University Care Monthly Inspection (updated 4/12/18)

• Document No.

• Audit Title Monthly Inspection

• Client / Site UMMS - University Care

• Conducted on

  Date

• Prepared by Ted Saunders, CFPS

• Location
  Address

• Personnel

Functional testing of emergency/exit lighting is conducted during a monthly inspection for not less than 30 seconds, except as otherwise permitted per NFPA 101 7.9.3.1(2) Inspection of fire extinguisher includes checking that pin is still in place, seal isn’t broken, inspection tag isn’t past due, and tag is dated and signed by auditor.

Emergency Lights

• Emergency light is functional

• Main exit vestibule

  Yes

  No

  N/A

• Main exit (interior)

  Yes

  No

  N/A

• Hall to Women's Center

  Yes

  No

  N/A

• Hallway door to Women's Center

  Yes

  No

  N/A

• Cancer Center

  Yes

  No

  N/A

• Stork's Nest (combo)

  Yes

  No

  N/A

• Door to medical records room (combo)

  Yes

  No

  N/A

• Exit from Women's Center waiting room (combo)

  Yes

  No

  N/A

• Exit from Women's Center treatment area

  Yes

  No

  N/A

• Entrance to OB/GYN hall (combo)

  Yes

  No

  N/A

• Wall near OB/GYN (combo)

  Yes

  No

  N/A

• End of OB/GYN hall (combo)

  Yes

  No

  N/A

• OB/GYN room 145 (combo)

  Yes

  No

  N/A

• Patient restroom in OB/GYN

  Yes

  No

  N/A

• OB/GYN exit to lobby (combo)

  Yes

  No

  N/A

• Hall by lab (combo)

  Yes

  No

  N/A

• Inside lab

  Yes

  No

  N/A

• Treatment area to lobby (combo)

  Yes

  No

  N/A

• Opposite nurse's station (combo)

  Yes

  No

  N/A

• Treatment area by hall to lab (combo)

  Yes

  No

  N/A

• End of hall to lunchroom (combo)

  Yes

  No

  N/A

• Community room (combo)

  Yes

  No

  N/A

• Rear hall junction (ceiling mount combo)

  Yes

  No

  N/A

• At rear exit (combo)

  Yes

  No

  N/A

• In kitchenette

  Yes

  No

  N/A

• Rear side exit (combo)

  Yes

  No

  N/A

• Archway from treatment area to waiting room (combo)

  Yes

  No

  N/A

• Archway to Couaro's desk (combo)

  Yes

  No

  N/A

• Men's restroom

  Yes

  No

  N/A

• Women's restroom

  Yes

  No

  N/A

• Patient restroom near nurse's station

  Yes

  No

  N/A

Exit Lights

• Exit lights are functional

• Door from Cancer Center

  Yes

  No

  N/A

• In Cancer Center

  Yes

  No

  N/A

• Front hall to Women's Center

  Yes

  No

  N/A

Fire Extinguishers

• Extinguishers are charged, mounted, tagged and intact.

• Front security desk

  Yes

  No

  N/A

• Hall to Women's Center

  Yes

  No

  N/A

• By Stork's Nest

  Yes

  No

  N/A

• Lab hallway

  Yes

  No

  N/A

• Inside lab

  Yes

  No

  N/A

• Kitchenette

  Yes

  No

  N/A

• Rear side entrance

  Yes

  No

  N/A

Inspection to identify all fire hazards, obstacles in evacuation routes, and other unsafe conditions

• Clear of all fire hazards, obstacles in evacuation routes, and other unsafe conditions

  Yes

  No

  N/A