Title Page

  • Name of ward/department

  • Conducted on

  • Prepared by

  • Location
  • Please note that this inspection template is intended to provide guidance on the tasks that should be carried out and areas that should be examined. It is in no way intended to provide prescriptive rules on what must be done.

  • Reception/Waiting Room
  • Room/Location

Estates Tasks

  • Fans

  • Walls

  • Ceiling

  • All external glazing

  • Ventilation grilles

Cleaning Tasks

  • Switches, sockets, data points

  • Walls

  • All doors

  • All internal glazing (including partitions)

  • Mirrors

  • Radiators

  • Floor (Polished)

  • Floor (Non-slip)

  • Floor (Soft floor)

  • Electrical items

  • Low surfaces

  • High surfaces

  • Chairs

  • Tables

  • Hand hygiene/alcohol rub dispensers

  • Waste receptacles

  • Curtains/Blinds

  • Replenishment

  • Sinks/Hand-wash basins

  • Treatment Room
  • Treatment room description

Nursing Tasks

  • Weighing scales, manual handling equipment

  • Drip stands

  • Other medical equipment (NOT CONNECTED TO PATIENT)

  • Medical gas equipment

  • Notes and drugs trolley

Estates Tasks

  • Fans

  • Walls

  • Ceiling

  • All external glazing

  • Ventilation grilles

Cleaning Tasks

  • Bedside alcohol, clipboards and noticeboards

  • Switches, sockets, data points

  • Walls

  • All doors

  • All internal glazing (including partitions)

  • Mirrors

  • Radiators

  • Floor (Polished)

  • Floor (Non-slip)

  • Electrical items

  • Low surfaces

  • High surfaces

  • Chairs

  • Beds

  • Lockers

  • Tables

  • Hand wash/toilet roll/hand towel dispenser

  • Hand hygiene/alcohol rub dispensers

  • Waste receptacles

  • Curtains/Blinds

  • Replenishment

  • Sinks/hand-wash basins

  • Storeroom
  • Name/location of storeroom

Nursing Tasks

  • Weighing scales, manual handling equipment

  • Drip stands

  • Other medical equipment (NOT CONNECTED TO PATIENT)

  • Medical gas equipment

Estates Tasks

  • Fans

  • Walls

  • Ceiling

  • All external glazing

  • Ventilation grilles

Cleaning Tasks

  • Switches, sockets and data points

  • Walls

  • All doors

  • All internal glazing (including partitions)

  • Radiators

  • Floor (Non-slip)

  • Floor (Soft floor)

  • Electrical items

  • Cleaning equipment

  • Low surfaces

  • High surfaces

  • Stairwell
  • Stairwell description/location

Estates Tasks

  • Walls

  • Ceiling

  • All external glazing

  • Ventilation grilles

  • Low surfaces

  • High surfaces

Cleaning Tasks

  • Switches, sockets, data points

  • Walls

  • All doors

  • All internal glazing (including partitions)

  • Radiators

  • Floor (Polished)

  • Floor (Non-slip)

  • Low surfaces

  • High surfaces

  • Hand hygiene/alcohol rub dispensers

  • Curtains and blinds

  • Staff Room
  • Description/Location of staff room

Estates Tasks

  • Walls

  • Ceiling

  • All external glazing

  • Ventilation grilles

Cleaning Tasks

  • Switches, sockets, data points

  • Walls

  • All doors

  • All internal glazing (including partitions)

  • Mirrors

  • Radiators

  • Floor (Polished)

  • Floor (Non-slip)

  • Floor (Soft floor)

  • Electrical items

  • Low surfaces

  • High surfaces

  • Chairs

  • Tables

  • Lockers

  • Hand wash/toilet roll/hand towel dispenser

  • Hand hygiene/alcohol rub dispensers

  • Waste receptacles

  • Curtains and blinds

  • Fridges and freezers

  • Ice machines and hot water boilers

  • Kitchen/Storage cupboards

  • Microwaves

  • Replenishment

  • Sinks/hand-wash basins

  • Nurse Station
  • Location/Description of nurse station

Nursing Tasks

  • Weighing scales, manual handling equipment

  • Other medical equipment (NOT CONNECTED TO PATIENT)

  • Notes and drugs trolley

Estates Tasks

  • Fans

  • Walls

  • Ceiling

  • All external glazing

  • Ventilation grilles

Cleaning Tasks

  • Switches, sockets, data points

  • Walls

  • All doors

  • All internal glazing (including partitions)

  • Mirrors

  • Radiators

  • Floor (Polished)

  • Electrical items

  • Low surfaces

  • High surfaces

  • Chairs

  • Tables

  • Hand wash/toilet tissue/hand towel dispenser

  • Hand hygiene/alcohol rub dispensers

  • Waste receptacles

  • Curtains and blinds

  • Replenishment

  • Sinks/hand-wash basins

  • Office
  • Office description/location

Nursing Tasks

  • Electrical Items

Estates Tasks

  • Fans

  • Walls

  • Ceiling

  • All external glazing

  • Ventilation grilles extract and inlets

Cleaning Tasks

  • Switches, sockets, data points

  • Walls

  • All doors

  • All internal glazing (including partitions)

  • Mirrors

  • Radiators

  • Floor (Polished)

  • Floor (Non-slip)

  • Floor (Soft floor)

  • Electrical items

  • Low surfaces

  • High surfaces

  • Chairs

  • Tables

  • Hand wash/toilet roll/hand towel dispenser

  • Hand hygiene/alcohol rub dispensers

  • Waste receptacles

  • Curtains and blinds

  • Replenishment

  • Sinks/hand-wash basins

  • Kitchen
  • Location/Description of kitchen

Estates Tasks

  • Ceiling

  • All external glazing

  • Ventilation grilles

  • Pest control devices

Cleaning Tasks

  • Switches, sockets, data points

  • Walls

  • All doors

  • All internal glazing including partitions

  • Radiators

  • Floor (Polished)

  • Floor (Non-slip)

  • Electrical items

  • Low surfaces

  • High surfaces

  • Hand wash/toilet roll/hand towel dispenser

  • Waste receptacles

  • Dishwashers

  • Fridges and freezers

  • Kitchen/Storage cupboards

  • Microwaves

  • Replenishment

  • Sinks/hand-wash basins

  • Waste Cupboard
  • Waste cupboard location

Estates Tasks

  • Walls

  • Ceiling

  • Ventilation grilles extract and inlets

Cleaning Tasks

  • Switches, sockets, data points

  • Walls

  • All doors

  • All internal glazing (including partitions)

  • Floor (Non-slip)

  • Low surfaces

  • High surfaces

  • Waste receptacles

  • Entrance
  • Entrance location

Estates Tasks

  • Walls

  • Ceiling

  • All external glazing

  • Ventilation grilles

Cleaning Tasks

  • Switches, sockets, data points

  • Walls

  • All doors

  • All internal glazing (including partitions)

  • Mirrors

  • Radiators

  • Floor (Polished)

  • Floor (Non-slip)

  • Floor (Soft floor)

  • Low surfaces

  • High surfaces

  • Chairs

  • Tables

  • Hand wash containers

  • Hand hygiene/alcohol rub dispensers

  • Replenishments

  • Sinks

  • Domestic Cupboard
  • Description/Location of domestic cupboard

Estates Tasks

  • Walls

  • Ceiling

  • All external glazing

  • Ventilation grilles

Cleaning Tasks

  • Switches, sockets, data points

  • Walls

  • All doors

  • All internal glazing (including partitions)

  • Radiators

  • Floor (Polished)

  • Floor (Non-slip)

  • Floor (Soft floor)

  • Electrical items

  • Cleaning equipment

  • Low surfaces

  • High surfaces

  • Hand wash/toilet tissue/hand towel dispenser

  • Waste receptacles

  • Curtains and blinds

  • Kitchen/Storage cupboards

  • Replenishment

  • Sinks/hand-wash basins

  • Dirty Utility
  • Description

Estates Tasks

  • Walls

  • Ceiling

  • All external glazing

  • Ventilation grilles

Cleaning Tasks

  • Commodes

  • Switches, sockets, data points

  • Walls

  • All doors

  • All internal glazing (including partitions)

  • Radiators

  • Floor (Polished)

  • Floor (Non-slip)

  • Floor (Soft floor)

  • Low surfaces

  • High surfaces

  • Tables

  • Hand wash/toilet roll/hand towel dispenser

  • Hand hygiene/alcohol rub dispensers

  • Waste receptacles

  • Curtains and blinds

  • Kitchen/Storage cupboards

  • Replenishment

  • Sinks/hand-wash basins

  • Clean Utility
  • Description/Location

Nursing Tasks

  • Weighing scales, manual handling equipment

  • Notes and drugs trolley

Estates Tasks

  • Walls

  • Ceiling

  • All external glazing

  • Ventilation grilles

Cleaning Tasks

  • Commodes

  • Switches, sockets, data points

  • Walls

  • All doors

  • All internal glazing (including partitions)

  • Radiators

  • Floor (Polished)

  • Floor (Non-slip)

  • Floor (Soft floor)

  • Low surfaces

  • High surfaces

  • Hand wash/toilet roll/hand towel dispenser

  • Hand hygiene/alcohol rub dispensers

  • Waste receptacles

  • Curtains and blinds

  • Kitchen/Storage cupboards

  • Replenishment

  • Sinks/hand-wash basins

  • W/C
  • WC Location

Estates Tasks

  • Walls

  • Ceiling

  • Ventilation grilles

Cleaning Tasks

  • Switches, sockets, data points

  • Walls

  • All doors

  • Mirrors

  • Radiators

  • Floor (Polished)

  • Floor (Non-slip)

  • Low surfaces

  • High surfaces

  • Chairs

  • Hand wash/toilet roll/hand towel dispenser

  • Waste receptacles

  • Curtains and blinds

  • Toilets and bidets

  • Replenishment

  • Sinks/Hand-wash basins

  • Bathroom/Shower
  • Bathroom/Shower location

Estates Tasks

  • Walls

  • Ceiling

  • Ventilation grilles

Cleaning Tasks

  • Switches, sockets, data points

  • Walls

  • All doors

  • Mirrors

  • Radiators

  • Floor (Polished)

  • Floor (Non-slip)

  • Low surfaces

  • High surfaces

  • Chairs

  • Hand wash/toilet roll/hand towel dispenser

  • Waste receptacles

  • Curtains and blinds

  • Showers

  • Toilets and bidets

  • Replenishment

  • Sinks/hand-wash basins

  • Baths

  • Bed area
  • Description/Location of bed area

Nursing Tasks

  • Drip stands

  • Medical equipment (CONNECTED TO PATIENT)

  • Other medical equipment (NOT CONNECTED TO PATIENT)

  • Medical gas equipment

  • Notes and drugs trolley

  • 12. Patient personal items e.g. cards, suitcase

Estates Tasks

  • Fans

  • Walls

  • Ceiling

  • All external glazing

  • Ventilation grilles

Cleaning Tasks

  • Bedside alcohol, clipboards and notice boards

  • Switches, sockets, data points

  • Walls

  • All doors

  • All internal glazing (including partitions)

  • Mirrors

  • Patient entertainment in bay

  • Radiators

  • Floor (Polished)

  • Floor (Non-slip)

  • Electrical items

  • Cleaning equipment

  • Low surfaces

  • High surfaces

  • Chairs

  • Beds

  • Lockers

  • Tables

  • Hand wash/toilet roll/hand towel dispenser

  • Hand hygiene/alcohol rub dispensers

  • Waste receptacles

  • Curtains and blinds

  • Replenishment

  • Sinks/Hand-wash basins

  • Consultation/Examination Room
  • Name/Description of consultation/examination room

Nursing Tasks

  • Weighing scales, manual handling equipment

  • Other medical equipment (NOT CONNECTED TO PATIENT)

  • Notes and drugs trolley

Estates Tasks

  • Fans

  • Walls

  • Ceiling

  • All external glazing

  • Ventilation grilles

Cleaning Tasks

  • Switches, sockets, data points

  • Walls

  • All doors

  • All internal glazing (including partitions)

  • Mirrors

  • Radiators

  • Floor (Polished)

  • Floor (Non-slip)

  • Floor (Soft floor)

  • Electrical items

  • Low surfaces

  • High surfaces

  • Chairs

  • Tables

  • Hand wash/toilet tissue/hand towel dispenser

  • Hand hygiene/alcohol rub dispensers

  • Waste receptacles

  • Curtains and blinds

  • Replenishment

  • Sinks/hand-wash basins

  • Corridors
  • Corridor location

Estates Tasks

  • Walls

  • Ceiling

  • All external glazing

  • Ventilation grilles

Cleaning Tasks

  • Switches, sockets, data points

  • Walls

  • All doors

  • All internal glazing (including partitions)

  • Radiators

  • Floor (Polished)

  • Floor (Non-slip)

  • Floor (Soft floor)

  • Electrical items

  • Cleaning equipment

  • Low surfaces

  • High surfaces

  • Chairs

  • Hand wash/toilet roll/hand towel dispenser

  • Hand hygiene/alcohol rub dispensers

  • Curtains and blinds

  • Replenishment

  • Sinks/hand-wash basins

  • Approach Corridor
  • Corridor location

Estates Tasks

  • Walls

  • Ceiling

  • All external glazing

  • Ventilation grilles

Cleaning Tasks

  • Switches, sockets and data points

  • Walls

  • All doors

  • All internal glazing (including partitions)

  • Radiators

  • Floor (Polished)

  • Floor (Non-slip)

  • Floor (Soft floor)

  • Low surfaces

  • High surfaces

  • Chairs

  • Hand wash/toilet roll/hand towel dispenser

  • Hand hygiene/alcohol rub dispensers

  • Curtains and blinds

  • Replenishment

  • Sinks/hand-wash basins

  • Day/Quiet room
  • Location/Description of day/quiet room

Estates Tasks

  • Walls

  • Ceiling

  • All external glazing

  • Ventilation grilles

Cleaning Tasks

  • Switches, sockets and data points

  • Walls

  • All doors

  • All internal glazing (including partitions)

  • Radiators

  • Floor (Polished)

  • Floor (Soft Floor)

  • Electrical items

  • Low surfaces

  • High surfaces

  • Chairs

  • Tables

  • Hand wash/toilet tissue/hand towel dispenser

  • Hand hygiene/alcohol rub dispensers

  • Waste receptacles

  • Curtains and blinds

  • Replenishment

  • Sinks/hand-wash basins

Sign-Off

  • Closing comments

  • Signature (Auditor)

  • Signature (Ward/Senior Manager)

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.