Has the last audit been reviewed?
Are there any outstanding concerns?
All furniture and equipment is in sound condition? (no chipped or torn surfaces- no leaky faucets)
All wall-mounted devices (lights, TV’s, pictures, signs, containers, handrails, etc.) are secure and not loose?
Area is without clutter?
No evidence of daisy chains?
Items are not stored within 36" of an electrical panel?
Electrical cords, plugs, plates and switches are in good repair?
Extension cords only used temporarily but not on a permanent everyday basis?
The underside of beds and counters are free of electrical “wire nests” where feet could be entangled?
Medications/medical supplies have not passed expiration dates?
Supply area is clean?
Black boxes have been emptied and are not overflowing.
Appropriate items in black boxes?
No boxes on the floor. All supplies 6 inches off the floor?
No items stored under the sink
Ceiling tiles clean and intact?
Floors free of dirt, dust and litter?
Ledges, walls and air vents free of dust?
Toilets and sinks secure and clean?
Separation of clean and dirty?
Chemicals are properly labeled and secured
Staff knows how to access Safety Data Sheets (SDS)?
PPE is available?
Safety Data Sheet stickers are intact on phones?
Eye wash is flushed and logged?
Sharps containers are secured in their holders, not accessible to residents and not more than three-fourths full?
Containers used for regulated or infectious waste are covered, leak proof, and clearly labeled as a biohazard?
Can staff explain what R.A.C.E stands for?
Can staff explain P.A.S.S. and what does it stand for?
Can staff explain what C.A.L.M. stands for?
Smoke detectors with 36" clearance from air supply to return?
Are the sprinkler heads free of dust?
Fire extinguisher(s) green tag current?
Fire extinguishers and pull stations clear of obstructions?
Automatic fire doors free from obstacles and positively latch when activated? (Doorways should not be blocked or wedged.)
All lights are working properly and flashlights with good batteries?
Placement of Hand Sanitizer is not adjacent (within 6”) to a potential ignition source?
Exits clear of obstructions?
Eighteen-inch clearance from ceiling is maintained?
Confidential shred bins are compliant with NFPA Code?
Halls/Corridors uncluttered and accessible?
Are compressed gas containers stored in designated areas only and secured?
Staff know the number to call to initiate an emergency response?
Employees, volunteers, students, contracted staff, physicians, contractors and venders wearing ID badges @ eye level?
Are valuables properly stored in department?
Staff know the procedures if a device/equipment does not work properly?
All medical equipment/devices has a current Bio-Medical sticker/Asset Tag?
Equipment is clean?
Crash cart is locked, logs complete, oxygen is full?
Defibrillator is plugged in and charging?
Equipment Asset numbers for biomed
Staff know what to do for an electrical failure?
Staff know who is authorized to shut off medical gases?
Hyperthermia cart is locked with log completed?
Staff know location of hyperthermia cart?
Sterilizer is clean and parameters are maintained?
Sterilizer has documented PM?
Sterilizer testing is up to date?
Floor is clean?
Power tools have guards in place?
PPE readily available?
36" clearance maintained around electric panels?
Fall protection for areas above 6 feet high?
LOTO equipment readily available?
Isolation exhaust fans are labeled?
Preventive action is required?
Preventive Action Plan:
Corrective action is required?
Cause of nonconformity
Organizational corrective plan:
Person/position responsible for implementation do corrective action
Determine actions needed by observing:
Results of. Actions taken: