Klc 6 S103 - Weekly First Aid Check Sheet

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Select date

  Date

• Check all first aid boxes contain minimum levels as listed for each box, if boxes are below minimum levels restock from surplus stock in the first aid room.
  If no stock available please notify Health and Safety Coordinator.

FA1 - First Aid Room

• Guidance leaflet - x1

  Yes

  No

• Wash proof Plasters - x20

  Yes

  No

• Sterile eye pads - x2

  Yes

  No

• Triangle bandages -x4

  Yes

  No

• Safety pins - x6

  Yes

  No

• Sterile dressing large - x2

  Yes

  No

• Sterile dressing medium -x6

  Yes

  No

• Disposable gloves (pair) -x2

  Yes

  No

• Face mask - x1

  Yes

  No

• Moist wipes - x5

  Yes

  No

• Foil blankets - x2

  Yes

  No

• Checked by

  Sign

FA2 - Main Office

• Guidance leaflet - x1

  Yes

  No

• Wash proof Plasters - x20

  Yes

  No

• Sterile eye pads - x2

  Yes

  No

• Triangle bandages -x4

  Yes

  No

• Safety pins - x6

  Yes

  No

• Sterile dressing large - x2

  Yes

  No

• Sterile dressing medium -x6

  Yes

  No

• Disposable gloves (pair) -x2

  Yes

  No

• Face mask - x1

  Yes

  No

• Moist wipes - x5

  Yes

  No

• Foil blankets - x2

  Yes

  No

• Checked by

  Sign

AED Equipment - Main Office

• Scissors (tuff cut)

  Yes

  No

• Razor - x1

  Yes

  No

  N/A

• Small towel

  Yes

  No

• Pair of AED pads (in date)

  Yes

  No

• Spare pair of AED pads (in date)

  Yes

  No

  N/A

• Spare battery

  Yes

  No

• Face mask

  Yes

  No

• Checked by

  Sign

FA3 - Soft Play

• Guidance leaflet - x1

  Yes

  No

• Wash proof Plasters - x20

  Yes

  No

• Sterile eye pads - x2

  Yes

  No

• Triangle bandages -x4

  Yes

  No

• Safety pins - x6

  Yes

  No

• Sterile dressing large - x2

  Yes

  No

• Sterile dressing medium -x6

  Yes

  No

• Disposable gloves (pair) -x2

  Yes

  No

• Face mask - x1

  Yes

  No

• Moist wipes - x5

  Yes

  No

• Foil blankets - x2

  Yes

  No

• Checked by

  Sign

FA4 - Catering

• Guidance leaflet - x1

  Yes

  No

• Wash proof Plasters - x20

  Yes

  No

• Sterile eye pads - x2

  Yes

  No

• Triangle bandages -x4

  Yes

  No

• Safety pins - x6

  Yes

  No

• Sterile dressing large - x2

  Yes

  No

• Sterile dressing medium -x6

  Yes

  No

• Disposable gloves (pair) -x2

  Yes

  No

• Face mask - x1

  Yes

  No

• Moist wipes - x5

  Yes

  No

• Foil blankets - x2

  Yes

  No

• Checked by

  Sign

FA9 - Catering Burns Kit

• Scissors (tuff cut)

  Yes

  No

• Guidance leaflet - x1

  Yes

  No

• Safety pins - x12

  Yes

  No

• Disposable gloves (pair) -x2

  Yes

  No

• Bandages - x2

  Yes

  No

• Gel Sachets - x3

  Yes

  No

• Burns Dressings - x3

  Yes

  No

• Checked by

  Sign

FA5 - Gym

• Guidance leaflet - x1

  Yes

  No

• Wash proof Plasters - x20

  Yes

  No

• Sterile eye pads - x2

  Yes

  No

• Triangle bandages -x4

  Yes

  No

• Safety pins - x6

  Yes

  No

• Sterile dressing large - x2

  Yes

  No

• Sterile dressing medium -x6

  Yes

  No

• Disposable gloves (pair) -x2

  Yes

  No

• Face mask - x1

  Yes

  No

• Moist wipes - x5

  Yes

  No

• Foil blankets - x2

  Yes

  No

• Checked by

  Sign

FA6 - Plant Room

• Guidance leaflet - x1

  Yes

  No

• Wash proof Plasters - x20

  Yes

  No

• Sterile eye pads - x2

  Yes

  No

• Triangle bandages -x4

  Yes

  No

• Safety pins - x6

  Yes

  No

• Sterile dressing large - x2

  Yes

  No

• Sterile dressing medium -x6

  Yes

  No

• Disposable gloves (pair) -x2

  Yes

  No

• Face mask - x1

  Yes

  No

• Moist wipes - x5

  Yes

  No

• Foil blankets - x2

  Yes

  No

• Checked by

  Sign

FA7 - Poolside

• Guidance leaflet - x1

  Yes

  No

• Wash proof Plasters - x20

  Yes

  No

• Sterile eye pads - x2

  Yes

  No

• Triangle bandages -x4

  Yes

  No

• Safety pins - x6

  Yes

  No

• Sterile dressing large - x2

  Yes

  No

• Sterile dressing medium -x6

  Yes

  No

• Disposable gloves (pair) -x2

  Yes

  No

• Face mask - x1

  Yes

  No

• Moist wipes - x5

  Yes

  No

• Foil blankets - x2

  Yes

  No

• Checked by

  Sign

Spinal Board

• Check Head Strap is in full working order

  Safe

  At Risk

• Check Green Strap is in full working order

  Safe

  At Risk

• Check Blue Strap is in full working order

  Safe

  At Risk

• Check Orange Strap is in full working order

  Safe

  At Risk

• Check Black Strap is in full working order

  Safe

  At Risk

• Check White Strap is in full working order

  Safe

  At Risk

• Check Back Pad is fit for purpose

  Safe

  At Risk

• Checked by

  Sign

FA8 - Evacuation Box

• Guidance leaflet - x1

  Yes

  No

• Wash proof Plasters - x20

  Yes

  No

• Sterile eye pads - x2

  Yes

  No

• Triangle bandages -x4

  Yes

  No

• Safety pins - x6

  Yes

  No

• Sterile dressing large - x2

  Yes

  No

• Sterile dressing medium -x6

  Yes

  No

• Disposable gloves (pair) -x2

  Yes

  No

• Face mask - x1

  Yes

  No

• Moist wipes - x5

  Yes

  No

• Foil blankets - x2

  Yes

  No

• Checked by

  Sign

Manager on Duty Mobile credit

• Credit to the nearest 10p

• Edition 3 September 2013 S103 First aid provisions check sheets