Joint Commission Readiness

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Units/Floors

• Does a staff member understand the Right to Know and SDS information?

  Yes

  No

  N/A

• Can a staff member say where the SDS info can be found?

  Yes

  No

  N/A

• Can a staff member speak to proper dwell times for the quat and bleach products?

  Yes

  No

  N/A

• Are individual bottles of quat labeled correctly?

  Yes

  No

  N/A

• Are all chemical labels in good condition and legible?

  Yes

  No

  N/A

• Are the areas free of any expired chemicals?

  Yes

  No

  N/A

• Can a staff member speak about education on any new cleaning products?

  Yes

  No

  N/A

• Can a staff member explain their role in safety?

  Yes

  No

  N/A

• Can a staff member articulate their role when a disaster plan is paged overhead?

  Yes

  No

  N/A

• Can staff demonstrate where to locate disaster plans and policies on Insite?

  Yes

  No

  N/A

• Can a staff member explain the evacuation plan in their area?

  Yes

  No

  N/A

• Can a staff member explain the SW for cleaning a patient room and restroom along with the proper chemicals for each step?

  Yes

  No

  N/A

• Are goggles being used properly?

  Yes

  No

  N/A

• Are the cleaning carts locked and secured?

  Yes

  No

  N/A

• Are the chemical stored away from the paper products?

  Yes

  No

  N/A

• Are the cleaning carts clear of any door props?

  Yes

  No

  N/A

• Do staff demonstrate wash in/wash out?

  Yes

  No

  N/A

• Are the cleaning carts always in the line of vision of the cleaner when in use and outside of the room they are cleaning?

  Yes

  No

  N/A

• Are wet floors signs put away after floors are dried?

  Yes

  No

  N/A

• Eyewash stations are present and marked in areas where chemicals require a 15 minutes flush?

  Yes

  No

  N/A

• Are the eyewash station logs up to date?

  Yes

  No

  N/A

• Are the ceiling tiles in good shape?

  Yes

  No

  N/A

• Lights and Light fixtures are working and clean?

  Yes

  No

  N/A

• Do all wall postings meet applicable fire safety code?

  Yes

  No

  N/A

• Are the walls and floors in good repair?

  Yes

  No

  N/A

• Are objects in the hallways being used once every 30 minutes?

  Yes

  No

  N/A

• Are the hallways clear of clutter and obstructions?

  Yes

  No

  N/A

• Are the electrical panels unobstructed and locked?

  Yes

  No

  N/A

• Are the fire extinguishers, pull stations, and gas valves unobstructed?

  Yes

  No

  N/A

• Are the sprinkler heads clean?

  Yes

  No

  N/A

• Are work areas free of staff food, drinks, and personal items? This includes carts and closets and all work areas.

  Yes

  No

  N/A

• Are all janitor closets locked and secured?

  Yes

  No

  N/A

• Is the cleaning equipment in good condition?

  Yes

  No

  N/A

• Are all areas under sinks clear of storage items?

  Yes

  No

  N/A

• Are the splash zones around sinks clear of paper products up to 3 feet?

  Yes

  No

  N/A

• Are soiled and clean items stored properly?

  Yes

  No

  N/A

• Items are stored properly 18 inches below ceiling and 6 inches above floor?

  Yes

  No

  N/A

• High dusting in areas is being completed?

  Yes

  No

  N/A

• Are the storage rooms clear of dust under equipment?

  Yes

  No

  N/A

• Overall appearance of the department is clean and clutter free?

  Yes

  No

  N/A

• The ice machines are clean and free of lime and mold?

  Yes

  No

  N/A

• The Pyxis machines are clean and dust free on top and underneath?

  Yes

  No

  N/A

• Are the call cords between 4 and 12 inches from the floor?

  Yes

  No

  N/A

• Are the call cords access free?

  Yes

  No

  N/A

• Are the trash receptacles the correct size and type for fire safety?

  Yes

  No

  N/A

• Are the Purell dispensers working properly?

  Yes

  No

  N/A

• Are the trash compactors free of any keys in the ignitions?

  Yes

  No

  N/A

Regulated Medical Waste / Hazardous Waste

• Are all the manifests being kept for the past 3 years?

  Yes

  No

  N/A

• Have all the staff that have been packaging the waste, signing the manifests, and keeping the records, been trained in the past year?

  Yes

  No

  N/A

• Are the trainer's certifications on file? Within the past 3 years?

  Yes

  No

  N/A

• Is all the waste properly labeled?

  Yes

  No

  N/A

• Is there proper signage on the doors of every RMW and Hazardous Waste storage area?

  Yes

  No

  N/A

• Is there a weekly safety checklist in the Hazardous Waste storage room?

  Yes

  No

  N/A

• Do all of the containers have a start date and end date?

  Yes

  No

  N/A

• Are all staff communication boards are kept up to date with no materials over 30 days old?

  Yes

  No

  N/A

Administration

• Are the OR cleaning assignments being kept for 1 rolling year?

  Yes

  No

  N/A

• Are the IV room cleaning assignments being kept for 1 rolling year?

  Yes

  No

  N/A

• TB Rooms - All techs have annual respiratory mask fit testing documented by OH?

  Yes

  No

  N/A

• All staff have DOVRs completed for their job title?

  Yes

  No

  N/A