Nursing Home Inspection Checklist

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Grounds

• Landscape maintained

  Yes

  No

  N/A

• Parking lot clean

  Yes

  No

  N/A

Lobby

• Good first impression

  Yes

  No

  N/A

• Free of odors

  Yes

  No

  N/A

• Floor maintained

  Yes

  No

  N/A

General Area

• Lighting adequate and operational

  Yes

  No

  N/A

• Temperature is comfortable

  Yes

  No

  N/A

• Area is free from odors

  Yes

  No

  N/A

• Noise level is acceptable/adequately controlled.

  Yes

  No

  N/A

• Ventilation is adequate

  Yes

  No

  N/A

• Stair treads in good condition

  Yes

  No

  N/A

• Handrails present, safe and secure

  Yes

  No

  N/A

• Electrical equipment tested, tagged and safe

  Yes

  No

  N/A

• Electrical switches/sockets in good condition

  Yes

  No

  N/A

• Furniture safe and undamaged

  Yes

  No

  N/A

• Other concerns

  Yes

  No

  N/A

• Work space free of clutter

  Yes

  No

  N/A

• One side of corridor being used

  Yes

  No

  N/A

• Hazard areas secured

  Yes

  No

  N/A

• Doors meet NFPA

  Yes

  No

  N/A

• Other concerns

  Yes

  No

  N/A

Emergency

• Access and egress paths clear

  Yes

  No

  N/A

• Fire fighting equipment easily accessible

  Yes

  No

  N/A

• Fire fighting equipment checked as required

  Yes

  No

  N/A

• Other concerns

  Yes

  No

  N/A

Kitchen

• Drains (floor and sink) clear and free flowing

  Yes

  No

  N/A

• Plumbing in good condition

  Yes

  No

  N/A

• Fridge clean, good condition

  Yes

  No

  N/A

• Microwave clean and maintained

  Yes

  No

  N/A

• Oven/stove safe and clean

  Yes

  No

  N/A

• Area free from pests or evidence thereof

  Yes

  No

  N/A

• Self closing doors

  Yes

  No

  N/A

• Breaker panels clear and lock

  Yes

  No

  N/A

External

• Seating available and safe

  Yes

  No

  N/A

• Tables safe and clean

  Yes

  No

  N/A

• Waste and cigarette butt bins available

  Yes

  No

  N/A

• Boundary fences safe and secure

  Yes

  No

  N/A

• Overhead structures safe and secure

  Yes

  No

  N/A

• Gutters and down spout is in good condition

  Yes

  No

  N/A

• Out Building is in good condition

  Yes

  No

  N/A

• Other concerns

  Yes

  No

  N/A

Patio/courtyard

• Cooking area clean and free from waste/rubbish

  Yes

  No

  N/A

• Area around Grill free of grease

  Yes

  No

  N/A

• Grill safe and in good condition

  Yes

  No

  N/A

• Gas supply secured cooker/heater

  Yes

  No

  N/A

• Walking path safe

  Yes

  No

  N/A

• Equipment secured from resident

  Yes

  No

  N/A

• Other concerns

  Yes

  No

  N/A

Laundry

• Electrical equipment in good condition

  Yes

  No

  N/A

• Lighting operating as designed

  Yes

  No

  N/A

• Floor/area free from water and being wet

  Yes

  No

  N/A

• Dryer filter clean

  Yes

  No

  N/A

• Rears of dryers clear and clean

  Yes

  No

  N/A

• Folding area cutter free and clean

  Yes

  No

  N/A

• Other concerns

  Yes

  No

  N/A

Housekeeping

• Clean behind and under furniture

  Yes

  No

  N/A

• Bathroom clean and supplied with paper towel and toilet paper

  Yes

  No

  N/A

• Resident rooms odor free

  Yes

  No

  N/A

• Residents Floors clean

  Yes

  No

  N/A

• Linen in good condition

  Yes

  No

  N/A

• Room Deep cleaning schedule is available

  Yes

  No

  N/A

• Other concerns in residents room

  Yes

  No

  N/A

• Other concerns

  Yes

  No

  N/A

Boiler room and electrical rooms

• Cutter free<br>

  Yes

  No

  N/A

• Breaker panel labeled

  Yes

  No

  N/A

• Fire extinguisher

  Yes

  No

  N/A

• Door secured

  Yes

  No

  N/A

• Other concerns in boiler room

  Yes

  No

  N/A

TELS

• Weekly TELS task up to date

  Yes

  No

  N/A

• Critical managed

  Yes

  No

  N/A

• Fire drills current

  Yes

  No

  N/A

• Other concerns

  Yes

  No

  N/A

More

• Other comments

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