Title Page
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Document No.
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Department / Audit Title
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Hospital Facility
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Conducted on
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Prepared by
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Location
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Name of Nursing Unit Manager
1.0. GENERAL HOUSEKEEPING in SELECTED AREA
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1.1. Are floors clear of debris and unwanted materials
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1.2. Are corridors/walkways and passages free of obstruction
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1.3. Are floor surfaces dry and free of slip hazards
2.0. EMERGENCY SYSTEM
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2.1. Are emergency exits signs posted ?
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2.2. Staff aware of location of emergency assembly points ? ASK RANDOM STAFF
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2.3. Are emergency exit maps posted and clearly marked ?
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2.4. Are emergency exits free from obstructions ?
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2.5. Do self-closing devices on stairway doors work properly ?
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2.6. Are emergency numbers displayed ?
3.0. FIRE PREVENTION
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3.1. Are fire extinguishers in place, clearly marked and signs clearly visible?
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3.2. Extinguishers free of obstruction ?
4.0. GENERAL LIGHTING
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4.1. Good natural lighting ?
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4.2. Light fittings clean and in good working order ?
5.0 ELECTRICAL SAFETY
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5.1. No broken plugs, sockets or switches ?
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5.2. No power leads crossing walkways ?
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5.3. No frayed or damaged leads ?
6.0. VOLUNTEERS - OFFICE HAZARDS
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6.1. Are office chairs in good condition i.e. casters, back rest and arm rest ?
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6.2. Desks in good condition i.e. sufficient leg room under desk, no nails protruding and wood not splintered ?
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6.3. Ventilation in office sufficient ?
7.0 ADDITIONAL COMMENTS/CONCERNS
