Title Page

  • Building

  • Location

  • Inspected by

  • Inspection Date

  • Are there at least 3 cleansing towelettes inside the kit?

  • Is the packaging of the cleansing towelettes tampered with or opened?

  • Has the expiration date of the cleaning towelettes passed?

  • Are there at least 3 alcohol wipes inside the kit?

  • Is the packaging of the alcohol wipes tampered with or unsealed?

  • Has the expiration date of the alcohol wipes passed?

  • Is there antibiotic ointment in the kit?

  • Is the packaging of the antibiotic ointment tampered with or unsealed?

  • Has the expiration date of the ointment passed?

  • Is there a cold compress in the kit?

  • Does the cold compress appear to be soiled, dirty, or previously used?

  • Are there at least 5 adhesive bandages in the kit?

  • Are there small gauze pads (2"x2") in the kit?

  • Are there large gauze pads (4"x4") in the kit?

  • Is there rolled gauze in the kit?

  • Is there adhesive tape in the kit?

  • Are there tweezers in the kit?

  • Is there at least 2 pairs of medical gloves in the kit?

  • Do the medical gloves appear to be used?

  • Are there any rips or tears in the gloves?

  • Are there directions for first aid and how to request medical assistance in the kit or within visible distance from the kit?

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