Audit

Life Safety

Will the fire alarm and/or detection system be inoperable or impaired? ( If yes Fill out interim Life Safety Measures )

Will emergency exits be obstructed? ( If yes fill out Interim Life Safety Measures )

Will repairs or maintenance be over occupied work areas? ( if yes fill out Interim Life Safety Measures )

Will normal traffic need to be rerouted? ( If yes fill out Interim Life Safety Measures )

Will their be work above the ceiling? ( If yes fill out Facilities Management Work Permit )

Infection Control

Will air quality be affected temperature,moisture,dust,required air changes? (If yes give description of what will be done to maintain air quality )

Will work area need to be concealed due to dust or infection control? ( If yes give description of how area will be concealed )

Will noise levels be affected in the area? ( If yes give description of what will be done to minimize noise levels )

Safety

Is personal protective equipment available in work area?

Has everyone around the work area been notified of work to be performed?

Will their be any Hot Work? ( If yes have Facilities Management fill out hot work permit )

Is fire extinguisher available in work area?

Risk Assessment Results

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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.