Audit

General Safety

Are walking-working surfaces kept in a clean, orderly, sanitary condition and maintained free of hazards such as sharp or protruding objects, loose boards, corrosion, leaks, spills, snow, and ice. 29 CFR 1910.22(a)(1) and (a)(3); EC.02.01.01 EP 6

Risk Assessment Code

Isolated/Facility-wide Issue

Corrective Action Plan

Responsible Party

Estimated Completion Date

All places of employment shall be kept clean to the extent that the nature of the work allows. CFR 1910.141(a)(3)(i); EC.02.01.01 EP 3

Risk Assessment Code

Isolated/Facility-wide Issue

Corrective Action Plan

Responsible Party

Estimated Completion Date

All places of employment, passageways, storerooms, service rooms and walking-working surfaces are kept in a clean, orderly, and sanitary condition. 29 CFR 1910.22(a)(1); EC.02.01.01 EP 3

Risk Assessment Code

Isolated/Facility-wide Issue

Corrective Action Plan

Responsible Party

Estimated Completion Date

All walking-working surfaces are inspected, regularly and as necessary, and maintained in a safe condition? 29 CFR 1910.22(d)(1); EC.02.01.01 EP 3

Risk Assessment Code

Isolated/Facility-wide Issue

Corrective Action Plan

Responsible Party

Estimated Completion Date

Are staff refrigerators clean and food products not expired? 29 CFR 1910.141(g)(2); EC.02.01.01 EP 3
Specific to expiration dating and discarding unused food, organizations are expected to comply with the product manufacturer's guidelines for safe storage as well as applicable law/regulation that may be defined by your local authority having jurisdiction (i.e. local or state health department, etc.).

Are spaces underneath sinks kept clear of stored items? IC.02.02.01 EP 1

No food or drinks in patient care areas, nurse's stations or in work areas where there is a reasonable likelihood of occupational exposure. 29 CFR 1910.1030(d)(2)(ix)

Are ice machines cleaned and schedule of cleaning posted? IC.02.02.01 EP 1

Are combustible materials stored appropriately and not near a heat source? EC.02.01.01 EP 3

Are patient rooms clean? EC.02.06.01 EP 20

Are treatment rooms (space clean, unobstructed, and personal belongings secured)? EC.02.06.01 EP 1

Is lighting suitable for patient treatment and care? EC.02.06.01 EP 11

Electrical Safety

Are portable cord and plug-connected equipment and flexible cord sets (extension cords) visually inspected for external defects (such as loose parts, deformed and missing pins, or damage to outer jacket or insulation) before use on any shift, and for evidence of possible internal damage (such as pinched or crushed outer jacket)? Cord and plug-connected equipment and flexible cord sets (extension cords) which remain connected once they are put in place and are not exposed to damage need not be visually inspected until they are relocated. DA PAM 385-26, paragraph 2-4x; NFPA 70; EC.02.01010 EP 3

Risk Assessment Code

Isolated/Facility-wide Issue

Corrective Action Plan

Responsible Party

Estimated Completion Date

Are all possible shock hazards eliminated? 29 CFR 1910.303(b)(1); EC.02.01.01 EP 3

Risk Assessment Code

Isolated/Facility-wide Issue

Corrective Action Plan

Responsible Party

Estimated Completion Date

Are arcing parts of electric equipment that in ordinary operation produce arcs, sparks, flames, or molten metal enclosed or separated and isolated from all combustible material? 29 CFR 1910.303(d)

Risk Assessment Code

Isolated/Facility-wide Issue

Corrective Action Plan

Responsible Party

Estimated Completion Date

Are receptacle faceplates installed so that they completely cover the opening and seat against the mounting surface? DA PAM 385-26, paragraph 2-5d; EC.02.01.01 EP 3

Risk Assessment Code

Isolated/Facility-wide Issue

Corrective Action Plan

Responsible Party

Estimated Completion Date

Do electrical panels have proper clearance around (36 in (.9 m) (depth), 30 in (.76 m) (width) and 6.5 ft (1.98 m) (height) in most situations (see NFPA 70 (NEC), Article 110 for details) in front of panel door) and locate it so that it is not exposed to physical damage. DA PAM 385-26, paragraph 5-6; EC.02.01.01 EP 3

Risk Assessment Code

Isolated/Facility-wide Issue

Corrective Action Plan

Responsible Party

Estimated Completion Date

Are unused openings in boxes, raceways, auxiliary gutters, cabinets, equipment cases, or housings shall be effectively closed to afford protection substantially equivalent to the wall of the equipment? 29 CFR 1910.303(b)(7)(i); EC.02.01.01 EP 3

Risk Assessment Code

Isolated/Facility-wide Issue

Corrective Action Plan

Responsible Party

Estimated Completion Date

Are flexible cords (extension cords) and cables not used as a substitute for the fixed wiring of a structure or ran through holes in walls, ceilings, floors, run through doorways, windows, or similar openings? 29 CFR 1910.305(g)(1)(iv)(A); 29 CFR1910.305(g)(1)(iv)(B); 29 CFR 1910.305(g)(1)(iv)(C); EC.02.01.01 EP 3

Risk Assessment Code

Isolated/Facility-wide Issue

Corrective Action Plan

Responsible Party

Estimated Completion Date

Do adapters if used, maintain continuity of equipment grounding when connected? 29 CFR 1910.334(a)(3)(iii); EC.02.01.01 EP 3

Risk Assessment Code

Isolated/Facility-wide Issue

Corrective Action Plan

Responsible Party

Estimated Completion Date

Are Ground Fault Circuit Interrupters (GFCI) outlets in appropriate locations (e.g. within six feet of wet locations, all bathrooms, sinks, etc.)? DA PAM 385-26, paragraph 2-6a; EC.02.01.01 EP 3

Risk Assessment Code

Isolated/Facility-wide Issue

Corrective Action Plan

Responsible Party

Estimated Completion Date

There are no stringing of extension cords (daisy chain or splitting) or going from one cord to several (tree branching) unless approved by the local safety authority? DA PAM 385-26, paragraph 2-4n.

Risk Assessment Code

Isolated/Facility-wide Issue

Corrective Action Plan

Responsible Party

Estimated Completion Date

Are childproof electrical outlet covers in place, where required?

Are portable electric heaters not in-use/or authorized for use in the area? EC.02.01.01 EP 3

Fire Safety

Are fire doors kept shut and not propped open? NFPA 101; EC.02.03.01 EP 1

Risk Assessment Code

Isolated/Facility-wide Issue

Corrective Action Plan

Responsible Party

Estimated Completion Date

Are items stored kept a distance of 18 inches clearance of sprinklers or 24 inches in non-sprinkler locations from the ceiling? NFPA 13; LS.02.01.30 EP 6; EC.02.03.01 EP 4

Risk Assessment Code

Isolated/Facility-wide Issue

Corrective Action Plan

Responsible Party

Estimated Completion Date

Are storage areas that are fire protected by either an automatic sprinkler system or 1-hour fire resistant construction with positive latching? NFPA 101; LS.02.01.30 EP 2

Risk Assessment Code

Isolated/Facility-wide Issue

Corrective Action Plan

Responsible Party

Estimated Completion Date

Are emergency exit signs operate properly (e.g. illuminated and tested)? NFPA 101

Risk Assessment Code

Isolated/Facility-wide Issue

Corrective Action Plan

Responsible Party

Estimated Completion Date

Are emergency exit signs clearly indicated and visible from all directions? NFPA 101; EC.02.03.01 EP 27

Risk Assessment Code

Isolated/Facility-wide Issue

Corrective Action Plan

Responsible Party

Estimated Completion Date

Are exit access, routes, exits, and exit discharge clear of obstructions? 29 CFR 1910.36(g)(1); 29 CFR 1910.36(g)(2); 29 CFR 1910.36(d)(2); 29 CFR 1910.36(c)(1); LS.02.01.20 EP 13

Risk Assessment Code

Isolated/Facility-wide Issue

Corrective Action Plan

Responsible Party

Estimated Completion Date

Are portable fire extinguishers mounted, located and readily accessible to employees without subjecting the employees to possible injury? 29 CFR 1910.157(c)(1); LS.02.01.20 EP 27;

Risk Assessment Code

Isolated/Facility-wide Issue

Corrective Action Plan

Responsible Party

Estimated Completion Date

Are portable extinguishers visually inspected monthly and annotated on the fire extinguisher tag or other appropriate means? 29 CFR 1910.157(e)(2); EC.02.03.05 EP 15/16

Risk Assessment Code

Isolated/Facility-wide Issue

Corrective Action Plan

Responsible Party

Estimated Completion Date

Does the employer provide an educational program to familiarize employees with the general principles of fire extinguisher use and the hazards involved with incipient stage of fire-fighting upon initial employment and at least annually thereafter? 29 CFR 1910.157(g)(1) and (2); EC.02.03.01 EP 10

Risk Assessment Code

Isolated/Facility-wide Issue

Corrective Action Plan

Responsible Party

Estimated Completion Date

Is the fire emergency number readily available? EC.02.03.01 EP 10

Are flammable liquids and oxygen cylinders stored properly? NFPA 99; SB-8-75-S11; EC.02.03.01 EP 1

Are doors for stairwells, storage rooms, locker rooms, soiled linen rooms, and trash collection rooms kept closed at all times? LS.02.01.10 EP 5

Are items not stored on the floor in patient care areas? IC.02.02.01; LS.02.01.70 EP 4

Are manual fire alarm stations visually clear and free of obstructions? LS.02.01.70 EP 4

Are ceiling tiles in-place, free of stains, and free of damage?

Are waste paper receptacles made of noncombustible material? LS.02.01.70 EP 4

Does paper on the walls cover less than 10% of the wall space? LS.02.01.70 EP 4

Decorations meet applicable standards? LS.02.01.70 EP4

Are curtains fire-retardant? LS.02.01.70 EP 4

Is the unit's fire plan updated annually? Do staff members review the fire plan and are aware of the exit routes and assembly area?

Can personnel describe or demonstrate their specific roles and responsibilities in preparing for a building evacuation?

Does the unit have any ILSM in-place? (If applicable) EC.02.06.05 EP 2 & 3

Did the unit complete an ICRA and Risk Assessment prior to construction beginning? (If applicable)

Can personnel describe or demonstrate the location and proper use of equipment for evacuating or transporting patients to refuge areas?

Trash containers or solid linen containers are not greater than 35 gallons within a 64 square foot area? LS.02.01.70 EP 2

When was the last fire drill conducted? EC.02.03.03 EP 2

Date of last fire drill within the last 12 months? EC.02.03.03 EP 2

Was an AAR completed for the fire drill?

Medicine and Sharps Storage

Are storage containers locked when unattended? EC.02.01.01 EP 8

Are syringes and needles controlled to prevent public access? EC.02.01.01 EP 8

Are disinfectants or cleaners not stored with medications? EC.02.01.01 EP 3

Is the medication room locked/secured? EC.02.01.01 EP 8

Storage and Handling of Compressed Gases

Are compressed gases stored not exceeding the allowable quantity, properly secured, and segregated 20 feet from combustible materials in non-sprinkler areas or 5 feet in sprinkler areas? NFPA 99; SB-8-75-S11

Risk Assessment Code

Isolated/Facility-wide Issue

Corrective Action Plan

Responsible Party

Estimated Completion Date

Are O2 cylinders tagged properly empty/full/warning tag and do not oil tag? SB-8-75-S11; EC.02.01.01 EP 1 & 3

Risk Assessment Code

Isolated/Facility-wide Issue

Corrective Action Plan

Responsible Party

Estimated Completion Date

Are O2 cylinders bear proof of oxygen purity testing checks upon receipt? SB 8-75-S11; EC.02.01.01 EP 1& 3

Risk Assessment Code

Isolated/Facility-wide Issue

Corrective Action Plan

Responsible Party

Estimated Completion Date

Are compressed gas tanks properly labeled and secured to prevent them from falling or tipping over? Are the caps on when regulators are not in-place (no cylinders are to be stored with regulators attached). 29 CFR 1910.253(b)(2(ii) and (iv)

Risk Assessment Code

Isolated/Facility-wide Issue

Corrective Action Plan

Responsible Party

Estimated Completion Date

Are oxygen cylinders stored correctly? Are empty and full containers physically separated? In-use cylinders are not stored with full cylinders?

Hazardous Communication

Does the unit have a HAZCOM site-specific program with training? 29 CFR 1910.1200

Risk Assessment Code

Isolated/Facility-wide Issue

Corrective Action Plan

Responsible Party

Estimated Completion Date

Are the hazardous chemical inventories current and all Safety Data Sheets available for each hazardous chemical? 29 CFR 1910.1200(g)(1) and (g)(1)(i); EC.02.02.01 EP 1 and 11

Risk Assessment Code

Isolated/Facility-wide Issue

Corrective Action Plan

Responsible Party

Estimated Completion Date

Is personal protective equipment (PPE) available? 29 CFR 1910.132(a); EC.02.02.01 EP 3

Risk Assessment Code

Isolated/Facility-wide Issue

Corrective Action Plan

Responsible Party

Estimated Completion Date

Is PPE properly stored? 29 CFR 1910.132(f0(2)(v); EC.02.02.01 EP 3

Risk Assessment Code

Isolated/Facility-wide Issue

Corrective Action Plan

Responsible Party

Estimated Completion Date

Has the staff been trained on donning, doffing, storage, disposal, and limitations of PPE? 29 CFR 1910.132(f)(2)(iii); EC.02.02.01 EP 3

Risk Assessment Code

Isolated/Facility-wide Issue

Corrective Action Plan

Responsible Party

Estimated Completion Date

Does the HAZCOM representative on orders and have a training certificate?

Are all chemical labels in English? 29 CFR 1910.1200(f)(2); EC.02.02.01 EP2

Are chemicals separated by hazard type? EC.02.02.01 EP 35

Are labels properly affixed to incoming containers of hazardous materials? 29 CFR 1910.1200(f)(9); EC.02.02.01 EP 12

Are flammable storage cabinets properly marked with "Flammable - Keep Fire Away"? 29 CFR 1910.106(d)(3)(ii); EC.02.02.01 EP 12

Are flammable storage cabinets only used for flammables? EC.02.02.01 EP5

Are flammables stored and labeled correctly? EC.02.02.01 EP 5 and 12

There are no items stored on top or in front of a flammable storage cabinet? EC.02.02.01. EP 5

Are no more than 10 gallons of flammable liquids stored outside a flammable cabinet? NFPA 101 Chapter 19.3.2; EC.02.02.01 EP 5

Does the unit have emergency procedures for handling hazardous spills or exposures? 29 CFR 1910.106(e)(9)(i); EC.02.02.01 EP 3

If the staff familiar with the location of the eyewash station? EC.02.02.01 EP 3; ANSI Z358

Are eyewash stations activated weekly and emergency showers activated monthly? Is there documentation of the checks? EC.02.02.01 EP 3 ANSI Z358

Is the pathway to the eyewash station or shower unimpeded (10 seconds to reach)? EC.02.02.01 EP 3 ANSI Z358

BSL-2 DA PAM 385-69

Does the laboratory supervisor enforce institutional policies that control access to the laboratory?

Do personnel have access and screened for or enrolled in appropriate medical surveillance program?

Do personnel wash hands after working with potentially hazardous materials and before leaving the laboratory?

Is eating, drinking, smoking, handling contact lenses, applying cosmetics, and storing food for human consumption not allowed in laboratory areas?

Is mouth pipetting prohibited; mechanical pipetting devices used?

Are sharps such as needles, scalpels, pipettes, and broken glassware handled safely?

Are work surfaces decontaminated after any spill or splash of potentially hazardous material?

Are potentially infectious materials decontaminated before disposal?

Are biosafety symbols at the entrances of the laboratory with supervisor's name (or other responsible person), telephone number

Are personnel entering the laboratory advised of the potential hazards?

Is the laboratory-specific biosafety manual available and accessible?

Is potentially infectious materials placed in a durable, leak-proof, container during collection, handling, processing, storage, or transport within the facility?

Is laboratory equipment routinely decontaminated?

Is laboratory equipment decontaminated after spills, splashes, or other potential contamination? I

is laboratory equipment decontaminated before repairs, maintenance, or removal from the laboratory?

Is PPE removed before leaving non-laboratory areas?

Are the doors of the laboratory self-closing and have locks?

Does the laboratory have a sink for hand washing and located near the exit door?

Is the laboratory furniture capable of supporting anticipated loads and uses?

Are spaces around benches, cabinets, and equipment accessible for cleaning?

Are laboratory chairs covered with non-porous material and can be easily decontaminated?

Are vacuum lines protected with HEPA filters or their equivalent?

Safety Program Assessment

Is the ADSO/CDSO on appointment orders and has appropriate training? EC.01.01.01 EP 1

Does the unit have a statement of authority to intervene in any unsafe act that can cause serious injury or death?

Does the clinic/area have reporting procedures that involve property damage, occupational illnesses and injury to staff, patients, and visitors?

Does the clinic/area identify hazards? Does the clinic/area perform self-inspections at least monthly to identify and mitigate hazards? Dos the clinic/area have a risk assessment for all duties and have staff members review the risk assessments? EC.02.01.01 EP 1

Does the clinic/area have procedures for emergencies? Does staff know what to do for each type of emergency?

Can the staff describe their role in any actual or simulated disaster?

Are all employees part of a continuing training program?

Are safety/EOC policies and procedures up to date? EC.01.01.01 EP 3 & 6

Can personnel describe or demonstrate safety risks in the environment of care? EC.03.01.01 EP 2

Do all newcomers receive Environment of Care training and job specific standards before starting work

Can personnel describe or demonstrate actions to eliminate, minimize or report safety risks in the environment? EC.03.01.01 EP 2

Does the unit have annual evaluations of the EC Elements? EC.04.01.01 EP 15

Does the clinic have quarterly safety committee Dmeeting minutes on file; Accident tracking log and hazard tracking log up to date? EC.04.01.01 EP 1, 2 & 5

Does the unit have 5 years of the OSHA 300 logs? EC.04.01.01 EP 4

Do the sections have a DRAW, JSA or SOPs for procedures when there are no other instructions that identify hazards, hazard mitigation, and how to safely work? EC.02.01.01 EP 1

Safety Board Requirements (paper or electronic)

Is the unit's Strategic Safety Plan specific, measurable, attainable, realisitic, and timely?

is there reporting procedures for accidents and hazards posted?

Is a section's risk assessment posted for all employees to access? (Not more than 12 months old)?

Is the Federal Safety and Occupational Heatlh Poster signed and available?

Does the unit display the command safety policy letters?

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.