Audit

Instructions:
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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.

1.0 - Previous inspection

1.1 - Has the last inspection been reviewed?

2.0 - Fire Prevention

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.

3.0 - Electrical Safety

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.

4.0 - General Safety

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?

5.0 - Hazardous Marerial

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?

6.0 - Security Management

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?

7.0 - Utilities Management

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?

Completion

Additional Comments:

Audited by:
Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.