Hospital Safety Rounds by floor

• Conducted on

  Date

• Prepared by

• Location

  Select

• Floor

Fire Prevention Life Safety

• Automatic fire doors free from obstacles and positively latch when activated? (Doorways should not be blocked or wedged.)

  Yes

  No

  N/A

• Eighteen-inch clearance from ceiling is maintained?

  Yes

  No

  N/A

• Halls/Corridors uncluttered and accessible?

  Yes

  No

  N/A

• Doors and exits obstructed ie; boxes blocking exits or clutter or equipment blocking exits?

  Yes

  No

  N/A

• Fire doors close and latch?

  No

  N/A

  Yes

• Smoke doors close?

  No

  N/A

  Yes

• Are portable heaters being used and if so is it authorized per the first response plan?

  No

  N/A

  Yes

• Exit signs illuminated?

  No

  N/A

  Yes

• Fire alarms accessible?

  No

  N/A

  Yes

• Fire extinguishers accessible?

  No

  N/A

  Yes

• Flammable and hazardous materials properly stored and labeled?

  No

  N/A

  Yes

• Smoke detectors unobstructed?

  No

  N/A

  Yes

• Sprinklers unobstructed?

  No

  N/A

  Yes

General Safety Management

• Hearing protection is available in loud noise areas?

  Yes

  No

  N/A

• Hearing protection required signs posted in loud noise areas?

  Yes

  No

  N/A

• Eyewash stations: Inspection tags are present and up to date?

  Yes

  No

  N/A

• Warning signs or barricades are placed when work creates a hazard (wet floor, maintenance work in ceiling)?

  Yes

  No

  N/A

• Electrical cords and plugs in a safe condition?

  No

  N/A

  Yes

• Electrical panels accessible (3')?

  No

  N/A

  Yes

• Emergency reference guides available?

  No

  N/A

  Yes

• Stairwells clear?

  No

  N/A

  Yes

• Storage and mechanical rooms clean?

  No

  N/A

  Yes

Hazardous Materials

• Are rooms kept clean and tidy?

  No

  N/A

  Yes

• Are Hazardous Materials entered into Chem Watch?

  No

  N/A

  Yes

• PPE readily available and used?

  No

  N/A

  Yes

• Sharps container overfilled?

  No

  N/A

  Yes

• Date of when last update of Hazardous Material List in Chem Watch?

  No

  N/A

  Yes

• Products properly labeled and stored?

  No

  N/A

  Yes

Waste Management

• Is PHI being disposed of properly?

  Yes

  No

  N/A

• Appropriate items in general trash?

  No

  N/A

  Yes

• Appropriate items in red bags?

  No

  N/A

  Yes

• Appropriate items in RCRA bins?

  No

  N/A

  Yes

• Are Deterra containers closed?

  No

  N/A

  Yes

• Appropriate items in sharps container?

  No

  N/A

  Yes

• Are items being distributed into proper waste streams?

  No

  N/A

  Yes

Additional findings or issues?

• Additional issues or findings?

  Yes

  No

  N/A