HIPAA Annual Risk Analysis - duplicate

• Conducted on

  Date

• Prepared by

• Location
  Address

Devices (computers, printers, iPads, etc)

• Are devices in good working order?

  Yes

  No

  N/A

• If any device is less than in GOOD working order, record details.

• Are devices free of visual damage?

  Good

  Fair

  Poor

  N/A

• If any device has any damage, record details.

• Are passwords stored on devices in a manner that allows others to use access to secured passwords (on sticky notes, etc.)

  Yes

  No

  N/A

• If yes, record details.

• Do devices match Asset Guard information?

  Yes

  No

  N/A

• If no, record details.

• Has all information been updated in Asset Guard for this date’s inspection?

  Yes

  No

  N/A

• If no, record details.

• Are devices stored in a secure location when not in use?

  Yes

  No

  N/A

• Record details. Include storage location and if location is locked?

• Do all devices have chargers?

  Yes

  No

  N/A

• If no, record details.

• Do all devices hold a charge adequately?

  Yes

  No

  N/A

• If no, record details.

• Are there any other needs for devices that should be followed up?

  Yes

  No

  N/A

• If yes, what needs are being addressed?

• Do any employees leave the facility at any time with devices?

  Yes

  No

  N/A

• If yes, does this employee have written approval to remove device from facility? (Attach documentation)

• Are all rehabilitation department areas secure when not in use?

  Yes

  No

  N/A

• How are areas secured?

• Is there printed or written PHI in the department areas?

  Yes

  No

  N/A

• If yes, describe what manner of PHI?

• Is printed or written PHI the minimum necessary to fulfill job requirements?

  Yes

  No

  N/A

• If no, record details.

• Is PHI secured properly?

  Yes

  No

  N/A

• If no, record details.

• Do any employees leave the facility at any time with written or printed PHI?

  Yes

  No

  N/A

• If yes, record details.

• Yes

  No

  N/A