Information
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
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Staff Procedures For Fire Emergencies:
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Did Staff Pull Fire Alarm?
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Did Staff Close Doors Promptly?
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Does Staff Know Code For Fire?
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Did Staff Bring Fire Extinguisher To The Code Red?
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Could Staff Explain How To Use A Fire Extinguisher Or P.A.S.S. (P-Pull Pin, A-Aim, S-Squeeze Handle, S-Sweep Over Fire)
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Did Staff Know Meaning Of R.A.C.E. ( R-Rescue, A-Alarm, C-Contain Fire, Extinguish)
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Did Staff Know How To Move Patients Away From Fire?
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Was Staff Able To Locate Their Written Fire Evacuation /Relocation Plan and Evacuation Diagram?
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Was Staff Able To Locate Emergency Preparedness Manual and Emergency Conditions Matrix?
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Were Evacuation Corridors Cleared of Carts and Other Temporary Obstructions?
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Was Staff Able To Point Out The Location Of The Medical Gas Zone Valves?
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Did Staff Know Who Has Authority To Shut Off Medical Gas Zone Valves? (F.R.E.S.H.-F-Fire Chief, R-Respiratory Theraphy, E-Engineering, S-Safety Officer, H-House Coordinator)
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Life Safety Systems
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Did The Pull-Box Activate The Life Safety System? (Fire Alarm)
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Did All Alarms and Strobes Function?
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Did All Fire/Smoke Compartment Doors Automatically Close?
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Could The Overhead Page For Code Red Be Heard?
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Did Life Safety System Re-Set After Alarm Acknowledgement?
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Remarks:
