• Document No.

  • Site supervisor performance audit

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel


  • Progress notes are being reviewed daily?

  • Availability is filled out on appointment calendar?

  • All meetings and appointments scheduled on calendar?

  • Treatment plans, CSSP Addendum, SMA, IAPP, My Crisis all up to date and signed by appropriate team members

  • Incident reports completed and reviewed within 24 hours?


  • Schedule is out 3 weeks in advance with no open shifts

  • Schedule reflected who actually worked


  • Time punches are approved daily

  • Vacations approved at least 2 weeks in advance

Site appearance

  • Cleaning checklist being competed and followed up on

  • Site is clean, well maintained, maintanence concerns are being reported

Staff training

  • Supervisions with all staff are completed?

  • All trainings have been completed with staff

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.