• Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Supervisor / Manager Name and Contact Number:

  • Police Department Contact and phone number:

  • Who Does Maintance?

  • Safety Rep: and contact Number

  • Site / Address / Phone number
  • Security Rep and Contact Number

  • Personnel

  • Front Layout

Security Technology

  • Card Access in use? / What System?

  • Panic Alarms in Use? What System? Where do they Report to?

  • Security Alarm system in use? What system if yes?

General Security questions

  • Are there CCTV Cameras on site?

  • What CCTV System?

  • How Many doors to the Exterior?

  • How many entrances are unlocked at a time zone?

  • Is Behavioral Health on Site

  • Are Narcotics Keep on Site?

  • Any High Security Incidents in the Last Year?

Money Storage

  • Is Money Keep on Site?

  • Is Money Keep over Night?

  • Is there a Safe on Site?

Active shooter

  • Is there a separation from the registration area/waiting to back area?

  • Is there locking hardware on the doors?

  • Is There Lock Down Buttons in Place? If Yes Locations?

  • Is there a Designated Safe Area? Where?

Documentation /Drills

  • Are Security Alert Code Green Drills Conducted on Site? Last one

  • Is Security Alert Code Green Policy up to Date?

Safe knowledge

  • Are Staff Aware of Active Shooter Plan and Location?

  • Are Staff Aware of who to call when they have a combative patient?

  • Are staff aware of where to complete Security Incident Report?

General Notes

  • Summary Notes:

End Of Assessment

  • Security Rep

  • Building Manager Supervisor or Rep

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.