• Audit Title

  • Conducted on

  • Prepared by

  • Location
  • FC: Fully Capable / No risks identified

    C: Capable / Minor risks identified

    CL: Capable with Limitations / Major risks identified

1 - Personnel

  • 1.a Is the module fully staffed?

  • 1.b Is the staffing of the module organized according to SOP?

  • 1.c Are personnel properly trained to operate the module equipment?

  • Is personnel aware of the lines of coordination with the other modules?

2 - Material

  • 2.a Is all necessary equipment to support the module available?

  • 2.b Is the equipment fit for purpose?

  • 2.c Are storage facilities available to store temperature related pharmaceuticals?

  • 2.d Are direct exchange items available to replace default medical equipment?

3 - Procedures

  • 3.a Is there a system in place for re-supply of lower roles?

  • 3.b Are procedures available for the disposal of medical (contaminated) waste?

  • 3.c Are the C2 arrangements for the module published?

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.