• Audit Title

  • Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Fire Prevention

  • Fire doors close and latch?

  • Smoke doors close?

  • Doors wedged?

  • Exit signs illuminated?

  • Fire alarms accessible?

  • Fire extinguishers accessible?

  • Flammables stored appropriately?

  • Medical gas stored appropriately?

  • Appropriately Use of bulk medical gas storage rooms?

  • Smoke detectors unobstructed?

  • Sprinklers unobstructed?

  • Appropriate use of decorations?

  • Fire and smoke barrier penetrations sealed?

Security Management

  • Medications secured?

  • Syringes and needles secured?

  • Medical records secured?

  • Staff wearing IDs?

  • Belongings secured?

Log Sheet Documentation

  • Crash carts - daily?

  • Refrigerators - daily?

  • Fire Extinguishers - monthly?

Safety Management

  • Electrical cords and plugs in a safe condition?

  • Extension cords are not in use?

  • GFI outlet within 6' of water source?

  • Electrical panels accessible (3')?

  • Corridors unobstructed?

  • Emergency reference guides available?

  • Flashlights available?

  • Lifting equipment available?

  • Stairwells clear?

  • Step stools available?

  • Storage and mechanical rooms clean?

Utilities Management

  • Ceiling tiles stained?

  • Oxygen shut off valves labeled?

Clinical Equipment

  • Current PM sticker?

  • Alarms disabled?

Hazardous Materials

  • Appropriate use of utility rooms?

  • Sharps containers overfilled?

  • PPE available?

  • Products properly labeled and stored?

Infection Control

  • Hand-washing observed?

  • Isolation precautions followed?

  • Linen covered?

Waste Management

  • Appropriate items in general trash?

  • Appropriate items in red bags?

  • Appropriate items in RCRA cans?

  • Appropriate items in sharps container?

  • Appropriate handling of waste streams?

Recommended Follow-up?

  • Follow-up for manager?

  • Follow-up for Facilities?

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.