Information
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
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Select date
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Location:
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Does site contain Asbestos? If so, see Asbestos containment procedures and form.
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Adequate barriers in place?
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Barrier smoke tight/ no combustible?
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Barrier dust proof with walk-off "sticky" pads in place?
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Proper construction signage "Authorized personnel only" / "Contact Engineering for access" signage in place?
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Applicable SAMC permits in place and on display?
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Contractor following proper FGI guidelines for Healthcare construction (Negative pressure relationship with HEPA filtration)?
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Site ADA compliant?
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All trades following OSHA guidelines?
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ILSM, if necessary, in place?
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Trades properly trained regarding ILSM?
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Temporary Fire Protection, if needed, in place?
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Trades aware of Emergency egress routes?
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ILSM Fire Drills being performed?
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All exits clear and not blocked by carts or material?
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Free access to Emergency Services (doors, entrances, drives) not obstructed?
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Alternate route around construction site clearly marked?
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Have trades been properly trained on how to notify PBX in the event of a fire?
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Smoking is prohibited on site and all trades have acknowledged policy?
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Site is clean and orderly?
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Trades are aware of adjacent patient care areas effected by their work and noise?
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Site access restricted?
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Storage of material on site clean, orderly, and not excessive?
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Fire, Smoke control, and Sprinkler systems maintained and functional?
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Will there be any Noise, Vibration, or Drilling involved? If so, fill out "Noise and Vibration Risk Assessment" form.
