MSBEA Audit

• Document No.

• Type of Audit

  Yes

  No

  N/A

• Federal Database and Mandatory Audit

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Start Point

• Were you greeted when entering?

  Yes

  No

  N/A

• Where you signed in and given a visitor badge?

  Yes

  No

  N/A

• Was the staff member dressed professionally? Did they have a name badge on>

  Yes

  No

  N/A

• who was the staff member that waited on you?

• Explain if you feel they were not dressed professionally.

• How long did you wait to be seen?

Fire Prevention

• Evacuation plan displayed and understood by all staff?

  Yes

  No

  N/A

• Photo of evacuation plan

  Media

• <br>adequate directions and notices to exit?

  Yes

  No

  N/A

• Exits clear of obstructions

  Yes

  No

  N/A

• Photo Documentation

  Media

• Fire alarm system functioning correctly?

  Yes

  No

  N/A

General Lighting

• Light fixtures clean & in good condition?

  Yes

  No

  N/A

• Documentation

  Media

Building Safety

• Floor surfaces uncluttered?

  Yes

  No

  N/A

• Documentation

  Media

• Walkways adequately and intersections kept clear of boxes etc.?

  Yes

  No

  N/A

• Stairway Clear ?

  Yes

  No

  N/A

• Are Railing in good condition?

  Yes

  No

  N/A

Work Area(s)

• Clear of rubbish?

  Yes

  No

  N/A

• Confidential information not laying on desks?

  Yes

  No

  N/A

• If work areas are not in use are they locked?

  Yes

  No

  N/A

• Trash Bins Empty ?

  Yes

  No

  N/A

Record Keeping/ Confidentiality

• Did staff member in charge print you a list of staff upon request

  Yes

  No

  N/A

• Review Schedule is there a license staff member present at all times?

  Yes

  No

  N/A

• Was there any absence on schedule?

  Yes

  No

  N/A

• Is the license of each licensed staff member on display or in a designated area?

  Yes

  No

  N/A

Office Hazards

• Conditions of filing cabinets?

  Safe

  At Risk

  N/A

• Conditions of filing cabinets?

  Safe

  At Risk

  N/A

• Photocopier/Fax positioned to avoid breech of confidentiality

  Safe

  At Risk

  N/A

Security

• Is facility in an area that is patrolled by police?

  Yes

  No

  N/A

• Review vistior log on i pad or go to swipe on website use login
  
  jrobbins@msbea.com password yreffej
  
  sign off on log review

• Estimated number of visitors each week

• Have there been security problems in the past?

  Yes

  No

  N/A

• Are all new staff trained on security ?

  Yes

  No

  N/A

• Are two way radios used

  Yes

  No

  N/A

• is there a sufficient quantity of them

  Yes

  No

  N/A

• Are radios functioning properly ?

  Yes

  No

  N/A

• Are radio codes used?

  Yes

  No

  N/A

• is radio communication professional and approriate

  Yes

  No

  N/A

• Are cell phones used?

  Yes

  No

  N/A

• Are Cameras installed

  Yes

  No

  N/A

• How Many are functional

• How many are inoperable

• Are they actively monitored or reviewed

  Yes

  No

  N/A

• Photo of monitoring system

  Media

• is there a regular lock up routine

  Yes

  No

  N/A

• are staff issued badges with licensed number or non licensed staff shown on it

  Yes

  No

  N/A

• are visitors announced before entering office areas by phone or radio call

  Yes

  No

  N/A

• are visitors escorted through the facility

  Yes

  No

  N/A

• Does staff question persons without badge

  Yes

  No

  N/A

• Are keys to building controlled

  Yes

  No

  N/A

• Request to see list of key holders and are there issues

• are there policies in effect regarding usernaem/ password sharing

  Yes

  No

  N/A

• Are the staff logging off computers when not at work area

  Yes

  No

  N/A

HR

• Maintain files in locked file cabinets<br>Ensure access to file cabinet keys is managed <br>securely

  Safe

  At Risk

  N/A

• Are only employees designated by the department head <br> allowed access?

  Yes

  No

  N/A

• Ensure contents are not visible to others when <br>reviewing the file<br>

  Safe

  At Risk

  N/A

• Is there a job application and offer letter? - in each file-

  Yes

  No

  N/A

• Is there a current job description in each employee file, and is each job description signed by the employee?

  Yes

  No

  N/A

• Are the required Acknowledgement forms signed by the staff

  Yes

  No

  N/A

• Is there a signed Acknowledgment of Receipt of company equipment

  Yes

  No

  N/A

• Is there a completed checklist indicating issues covered during new hire orientation? or can a progress report be printed by the person in charge through the HRM system

  Yes

  No

  N/A

• Are disciplinary action notices (counseling sessions/written warnings, performance improvement plans) signed by the supervisor and is supporting documentation attached, if applicable? Do the notices include future expectations with deadlines and consequences for failing to meet the expectations? -- Known as employee notes -- either in file or in HRM person in charge should be able to show you one note per working day

  Yes

  No

  N/A

• Are termination letters/form or letters of resignation placed in the archived or terminated staff files?

  Yes

  No

  N/A

• Is there a completed Form I-9 for each employee hired after November 6, 1986? <br> (Form I-9 Employment Verification (kept in separate folder or binder)

  Yes

  No

  N/A

• Is each Form I-9 completed within 3 days of the employee’s start date?

  Yes

  No

  N/A

• Is the Form I-9 filled out accurately? with copies of appropriate ID

  Yes

  No

  N/A

• Other Notes:

• Signature of Auditor

  Sign

• Printed Name of Auditor

• Signature of Designated Representative

  Sign

• Printed Name of Designated Representative

• Title of Designated Representative