1. Answer "Yes", "No", "N/A" for the questions below.
2. Add photos and notes by clicking on the paperclip icon.
3. To add a Corrective Measure click on the paperclip icon then "Add Action", provide a description, assign to a member, set priority and due date.
4. Complete audit by providing digital signature.
5. Share your report by exporting as PDF, Word, Excel or Web Link.
1.1 - Has the last inspection been reviewed?
2.1 - Door wedged or propped open, none found?
2.2 - Fire doors are not blocked by carts, equipment, or materials?
2.3 - Extinguishers is not missing damaged, or discharged?
2.4 - Extinguishers has current inspection documentation?
2.5 - Extinguishers clear of obstructions?
2.6 - Sprinkler Heads/Smoke Detectors are clean & intact?
2.7 - Indicator Lights are not obstructed?
2.8 - Fire Exit signs are illuminating and working properly?
2.9 - Fire Doors close and latch properly?
2.10 - Storage is less than 18" from ceiling?
2.11 - Doors to Soiled/Clean/Hazardous Materials Rooms closed locked?
2.12 - Emergency Exit Corridors / Doors are clear?
2.13 - All wheeled equipment in corridor is "attended"?
2.14 - Flammables, stored appropriately?
2.15 - Penetrations to Walls / Ceilings / Floors, not present?
2.16 - No unauthorized space heaters present?
2.17 - No unauthorized heat producing equipment present (Toasters, etc)
2.18 -Trash containers are no more than 32-gallons in capacity.
3.1 - Electrical outlets are not damaged or loose?
3.2 - Critical equipment is plugged into Red Outlet?
3.3 - All extension cords are equipped with a ground prong?
3.4 - All switches, receptacles and computer boxes have covers or plates?
3.5 - Electrical panels are accessible - 36" clearance around panels.
4.2 - All wheelchairs are in good repair and with both footrest?
4.1 - Handrails are attached firmly to the walls?
4.4 - Floors - tiles, carpet in good repair - no trip hazards?
4.5 - Stairwell lights working?
4.6 - Storage Rooms clean and orderly?
4.7 - No items are being stored under the sinks?
4.8 - Step ladders available to reach high places are in good shape?
4.9 - No electrical cords, telephone and computer wires in area that might entangle feet?
4.10 - Desk, chairs, furniture in safe condition?
4.11 - Patient Room furniture in safe condition?
4.12 - No evidence of food, drinks or eating occurring around computers or nurse station?
4.13 - Storage is at least 6" from the floor. No boxes on the floor?
5.1 - Eye wash station inspected weekly and documented?
5.2 - High level disinfectant policy being followed - QC, documentation, etc?
5.3 - Medical gas cylinders are stored where full and empties are separated?
5.4 - Medical gas cylinders are restrained properly in bins, racks, or hand carts?
5.5 - Biohazard containers are stored properly?
5.6 - Sharps boxes are no more than 3/4 full; syringe disposed of properly?
5.7 - Staff are able to obtain a MSDS?
5.8 - Secondary container are labeled properly?
5.9 - Hazardous materials properly stored?
6.1 - Employee personal items are secured out of sight?
6.2 - Employee I.D. Badges visible and worn properly?
6.3 - Confidential Materal secured /protected?
6.4 - High risk patient's, equipment areas, hazardous material area rooms are secure?
6.5 - Medications secured?
6.6 - Doors with security hardware operate properly?
6.7 - Code carts locked and in view of staff?
7.1 - All lights are operational, no lights out?
7.2 - Ceiling tiles, none discolored,/wet/damaged?
7.3 - HVAC System - Air temperature within condor table range?
7.4 - Plumbing, faucets,, toilets operational (no leaks)?
7.5 - Ice machine clean and maintenance on schedule?
7.6 - Lights in nearest stairwell operational?