1. Previous Inspection

1.1 Has the last EoC Inspection been reviewed?

1.2 Have all outstanding concerns been resolved?

A. Life Safety Management

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

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

A3. Are pull stations, fire extinguishers, electrical panels and medical gas shut-offs unobstructed?

A4. Are fire extinguisher monthly checks completed?

A5. Is material stored 18" below sprinkler heads?

A6. Is the area free of signs of smoking?

B. Safety Management

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

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

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

B4. Are needle boxes less than 2/3 full?

B5. Are eyewash stations inspected weekly?

C. Security Management

C1. Are employees wearing ID badges?

C2. Are medication carts locked and crash carts checklist completed, up to date?

C3. Are mechanical, electrical, janitorial, communication rooms and electrical panels locked?

C4. Are staff's personal belongings properly safeguarded to prevent theft?

D. Infection Prevention

D1. Is clean linen covered and kept separate from soiled linens?

D2. Are patient's refrigerators clean, free of unopened & unlabeled containers and temp checks completed?

D4. Is medical waste kept in red biohazard bags or containers?

D3. Is medication and food kept in separate refrigerators?

D5. Are underneath sink areas clear of any storage?

D6. Is PPE readily available?

D7. Are employees eating and drinking in designated areas?

E. Utility Management

E1. Are electrical outlets in good condition with wires safely maintained?

E2. Are compressed gases stored properly, (empty separated from full) no more than 12 full E cylinders stored in one smoke area?

F. Medical Equipment Management

F1. Is medical equipment clean, properly inspected and tagged?

G. Hazardous Material Management

G1. Are Chemicals stored away from patient contact and clean items?

G2. Are primary and/or secondary chemical containers properly labeled?

H. Emergency Management

H1. Do written Emergency plans exist for this site and were they reviewed (to include: Emergency Operations All Hazards Plan, Code Red Plan, Code Amber Plan, Code White Plan, Code Grey Plan, Code Orange Plan, Code Brown Plan and Emergency Transport Plan)?

H2. Has Fire Drill been completed and documented for this location?

H3. Has an Emergency Drill been completed and documented for this location?

H4. Has HVA been completed and documented for this location?

H5. Has HVA been reviewed for this calendar year?

I. Additional Identified Deficiencies

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Department/Unit Representative
Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.