Sharps Disposal Kit Audit

• Site conducted

  Select

• Date of Inspection

  Date

• Inspection Completed By

• Have any incident reports been submitted since the last audit? (Involving the Sharps Kit)

  Yes

  No

• Locate the SHARPS DISPOSAL KIT

• Is the SHARPS DISPOSAL KIT easily ACCESSIBLE ? (No obstructions, is well lit, easy to reach)

  Yes

  No

• Is the SHARPS DISPOSAL KIT ? (no dust, rust, water leaking or dirt in or on top of the station)

  Yes

  No

• Is the TAMPER SEAL intact and IN DATE (within the next 2 months) ?

  Yes

  No

DISPOSABLE GLOVES

• Locate the DISPOSABLE GLOVES

• How many pairs of DISPOSABLE GLOVES are available ?

• Do the DISPOSABLE GLOVES appear to be in GOOD CONDITION ? (Not tampered with, opened, dirty, ect.)

  Yes

  No

DISINFECTANT WIPES

• Locate the DISINFECTANT WIPES

• How many DISINFECTANT WIPES are available ?

• Do the DISINFECTANT WIPES appear to be in GOOD CONDITION ? (Not tampered with, opened, dirty, ect.)

  Yes

  No

SHARPS BIN

• Locate the SHARPS BIN

• How many SHARPS BINS are available ?

• Do the SHARPS BINS appear to be in GOOD CONDITION ? (Not tampered with, damaged, dirty, ect.)

  Yes

  No

STAINLESS STEEL FORCEPS

• Locate the STAINLESS STEEL FORCEPS

• How many STAINLESS STEEL FORCEPS are available ?

• Are the STAINLESS STEEL FORCEPS in GOOD CONDITION ? (Not tampered with, damaged, dirty, ect.)

  Yes

  No

PLASTIC FORCEPS

• Locate the PLASTIC FORCEPS

• How many PLASTIC FORCEPS are available ?

• Are the PLASTIC FORCEPS in GOOD CONDITION ? (Not tampered with, damaged, dirty, ect.)

  Yes

  No

SAFE HAND GRABBING DEVICE

• Locate the SAFE

• How many SAFE HAND GRABBING DEVICES are available ?

• Are the PLASTIC FORCEPS in GOOD CONDITION ? (Not tampered with, damaged, dirty, ect.)

  Yes

  No

• Please add any additional notes from your inspection below