Northside Hospital Environment of Care Inspection - Non-Clinical

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

1. Previous Inspection

• 1.1 Has the last EoC Inspection been reviewed?

  Yes

  No

  N/A

• 1.2 Have all outstanding concerns been resolved?

  Yes

  No

  N/A

A. Life Safety Management

• A1. Doors: Latch properly, free of doorstops, closures on storage room doors are functional?

  Yes

  No

  N/A

• A2. Are exit doors and stairwells unobstructed and clearly marked/illuminated EXIT?

  Yes

  No

  N/A

• A3. Are pull stations, fire extinguishers and electrical panels unobstructed?

  Yes

  No

  N/A

• A4. Is material stored 18" below sprinkler heads?

  Yes

  No

  N/A

• A5. Are fire extinguisher monthly checks completed?

  Yes

  No

  N/A

• A6. Is the area free of signs of smoking?

  Yes

  No

  N/A

B. Safety Management

• B1. Are corridors and passageways unobstructed with undamaged floors, walls, ceilings and handrails?

  Yes

  No

  N/A

• B2. Are general areas clean and clear of clutter, with furnishings, floors, walls and ceilings in good conditions?

  Yes

  No

  N/A

• B3.. Are storage and equipment rooms clean and free of clutter?

  Yes

  No

  N/A

• B4. Are eyewash stations inspected weekly?

  Yes

  No

  N/A

C. Security Management

• C1. Are employees wearing ID badges?

  Yes

  No

  N/A

• C2. Are mechanical, electrical, janitorial, communication rooms and electrical panels locked?

  Yes

  No

  N/A

• C3. Is the Code One icon on PC's?

  Yes

  No

  N/A

• C4. Were all Code One Locations correct for these PCs?

  Yes

  No

  N/A

D. Infection Prevention

• D1. Is PPE readily available?

  Yes

  No

  N/A

• D2. Are underneath sink areas clear of any storage?

  Yes

  No

  N/A

• D3. Are employees eating and drinking in designated areas?

  Yes

  No

  N/A

E. Hazardous Material Management

• E1. Are Chemicals safely stored away?

  Yes

  No

  N/A

• E2. Are alll chemical containers properly labeled?

  Yes

  No

  N/A

F. Utility Management

• F2. Are electrical outlets in good condition with wires safely maintained?

  Yes

  No

  N/A

G. Additional Identified Deficiencies