Audit

Contractor acknowledges proper insurance, certification, licensure

Add media

Adequate barriers, cones, safety tape in place as necessary.

Add media

Ceilings will be closed during breaks, meals, or for any period longer than 30 minutes in duration

Add media

If tile removed in High Risk areas (ICU, Nursery, NICU, etc.) containment is required

Add media

PCRA/ ICRA required

Add media

Map identifying work area(s) submitted prior to permit issuance

Add media

Penetrations required/ permit issued

Add media

Dust containment in proper working order with HEPA negative pressure

Add media

Per-existing conditions identified

Add media

Interim Life Safety Measures in place, if necessary

Add media

Contractors trained regarding ILSM

Add media

No cables or supports on sprinkler pipe

Add media

Contractors aware of egress routes

Add media

Disruption to facility kept at a minimum in high-traffic areas

Add media

All exits clear

Add media

Free access to Emergency Services

Add media

Alternate routes for public and emergency use

Add media

Additional firefighting staff and equipment available in conjunction with "Hot Work" permit if performing any work above ceiling

Add media

Smoking is strictly prohibited

Add media

Construction site clean and orderly

Add media

Contractors are informed if adjacent areas affected

Add media

Proper ladders/ scaffolding in use

Add media

Effective site storage of materials and equipment

Add media

Fire zones maintained, contractors aware of changes

Add media

Will there be any Noise and Vibration Risks? (Noise and Vibration Risk Assessment" form required if answered "Yes")

Add media
Select date
Add signature
After completion of work, inspections SHALL be scheduled with a representative of Facility Engineering prior to job closure and final approval. Any deficiencies will be corrected by contractor within three (3) business days after notification of deficiency. If no corrective action for the non-compliant work is made, South Austin Medical Center will make the appropriate corrections at market cost ($30.00/ Hr labor, plus material) and invoice the deficient party.
Add signature
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.