First Aid Room Inspection

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

Condition of First Aid Room

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• Is the room adequately ventilated?

  Yes

  No

  N/A

• Is there a sink plumbed into the room?

  Yes

  No

  N/A

• Is the first aid room at least 100 square feet?

  Yes

  No

  N/A

• Is there access to 45 liters of potable water?

  Yes

  No

  N/A

• Is there access to hot water?

  Yes

  No

  N/A

• Is the floor non-porous?

  Yes

  No

  N/A

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Signage

• Is there a notice posted on the outside for how to summon or find the first aid attendant?

  Yes

  No

  N/A

• Is there a no smoking sign posted inside the first aid room?

  Yes

  No

  N/A

• Is there a no smoking sign posted at the entrance to the first aid room?

  Yes

  No

  N/A

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Location and access

• Is the first aid room located as near to the work area as practicable?

  Yes

  No

  N/A

• Is the first aid room within a building?

  Yes

  No

  N/A

• Can a stretcher enter the room without having to be tipped or turned?

  Yes

  No

  N/A

• Is the facility locked to prevent theft and vandalism?

  Yes

  No

  N/A

Utlities

• Is the room clean?

  Yes

  No

  N/A

• Is the room adequately heated?

  Yes

  No

  N/A

• Is the room warm?

  Yes

  No

  N/A

• Is the room dry?

  Yes

  No

  N/A

• Is the room adequately illuminated?

  Yes

  No

  N/A

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• 3 blankets

  0

  1

  2

  3

• Non-Porous Mattress

  Yes

  No

  N/A

• Pillows with non porous surface

  0

  1

  2

• Sheets

  0

  1

  2

  3

  4

• Refuse pail with lid

  Yes

  No

  N/A

• Package of paper towels

  Yes

  No

  N/A

• Eye cup

  Yes

  No

  N/A

• Safety Pins

  0

  1-10

  11-17

  18

• 4.5 kg sand bags

  0

  1

  2

• 11.5 cm stainless steel sliver forceps

  Yes

  No

  N/A

• 15 cm stainless steel thin nosed plier-type forceps

  Yes

  No

  N/A

• 14 cm stainless steel bandage scissors

  Yes

  No

  N/A

• Universal scissors

  Yes

  No

  N/A

• Oral thermometer

  Yes

  No

  N/A

• Nail brush

  Yes

  No

  N/A

• Penlight or flashlight with batteries

  Yes

  No

  N/A

• Patient assessment charts

  0

  1-25

  26-49

  50

• First aid record book with pen/pencil

  Yes

  No

  N/A

• 14 cm x 19 cm antiseptic towelettes, individually packaged

  Yes

  No

  N/A

• 150 ml liquid antibacterial soap

  Yes

  No

  N/A

• eye lamp, self illuminating, magnifying

  Yes

  No

  N/A

• cold packs

  0

  1-5

  6

• expanded metal splints, minimum length 60 cm

  0

  1-11

  12

• tongue depressors

  0

  1-49

  50

• Cotton tip applicators

  0

  1-99

  100

• 30 g tubes water soluble burn treatment

  0

  1

  2

• 100 ml liquid adhesive tape remover

  Yes

  No

  N/A

• sterile adhesive dressings (band-aids)

  Yes

  No

  N/A

• sterile skin closures

  0

  1-49

  50

• 20 cm x 25 cm sterile abdominal dressings, individually packaged

  0

  1-5

  6

• sterile eye pads, individually packaged

  0

  1-5

  6

• 30 cm x 40 cm sterile abdominal dressings, individually packaged

  0

  1-5

  6

• 7.5 cm x 7.5 cm gauze sponges

  0

  1-199

  200

• 7.5 cm x 7.5 cm sterile gauze dressings, individually packaged

  0

  1-71

  72

• 10 cm x 10 cm sterile gauze dressings, individually packaged

  0

  1-71

  72

• 10 cm x 16.5 cm sterile pressure dressings with crepe ties

  0

  1-5

  6

• 2.5 cm x 4.5 m adhesive crepe bandages

  0

  1

  2

• 2.5 cm x 4.5 m rolls of adhesive tape

  0

  1

  2

  3

  4

• 5 cm x 4.5 m rolls of adhesive tape

  0

  1-2

  3

• 7.5 cm x 4.5 m crepe roller bandages

  0

  1-5

  6

• 7.5 cm x 4.5 m esmarch gum rubber bandage

  Yes

  No

  N/A

• 5 cm x 1.8 m conforming gauze roller bandages

  0

  1-3

  4

• 7.5 cm x 1.8 m conforming gauze roller bandages

  0

  1-3

  4

• cotton triangular bandages, minimum length of base 1.25 m

  Yes

  No

  N/A

• 4.5 m tubular finger bandage with applicator

  Yes

  No

  N/A

• 500 ml sterile 0.9% sodium chloride solution (saline)

  0

  1

  2

• kidney basin

  Yes

  No

  N/A

• wash basin

  Yes

  No

  N/A

• cold instrument sterilizer

  Yes

  No

  N/A

• 4.5 liter non-rusting germicidal solution for instrument tray

  Yes

  No

  N/A

• chair suitable for treating injured worker with non-porous surface or covered with non-porous material

  Yes

  No

  N/A

• portable urinal, if overnight care may be required

  Yes

  No

  N/A

• bedpan, if overnight care may be required

  Yes

  No

  N/A

• Oxygen Therapy Unit

  Yes

  No

  N/A

• Portable suction unit

  Yes

  No

  N/A

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Equipment Needs

Facility Improvements

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