGES in date ?

  Yes

  No

• What is the EXPIRY DATE on the TRIANGULAR BANDAGES ?

  Date

• Is the EXPIRY DATE within the next 2 MONTHS ?

  Yes

  No

SAFETY PINS

• Locate the SAFETY PINS

  

• How many SAFETY PINS are available ?

• Do the SAFETY PINS appear to be in GOOD CONDITION ? (clean, free of rust, working condition, ect.)

  Yes

  No

MEDIUM STERILE DRESSINGS (12 X 12 CM)

• Locate the MEDIUM STERILE DRESSINGS (12 X 12 CM)

  

• How many MEDIUM STERILE DRESSINGS are available ?

• Do the MEDIUM STERILE DRESSINGS appear to be in GOOD CONDITION ? (Not tampered with, not opened, dirty, ect.)

  Yes

  No

• Use the medium sterile dressing with the expiry date closest to the current date of inspection for reference when answering the questions below

• Are the MEDIUM STERILE DRESSINGS in date ?

  Yes

  No

• What is the EXPIRY DATE on the SMALL STERILE DRESSINGS ?

  Date

• Is the EXPIRY DATE within the next 2 MONTHS ?

  Yes

  No

LARGE STERILE DRESSINGS (18 X 18 CM)

• Locate the LARGE STERILE DRESSINGS (18 X 18 CM)

  

• How many LARGE STERILE DRESSINGS are available ?

• Do the LARGE STERILE DRESSINGS appear to be in GOOD CONDITION ? (Not tampered with, not opened, dirty, ect.)

  Yes

  No

• Use the large sterile dressing with the expiry date closest to the current date of inspection for reference when answering the questions below

• Are the LARGE STERILE DRESSINGS in date ?

  Yes

  No

• What is the EXPIRY DATE on the LARGE STERILE DRESSINGS ?

  Date

• Is the EXPIRY DATE within the next 2 MONTHS ?

  Yes

  No

MOIST WIPES

• Locate the MOIST WIPES

  

• How many MOIST WIPES are available ?

• Do the MOIST WIPES appear to be in GOOD CONDITION ? (Not tampered with, not opened, dirty, ect.)

  Yes

  No

DISPOSABLE GLOVES

• Locate the DISPOSABLE GLOVES

  

• How many DISPOSABLE GLOVES are available ?

• Do the DISPOSABLE GLOVES appear to be in GOOD CONDITION ? (Not tampered with, damages, dirty, ect.)

  Yes

  No

• Please add any additional notes from your inspection below