Information

  • Document No.

  • This is your EOC Rounds Report. Please respond within 15 days with corrections. Thank you: Roger Diller 580-213-2504

  • Client / Site

  • Conducted on

  • Location

EC related items

  • Ceiling tiles are in place, not moldy or broken.

  • Sprinkler escutcheon are in place and properly seated.

  • Are all stairwells free of stored items and no penetrations in walls?

  • Fire extinguisher, pull station and medical gas shut offs unobstructed?

  • Plumbing escutcheons in place and no holes or other than cleaning supplies in cabinet under sinks.

  • Are cables and wire neatly secured and out of the way under desks and work areas?

  • Is storage >18” below sprinkler heads?

  • Are floors clean and free of slip hazards?

  • Are all patients sleeping room doors unobstructed (doors can close & latch)? doors blocked open?

  • Are corridors clear of non-movable items and all carts on one side of corridor?

  • Are fire extinguishers & hose cabinets unobstructed? inspections current?

  • No candles with wicks, or fragrance devices?

  • Are all compressed gas tanks secured in a rack or holder? Less than 12 new cylinders in smoke zone?

  • Do all smoke & fire doors latch & close properly (top, bottom, and center)?

  • Appropriate temp, humidity and airflow relationships observed?

  • Is emergency equipment connected to red outlets?

  • Are EXIT signs illumination working? Egress route clearly marked?

  • Med cart/Drugs/Needles locked or secured?

  • Employee purses secured?

  • Are call cords in appropriate locations, appropriate length, and unobstructed?

  • Space heaters are in appropriate locations and of appropriate type?

  • Are patient records appropriately covered? HIPPA?

  • Are all public area electric breaker boxes locked?

  • Are all employees, physicians and contractors wearing ID Badges?

  • Are all chemicals/containers labeled?

  • Eye wash if needed is there and being inspected?

  • Additional Comments.

IC related items

  • Refrigerator signs appropriate and appropriate items stored in refrigerator?

  • Soap, towels & hand sanitizer are readily available?

  • No boxes on the floor? No corrugated boxes in patient care area or food storage.

  • No excessive trash/linen in soiled utility rooms and labeled correctly?

  • PPE boxes fully stocked?

  • Temp / Crash cart logs Complete?

  • Are needle / sharp boxes secured and less than 2/3rds full.

  • Are all areas / rooms (fixtures/surfaces, vents) clean and free of dust accumulation?

  • All linen covered or in linen only room with door closed?

  • WOW and mouse appropriately cleaned without dust and spots?

  • Pill crusher / Splitter, glucometer and patient care equipment clean?

  • Washer/dryer disinfection between patient use documented? Lint filter cleaned?

  • Disinfection of community sinks,showers, tubs, etc. between patient use documented?

  • No expired medicines or supplies? Stock rotated to front?

  • 6 inch splash zone around sink maintained?

  • Refrigerators, microwaves etc. clean and free of defects?

  • Isolation carts adequately stocked and appropriate signage on door?

  • Are clean / dirty supplies, equip., etc. appropriately separated and bagged?

  • Employee food and covered drinks in appropriate areas?

  • Additional comments

  • name

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