Information
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Location
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Conducted on
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Prepared by
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Are permits displayed?
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Are construction personnel wearing proper PPE?
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Are air pressure barriers active? (Negative pressure maintained with HEPA filters, exhaust fans functioning, air quality adequate, no excess fumes/vapors)
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Are contractors following safe work practices? (Observe for trip and fall hazards, ladder safety, smoking rules met)
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Is the construction area secure? (Barriers adequate to prevent entry of unauthorized persons, vermin, etc.)
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Are patient care items and equipment removed from the construction area?
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Is the construction entry and adjacent area free of dust and debris?
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Are construction carts covered during transport of materials?
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Are construction personnel and materials transported on dedicated elevators? ( non patient use elevators)
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Has existing ductwork been sealed or covered?
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Is adequate signage in place?
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Signature
