Great Lakes Management Facility Inspection

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

Ensure that the workplace is safe in accordance with the PREVENT General Industry Guide:

• Safety Committee has Regular Meetings that are Documented<br>Management & employee equally represented?

  Yes

  No

  N/A

• Bloodborne Pathogens Training, sharps containers in use, BBP clean up kits available

  Yes

  No

  N/A

• Isolation Equipment / Personal Protective Equipment<br>Proper Use?

  Yes

  No

  N/A

• Extension Cords are Used Properly - Temporary Use Only

  Yes

  No

  N/A

• First Aid & CPR<br>with no EMS Response within 4 minutes<br>Training every 2 years?<br>

  Safe

  At Risk

  N/A

• Rugs, Floors, Surfaces free of Trip & Fall Hazards

  Yes

  No

  N/A

• Door Security Maintained for Resident Safety

  Yes

  No

  N/A

Resident Transfer Equipment in Good Condition

• First Aid Properly Stocked

  Yes

  No

  N/A

• To the Best of Your Knowledge All Other Hazards are Controlled?

  Yes

  No

  N/A

• Unaccompanied medcarts locked

  Yes

  No

  N/A

• No exposed sharps

  Yes

  No

  N/A

• Appropriate Transfer Techniques in Use

  Yes

  No

  N/A

• Appropriate handwashing/glove use techniques used

  Yes

  No

  N/A