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  • Audit Title

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Environmental compliance

  • Are items stored at least six inches off the floor?

  • Are items stored 18 inches below ceiling?

  • Are windows sills free of items?

  • Is overall appearance of unit clean and uncluttered?

  • Are hallways free of items?

  • Are ceiling tiles free from stains?

  • Is the area free from visible dust?

  • Are vents in the area clean and dust free?

  • Are work surfaces uncluttered and clean?

  • Are patient care areas free from staff food, drinks, and other belongings?

Equipment compliance

  • Is furniture safe and secure without worn or torn spots?

  • Are clean and dirty supplies stored separately?

  • Is dirty linen contained within hampers and soiled linen off the floor?

  • Have supplies been checked for outdated and rotated?

  • Items are not being stored within the splash zone (3 feet) of the sink?

Sharps/Biohazard compliance

  • Are sharps containers replaced when 2/3 full?

  • Are sharps containers secured?

  • Are biohazards labeled and handled appropriately/disposed of properly?

Temperature compliance

  • Are temperature logs up to date with actions taken when not in range?

  • Is the medication refrigerator labeled and free of food items?

  • Is the biohazard/breast milk refrigerator labeled and free of food items?

  • Do airborne precaution rooms have all door closed?

  • Is linen being transported covered?

  • Is linen stored and covered appropriately?


  • Are there any additional comments or concerns?


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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.