• Department / Audit Title

  • Conducted on

  • Prepared by(person doing inspection)

  • Location (Facility address)
  • Name of Unit Manager

1. Building and Internal Structures

  • 1.1 Floor Surfaces even and uncluttered?

  • 1.2 Entry and Walkways kept clear?

  • 1.3 Intersections kept clear of obstructions (boxes,trolleys and equipment)?

  • 1.4 Stairs and risers kept clear and in good repair?

  • 1.5 Liquid spills are removed quickly?

  • 1.6 Ceilings are clean and panels in good repair?

2. Chemicals and Dangerous Goods

  • 2.1 Hazardous Substances Register is up to date and available?

  • 2.2 Safety Data Sheets (SDS) available for all chemicals?

  • 2.3 All containers are labelled correctly?

  • 2.4 Is the correct Personal Protective Equipment (PPE) available and in good working condition?

  • 2.5 Are eye washes and showers easily accessed for spills?

3. Documentation

  • 3.1 Safety notice boards contain latest information?

  • 3.2 Department action plan reviewed monthly?

4. Electrical Safety

  • 4.1 Safety Switches are tested and tagged?

  • 4.2 No broken plugs, sockets or switches, no frayed or damaged cords and no strained leads?

  • 4.3 No leads across walkways or in areas where that can be run over or caught by equipment of staff?

5. Fire Prevention and Emergency Procedures

  • 5.1 Evacuation procedures are displayed appropriately for staff, patients and visitors?

  • 5.2 Fire extinguishers are located correctly and are clearly marked for type of fired to be used for?

  • 5.3 Extinguishers are checked regularly and serviced? (6 monthly)

  • 5.4 Extinguishers are kept clear of obstructions?

  • 5.5 Exit doors open easily from the inside?

  • 5.6 Exits and exit doors are clear of obstructions?

6. First Aid Facilities

  • 6.1 Are cabinets and contents clean and orderly?

  • 6.2 Contents are checked regularly for expired items and to restock after use?

  • 6.3 Cabinets are clearly labelled?

  • 6.4 Staff are aware of location and contents of first aid cabinets?

7. General Lighting

  • 7.1 Good natural / artificial lighting?

  • 7.2 Light fittings clean and in good condition?

  • 7.3 Emergency exit lighting is operable?

8. Medical Imaging Equipment

  • 8.1 Equipment and controls are kept clear?

  • 8.2 The floors around the equipment are kept clear?

  • 8.3 Is the appropriate shielding in place and in good condition?

  • 8.4 Emergency stop button is functional and easy to locate?

  • 8.5 There is adequate work space around the equipment?

  • 8.6 There is adequate lighting around the equipment and the controls?

  • 8.7 Noise levels are controlled in the MRI environment?

  • 8.8 The noise protection is clean and easily accessible to the MRI scan room?

  • 8.9 Radiation Compliance stickers are up to date?

  • 8.10 Staff are aware of lockout procedures and how to implement them in cases of breakdowns?

9. Office Equipment and Furniture?

  • 9.1 Office and waiting room furniture are in good condition?

  • 9.2 Workstations are ergonomically adjustable for different workers?

  • 9.3 Monitors and other screens are positioned to reduce glare from lighting?

10. Rubbish Disposal

  • 10.1 Rubbish bins are positioned at suitable points around the site?

  • 10.2 Regular emptying of bins occurs ?

  • 10.3 Staff are aware of their responsibility to ensure rubbish collection from their area is performed?

Storage Facilities

  • 11.1 Storage area is clear of obstructions and rubbish?

  • 11.2 Supplies are stored neatly to provide ease of access?

  • 11.3 Cylinders are stored with wall attachments to prevent falls?

  • Additional comments

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.