Information

  • 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?

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?

  • 2.e Is all documentation available?

3 - Procedures

  • 3.a Is the a system in place to ensure that medical and non-medical equipment are maintained to agreed levels?

  • 3.b Are procedures available regarding blood storage and suppy?

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

  • 3.d Is a quality program used for the storage and distribution of medical supplies and blood?

  • 3.e Is a list of equivalent pharmaceuticals of other nations available?

  • 3.f Is the cold chain (including blood supply) put in place?

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

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