Lovitt & Touche Annual External Safety & Health Audit 2023

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Attendees

• Facility Overview

Infection Control

• Employee control: signs posted for Hand washing & Hygiene guidelines; Touch-less sanitizing stations, Faucets & Paper towels; Cleaning & Sanitizing schedule is followed?

  Yes

  No

  Partial

  N/A

• Infection Control written policy and procedures for: Guests, Patients, Vendors or Customers? Controls may include: Entry protocols, Touch less Sanitizing stations that are secured & Self locking, Ventilation controls, PPE use, Staff safety training?

  Yes

  No

  Partial

  N/A

• Management oversight of the Infection Control program?

  Yes

  No

  Partial

  N/A

• Staff training is documented? Revised as needed?

  Yes

  No

  Partial

  N/A

• Laundry. Sanitizing detergents; scrubs cleaned and laundered daily?

  Yes

  No

  Partial

  N/A

• Stay home protocols for physically sick workers?

  Yes

  No

  Partial

  N/A

General Policies, Procedures & Training

• Per CARF Section 1.H.14. Comprehensive Health & Safety, self-Inspections are conducted at least semi-annually on each shift and results in a written report for areas inspected, recommendations and actions taken.

  Yes

  No

  N/A

• Is there a comprehensive written Health, Safety and Environmental policy & procedures plan in place?

  Yes

  No

  Partial

  N/A

• Written Emergency Procedures and Program for fires, bomb threats, natural disasters, utility failures, medical emergencies, violent or other threatening situations?

  Yes

  No

  Partial

  N/A

• Records Management and Storage via keypad or electronic lock in separate rooms?

  Yes

  No

  Partial

  N/A

• Personnel received documented competency-based training?<br>Upon hire and Annually - outline what type of training<br>in the following areas:<br>- Health and safety practices<br>- Identification of unsafe environmental factors<br>- Emergency & Evacuation procedures<br>- Identification & Reporting of critical incidents<br>- Medication management, if appropriate <br>- Reducing physical risks <br>- Workplace violence

  Yes

  No

  Partial

  N/A

• Isolation Practices - Written Policy & Procedures?

  Yes

  No

  Partial

  N/A

• Emergency Evacuation Written Program: Fire, Bomb Threats, Natural Disasters, Utility Failures, Medical Emergencies, Violent or Threatening Situations?

  Yes

  No

  Partial

  N/A

• Required Postings posted?

  Yes

  No

  Partial

  N/A

• Consumer Rights and Privacy Protection posters?

  Yes

  No

  Partial

  N/A

• Medical Facility - First Aid/CPR/AED? Training?

  Yes

  No

  Partial

  N/A

• Ventilator Competency Training?

  Yes

  No

  Partial

  N/A

• HazCom: Policy, SDS management and Container labeling: (Product identifier, Signal Word, Haz Statement, Pictograms, Precautionary Statement).

  Yes

  No

  Partial

  N/A

• PPE training and refresher training as required?

  Yes

  No

  Partial

  N/A

• <br>Other Comments:

  Yes

  No

  Partial

  N/A

General Safety

• Facility is clean and organized?

  Yes

  No

  Partial

  N/A

• Is adequate and functioning lighting provided in all areas?

  Yes

  No

  Partial

  N/A

• Is the elevator(s) inspection certificate(s) up to date?

  Yes

  No

  Partial

  N/A

• Elevator in good working condition?

  Yes

  No

  Partial

  N/A

• Are work areas free of tripping hazards (cords, frayed carpet, free standing electrical fixtures, broken floor tiles, etc.)?

  Yes

  No

  Partial

  N/A

• Is furniture (i.e. desks, chairs, filing cabinets) in safe condition?

  Yes

  No

  Partial

  N/A

• Is overhead storage utilized properly?

  Yes

  No

  Partial

  N/A

• Are filing cabinets free of items stored on top?

  Yes

  No

  Partial

  N/A

• Are all stored items 18 inches below ceilings equipped with fire sprinkler heads?

  Yes

  No

  Partial

  N/A

• Other Comments:

Fire & Electrical Hazards

• Does the facility have a fire suppression system in place and what type: Automatic Fire Suppression System or Standpipe System?

  Yes

  No

  Partial

  N/A

• Does the facility have Fire Extinguishers?

  Yes

  No

  Partial

  N/A

• Are fire extinguishers adequate. 1 every 75' and located in high hazard areas?

  Yes

  No

  Partial

  N/A

• Are fire extinguishers mounted with overhead locator signs?

  Yes

  No

  Partial

  N/A

• Are fire extinguishers inspected annually by a Servicing provider?

  Yes

  No

  Partial

  N/A

• Are monthly fire extinguishers inspections performed and inspections tags filled out?

  Yes

  No

  Partial

  N/A

• Are employees trained in the PASS system for extinguisher use?

  Yes

  No

  Partial

  N/A

• Smoke Detectors and Fire Alarms in working condition?

  Yes

  No

  Partial

  N/A

• Are Fire Risers serviced annually by a servicing company?

  Yes

  No

  Partial

  N/A

• Are all alarms functioning properly and routinely tested?

  Yes

  No

  Partial

  N/A

• Are planned and/or unplanned fire evacuation drills routinely conducted?

  Yes

  No

  Partial

  N/A

• Are electrical outlets adequate with no overloading, no missing grounding conductors or insulation damage?

  Yes

  No

  Partial

  N/A

• Are power and extension cords in good condition, no missing grounding conductors or insulation damage?

  Yes

  No

  Partial

  N/A

• Are circuits locations identified with a legend on the inside cover of the circuit panel doors?

  Yes

  No

  Partial

  N/A

• Are circuits panels free of uncapped or exposed openings "voids" in the circuit panel?

  Yes

  No

  Partial

  N/A

• Are 3' clearances maintained around all circuit panels & fire extinguishers?

  Yes

  No

  Partial

  N/A

• Are electrical closets free of storage?

  Yes

  No

  Partial

  N/A

• Other Comments:

General Environmental Control/Sanitation & Housekeeping

• Carpeted floors are clean, no frayed edges or damage?

  Yes

  No

  Partial

  N/A

• Are non-carpeted floors clean and in good condition?

  Yes

  No

  Partial

  N/A

• Are warning signs used during mopping procedures?

  Yes

  No

  Partial

  N/A

• Are floor mats in good condition, no curled edges, and not overlapped or placed on carpet?

  Yes

  No

  Partial

  N/A

• Are restrooms clean and sanitary?

  Yes

  No

  Partial

  N/A

• Are staff lounge and eating areas clean and sanitary?

  Yes

  No

  Partial

  N/A

• Are drinking fountains clean and in good working order?

  Yes

  No

  Partial

  N/A

• Facility is free of evidence of rodents, insects or vermin?

  Yes

  No

  Partial

  N/A

• Are ceiling fan blades clean and in safe working condition>

  Yes

  No

  Partial

  N/A

• Are walls and woodwork clean?

  Yes

  No

  Partial

  N/A

• Are cleaning schedules followed for refrigerators, microwaves, stoves and other kitchen appliances?

  Yes

  No

  Partial

  N/A

• Are Waste receptacles emptied nightly?

  Yes

  No

  Partial

  N/A

• Are Biohazard wastes collected separately in BioHazard identifiable waste receptacles and stored properly for collection?

  Yes

  No

  Partial

  N/A

• Other Comments:

Egress

• Are alarms installed to restrict improper use of exits and are they tested to ensure proper function?

  Yes

  No

  Partial

  N/A

• Are Evacuation routes Accessible & Understandable to: Persons served, Personnel & Other stakeholders including visitors?

  Yes

  No

  Partial

  N/A

• Are all exit doors marked with illuminated exit signs or by external sources providing a minimum of 5 foot candles of light?

  Yes

  No

  Partial

  N/A

• Are panic hardware (push bars) used at exit doors?

  Yes

  No

  Partial

  N/A

• Are emergency and exit lights working properly?

  Yes

  No

  Partial

  N/A

• Are doors designated to open outward?

  Yes

  No

  Partial

  N/A

• Are Exit discharges clear of obstructions inside and outside?

  Yes

  No

  Partial

  N/A

• Are Emergency Evacuation Plans posted and revised as needed?

  Yes

  No

  Partial

  N/A

• Are hallways & stairways maintained free of obstructions?

  Yes

  No

  Partial

  N/A

• Are stairways well lighted?

  Yes

  No

  Partial

  N/A

• Are stairway handrails secured?

  Yes

  No

  Partial

  N/A

• Are non-exiting doorways marked as "Not an Exit"?

  Yes

  No

  Partial

  N/A

• Other Comments:

Maintenance

• Are door closures and locks in good working order?

  Yes

  No

  Partial

  N/A

• Are ceiling tiles intact, undamaged?

  Yes

  No

  Partial

  N/A

• Is the building free from mold growth?

  Yes

  No

  Partial

  N/A

• Are HVAC ducts and filters clean and serviced?

  Yes

  No

  Partial

  N/A

• Are outside lights adequate and in working order?

  Yes

  No

  Partial

  N/A

• Are gates and fences in good condition?

  Yes

  No

  Partial

  N/A

• Is the building exterior in good condition?

  Yes

  No

  Partial

  N/A

• Is the building roof in good condition, no evidence of leaks?

  Yes

  No

  Partial

  N/A

• Sidewalks are free of raised adjoining slabs that are 1/4" or higher or have serious cracks or other damage?

  Yes

  No

  Partial

  N/A

• Are parking lots free of potholes?

  Yes

  No

  Partial

  N/A

• Are concrete tire stops and curbs in good condition?

  Yes

  No

  Partial

  N/A

• Overall General Comments or Concerns

• The Risk & Loss Advisors team at Marsh & McLennan Agency LLC provides consultative services to help our clients reduce their total cost risk. Contact your Risk Consultant or Client Service Team for assistance. Any statements concerning legal matters are based solely on our experience as Risk & Loss Advisors and are not to be relied upon as legal advice, for which you should consult your own professional advisors.

• This document is not intended to be taken as advice regarding any individual situation and should not be relied upon as such. Marsh & McLennan Agency LLC shall have no obligation to update this publication and shall have no liability to you or any other party arising out of this publication or any matter contained herein. Any statements concerning actuarial, tax, accounting or legal matters are based solely on our experience as consultants and are not to be relied upon as actuarial, accounting, tax or legal advice, for which you should consult your own professional advisors. Any modeling analytics or projections are subject to inherent uncertainty and the analysis could be materially affected if any underlying assumptions, conditions, information or factors are inaccurate or incomplete or should change. Copyright © 2021 Marsh & McLennan Agency LLC. All rights reserved. MarshMMA.com