Metro Health Security Rounds - New

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Location, Time and Date

• Location of Rounds

• Time & Date

  Date

Observations

• Are doors locked?

  Yes

  No

  N/A

• Add media

  Media

• Are all windows shut?

  Yes

  No

  N/A

• Intrusion Alarm Active?

  Yes

  No

  N/A

• Add media

  Media

• Are lights off?

  Yes

  No

  N/A

• Add media

  Media

• Areas safe and free from identified hazards that can injure staff, patients and/or visitors?

  Yes

  No

  N/A

• Add media

  Media

• Building and Grounds area free from Maintenance Issues or Repairs needed?

  Yes

  No

  N/A

• If no, was a work order submitted?

  Yes

  No

  N/A

• Add media

  Media

Completed By

• Signature of Officer Conducting Rounds

  Sign

• Printed Name