MMA - CARF Inspection

• Site conducted

  Select

• Conducted on

  Date

• Prepared by

• Location
  Address

• CARF Facility Safety & Loss Control Inspection Checklist
  Address

• Location:

• Completed By:

• Completion Date:

  Date

Area/Equipment/Item

• Emergency warning devices

  Safe

  At Risk

  N/A

• Means of entry/egress

  Safe

  At Risk

  N/A

• Emergency plan (evacuation, weather, medical, client)

  Safe

  At Risk

  N/A

• Housekeeping practices

  Safe

  At Risk

  N/A

• Entrance mats flat and surround areas are dry

  Safe

  At Risk

  N/A

• Spill clean-up procedure

  Safe

  At Risk

  N/A

• Condition of parking lot/sidewalk

  Safe

  At Risk

  N/A

• Overall condition of walking surfaces to prevent employee and customer STF incidents

  Safe

  At Risk

  N/A

• Hazardous substances (MNERTK)

  Safe

  At Risk

  N/A

• Infectious agents (BBP)

  Safe

  At Risk

  N/A

• Materials handling practices

  Safe

  At Risk

  N/A

• Hand-held tools/equipment

  Safe

  At Risk

  N/A

• Machine operation (guarding/LOTO)

  Safe

  At Risk

  N/A

• Electrical PM (wiring/clearance)

  Safe

  At Risk

  N/A

• Grounding of electrical equipment

  Safe

  At Risk

  N/A

• Food preparation areas

  Safe

  At Risk

  N/A

• Dining or eating areas

  Safe

  At Risk

  N/A

• Restrooms

  Safe

  At Risk

  N/A

• Sanitation

  Safe

  At Risk

  N/A

• Ventilation

  Safe

  At Risk

  N/A

• Illumination

  Safe

  At Risk

  N/A

• Noise levels

  Safe

  At Risk

  N/A

• Air contaminants

  Safe

  At Risk

  N/A

• General working environment

  Safe

  At Risk

  N/A

• Personal protective equipment

  Safe

  At Risk

  N/A

• Fire extinguishers

  Safe

  At Risk

  N/A

• Automatic fire protection systems

  Safe

  At Risk

  N/A

• Fire detection systems

  Safe

  At Risk

  N/A

• Building PM practices

  Safe

  At Risk

  N/A

• Security

  Safe

  At Risk

  N/A

• Client transportation

  Safe

  At Risk

  N/A

• Other: Tornado Drill

  Safe

  At Risk

  N/A

• Other: Fire Drill

  Safe

  At Risk

  N/A