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• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

RO

• Date of inspection

  Date

• Observer

  Select Anne Sallee Mark Ochenduszko Zachary Traficanti Matthew Cuddy

  • Anne Sallee
  • Mark Ochenduszko
  • Zachary Traficanti
  • Matthew Cuddy

• Location

SECURITY

• Limited access to facility by key card entry

  Yes

  No

  N/A

• Emergency numbers are located on or near phones

  Yes

  No

  N/A

• Personnel can find the panic button and understand their role in an emergency or incident

  Yes

  No

  N/A

• Personal valuables are secured or attended

  Yes

  No

  N/A

• Emergency contact list on freezer

  Yes

  No

  N/A

• Alarms are up to date

  Yes

  No

  N/A

LABORATORY PRACTICES

• Fire Safety Plan

  Yes

  No

  N/A

• Chemical Hygiene Plan

  Yes

  No

  N/A

• Biosafety Manual

  Yes

  No

  N/A

• BBP Exposure Control Plan

  Yes

  No

  N/A

• Personnel were observed wearing appropriate PPE

  Yes

  No

  N/A

• Signage on doors reflect the hazards (classIV lasers, Biosafety , Strong Magnetic field)

  Yes

  No

  N/A

• There is no evidence of eating or drinking

  Yes

  No

  N/A

• Refrigerators and microwaves in the lab are labeled

  Yes

  No

  N/A

• Extension cords/power strips not in use or for temporary use

  Yes

  No

  N/A

• Plants and animals not specifically associated with a registered protocol were not observed

  Yes

  No

  N/A

• No sandals /open toed shoes

  Yes

  No

  N/A

• Sharps are safely stored or discarded

  Yes

  No

  N/A

• Biohazard trash is not more than 2/3 full

  Yes

  No

  N/A

• Sharps waste containers are not more than 2/3 full

  Yes

  No

  N/A

• Clean broken glass boxes are not over filled

  Yes

  No

  N/A

• Personnel understand waste stream management<br> Only soiled or potentially infectious items are in biohazard trash

  Yes

  No

  N/A

• Biosafety cabinets are currently certified

  Yes

  No

  N/A

FIRE SAFETY

• Personnel understand their specific evacuation strategy

  Yes

  No

  N/A

• Doors are not propped open

  Yes

  No

  N/A

• Evidence of annual code red drill

  Yes

  No

  N/A

• Exit signs are properly illuminated, visible, and properly located to indicate egress route

  Yes

  No

  N/A

• Egress routes are free and clear of equipment and other obstacles

  Yes

  No

  N/A

• Fire alarm notification, detection and suppression systems, electrical panels, electric switches unobstructed

  Yes

  No

  N/A

• 18" of clearance below the plane of the sprinkler head

  Yes

  No

  N/A

• Fire extinguishers in the lab are unobstructed and inspected monthly by lab personnel

  Yes

  No

  N/A

CHEMICAL SAFETY

• Stored chemicals are segregated by hazard class

  Yes

  No

  N/A

• Combustible organic acids (glacial acetic acid)

  Yes

  No

  N/A

• Chemical waste streams are properly labeled and contained in the SAA

  Yes

  No

  N/A

• Flammable liquids are in a flammable storage cabinet. Flammable liquids are returned to the cabinet when not in use

  Yes

  No

  N/A

• Secondary containers are labeled and stored properly

  Yes

  No

  N/A

• Appropriate chemical spill kit available

  Yes

  No

  N/A

• SAA is in compliance

  Yes

  No

  N/A

FACILITIES

• No damage to walls , ceiling, floor. Lights function, doors not propped open

  Yes

  No

  N/A

• Trash is removed routinely

  Yes

  No

  N/A

• Floors are cleaned routinely

  Yes

  No

  N/A

• Floors and bench tops are clean and free of clutter

  Yes

  No

  N/A

• Chemical fume hoods have been tested by B&G

  Yes

  No

  N/A

• Compressed gas cylinders are secure

  Yes

  No

  N/A

• Are labels on sinks "No Dry Ice" "No mercury"

  Yes

  No

  N/A

• Vacuum breakers are installed on hoses (faucet contamination)

  Yes

  No

  N/A

• Cryogenic liquids are stored in a well ventilated area

  Yes

  No

  N/A

• Eye wash stations are unobstructed and tested weekly

  Yes

  No

  N/A

• Emergency showers are unobstructed and tested annually

  Yes

  No

  N/A

• Electrical panels are unobstructed /covered

  Yes

  No

  N/A

• Exposed wiring and damaged electrical cords were not observed

  Yes

  No

  N/A

FOLLOW UP

• Issues were resolved

  Yes

  No

  N/A