WCH Safety inspection -clinical area

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Life safety

• Do smoke/fire doors close and latch properly?

  Yes

  No

  N/A

• Fire doors designated with BMP labels?

  Yes

  No

  N/A

• Unobstructed closure of smoke/fire doors?

  Yes

  No

  N/A

• Unobstructed access to fire extinguishers?

  Yes

  No

  N/A

• Monthly fire extinguisher checks noted?

  Yes

  No

  N/A

• Unobstructed view of fire alarm pull station?

  Yes

  No

  N/A

• Stairwells clear of storage and properly lit?

  Yes

  No

  N/A

• 18" clearance in sprinkled areas?

  Yes

  No

  N/A

• 24" clearance in non-sprinkled areas?

  Yes

  No

  N/A

• Unobstructed path of egress?

  Yes

  No

  N/A

• Exit lights lit?

  Yes

  No

  N/A

• Fire diamond posted?

  Yes

  No

  N/A

• Audio visual page charts up-to-date?

  Yes

  No

  N/A

Security

• Alarm system checked?

  Yes

  No

  N/A

Infection control

• Shipping containers?

  Yes

  No

  N/A

• Linen/linen cart properly covered?

  Yes

  No

  N/A

• Clean medical equipment bagged and tagged?

  Yes

  No

  N/A

• Sharps containers overly filled?

  Yes

  No

  N/A

• Waterless hand sanitizers dated?

  Yes

  No

  N/A

• Items stored on floor?

  Yes

  No

  N/A

• Staff food and drink in undesignated areas?

  Yes

  No

  N/A

• Virex bottles in designated areas only? (2-nursery. 1- blood bank. 1-sleep lab)

  Yes

  No

  N/A

Signage

• Handwritten signs found?

  Yes

  No

  N/A

• Signage issues?

  Yes

  No

  N/A

Misc. issues

• Ceiling tiles in good condition?

  Yes

  No

  N/A

• Walls in good condition and free of holes?

  Yes

  No

  N/A

• Floor surfaces clean and free of cracks?

  Yes

  No

  N/A

• Slip, trip, or fall hazards?

  Yes

  No

  N/A

• Unauthorized items under sink?

  Yes

  No

  N/A

• Appropriate positive/negative air pressures? (Clean-positive soiled-negative)

  Yes

  No

  N/A

Hazmat

• Oxygen stored correctly?

  Yes

  No

  N/A

Equipment safety

• Extension cords?

  Yes

  No

  N/A

• Electrical checks on small appliances?

  Yes

  No

  N/A

• Locked electrical panels?

  Yes

  No

  N/A

• Access to electrical panels blocked?

  Yes

  No

  N/A

Food/nutrition areas

• Open food containers dated properly?

  Yes

  No

  N/A