Title Page

  • Nursing Home

  • Address
  • Safety Inspector

  • Conducted on

Nursing Home Safety Checklist

Environmental Safety

  • Are spills cleaned up immediately?

  • Are floors clutter/obstacle-free (with attention to the path between bed and bathroom)?

  • Are floors level (no step up or down into shower/bathroom)?

  • Are floors even-colored?

  • Are handrails distinctly different color from walls?

  • Are handrails and transfer poles clear for use?

  • Are locks on beds, stretchers, and wheelchairs secured?

  • Are furniture secured to the floor so there is a clear path around it?

  • Are chairs/benches placed strategically in hallways to provide a rest area for the elderly?

  • Are excess equipment/supplies/furniture removed from the rooms?

  • Are excess electrical and telephone wires secured?

  • Is safety around the bed environment (use of transfer poles/transfer assist rails) secured?

  • Is the call light placed and frequently used objects within the older adult's reach?

  • Is there adequate lighting, especially at night?

  • Are bathrooms large enough to bring in wheelchairs and walking aids?

  • Is there adaptive equipment in bathrooms (vertical, horizontal, diagonal grab bars near toilet and shower; raised toilet seat or commode; rubber-backed bath mat; shower seat; hand-held showerhead)?

  • Is the sink, toilet, soap and paper towel holder at low enough level to reach from wheelchair or standing?

Elderly Safety

  • Is the elderly oriented about surroundings, including bathroom, use of the bed, and location of call light?

  • Are older adults/families encourage to call for assistance when needed

  • Is properly fining nonskid footwear used?

  • Is ambulation assured as ordered?

  • Has the elderly's ability to interpret information been evaluated?

  • Have the potential medication side effects been evaluated?

  • Are assistive devices kept at the bedside and within reach?

Sign Off

  • Additional Observations

  • Nursing Home Safety Inspector Name & Signature

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