Title Page

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location

General Items

  • Has an infection control risk assessment & interim life safety measures assessment been performed prior to the start of work in all areas?

  • Have all infection control risk assessments & interim life safety measures assesments been filed and made accessible to everyone necessary?

  • Have all infection control risk assessments & interim life safety measures assesments been reviews by the owners representatives and RCCI staff?

  • Have requirements of all active infection control risk assessment & interim life safety measures assessments been communicated to all subcontractors performing the work in associated areas?

  • Have all employees completed the healthcare orientation prior to starting work?

Interim Life Safety

  • Are all exits identified and usable?

  • Are alternate routes identified?

  • Do all personnel know the means of egress?

  • Are the means of egress in the construction area are inspected daily?

  • Is there free and unobstructed access to emergency services?

  • Are all fire alarm and suppression systems unimpaired?

  • Is a temporary but equivalent system provided when the fire system is impaired, and is that system documented and tested monthly?

  • Before fire alarm systems are taken out of service, proper consideration is taken, including notifying the appropriate authority?

  • Smoking is prohibited and/or only allowed in designated areas?

  • Additional fire equipment and training is provided to personnel?

  • A minimum of two(2) fire drills per quarter, per shift, are conducted?

  • Facility- wide safety education programs are conducted to ensure the awareness of any life safety core deficiencies, construction hazards and interim life safety measures which are in place?

  • Are hot work permits being turned in daily and is a fire watch program established and used when required?

Infection Control

  • Has a negative air flow been established in all areas of work?

  • Is a negative pressure indicator (manometer, ball-in-the wall, etc.) in place at each area of work?

  • Is airflow and quality being monitored on a regular basis?

  • Are airflow and air quality reports being received and filed on a regular basis?

  • Are all negative air machines functioning properly?

  • Have the appropriate filters been installed and maintained in each negative air machine?

  • Is the leading edge of all duct sealed?

  • Are all duct returns capped, terminated or filtered?

  • Has all stored duct been sealed appropriately?

Housekeeping

  • Are areas of work being kept clean/swept in order to minimize track-out?

  • Are all corridors and surrounding areas swept/vacuumed and clean with no track-out?

  • Are all trash bins, gondolas, carts etc. cleaned prior to exiting work areas?

  • Are the wheels of all bins, gondolas, carts, etc. cleaned prior exiting work areas?

  • Have walk-off/sticky/damp mats been installed at the exits of work areas?

PPE

  • Is proper PPE worn at all times on site (hard hat, safety glasses, high viz, long pants and boots)?

  • Is task specific PPE worn when necessary(gowns, booties, masks, respirators, etc.)?

Area Isolation and Access Control

  • Have sealed partitions been installed around each area of work?

  • Do all temporary doors into work areas latch properly?

  • Have closures been installed in all temporary doors?

  • Are temporary construction partitions smoke and dust tight, and built of non-combustible or limited combustible material?

  • Is the construction area properly restricted from the rest of the facility with appropriate signage?

  • Has access to the construction area been limited to authorized personnel?

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.