Safety and Fire Assesment Checklist

Audit verification
Signature of the inspector
Date
Name
Electrical Safety and risks
Are electrical outlets authorized and in good condition?
Are used surge protectors authorized?
Are fuse boxes appropriately labeled?
Are electrical space heaters, extension cords or devices secured?
Are transformers placed in an approved surface?
Are electrical equipment and tools in safe condition?
Is HAZCOM training given to staff members?
Is PPE easily accessible and available?
Did you find proper labels on hazardous material containers?
Are all applicable hazardous materials stored in secondary containers?
Is there aproper storage of hazardous materials and cleaning agents?
Are Material Safety Data Sheets maintained and easily accessible?
Are SHARP containers affixed to the wall and emptied when 3/4 full?
Are laboratory rooms properly locked when not in use?
Eyewash Stations and safety
Are there adequate eye wash stations?
Are emergency eyewash stations and showers tested weekly and reported?
Are emergency eyewash stations clean with eye cap protectors installed and are they obstruction free?
Fire and safety checks
Are utility and fire alarm systems freely accessible?
Is there a monthly fire extinguisher inspections and are records kept for the same?
Are stairwells clean and obstruction free?
Do all exit doors function properly? And are they well maintained?
Are all latches working properly?
Are emergency exit signs functioning properly and visible clearly?
Are keys for unlocking patient bathrooms and toilets easily available in case of an emergency?
Did you find any broken or water damaged ceiling tiles?
In case of broken/damaged tiles, does it need repair/replacement?
Ignitable Liquid inspection
Did you find liquid chemicals stored below eye level in all sections?
Are flammable/combustible items protected with sprinkler system?
Are flammable/combustible items secured?
Medical facilites and reports
Are medical equipment users able to describe capabilities, limitations, and applications of equipment?
Are medical equipment users able to express operating and safety procedures for equipment use?
Are medical equipment users able to express emergency procedures in case of equipment failure?
Are users of medical equipment able to report problems, failures, and user errors?
Is there a routine check for expiration dates?
Are user manuals for equipment readily available and updated?
Are nurse call and security alarms tested monthly?
In patient bathrooms and toilets, are call buttons available?
Other checks
Is the temperature of hot water for the hot water bags and baths tested with a thermometer?
Did you find any other structural safety and tripping hazards?
Are hazards identified, recorded and are corrective actions taken?
Are safety, fire work orders prioritized and followed up?
Are drug cabinets, distinctive bottles, poisons secured and properly labelled?
Are safety related supply items requisitioned when needed?
Are emergency phone numbers easily accessible?
Are storage rooms organized with heavier items on lower shelves?
Doors of storage rooms are properly secured and locked?
Is there a distance of 18 inches between sprinklers and stored materials?
Are curtains of storage rooms changed every 6 months?
Protective gear and disinfection
Is appropriate PPE available and worn?
Is PPE available, properly maintained and used when required?
Is the steam always shut off before opening any sterilizer?
Safety plan evaluation
Can the staff members explain about the safety risk in the environment of care?
Are staff members able to express the actions to reduce safety risks in the environment?
Are all areas including corridors obstruction free and reduce slipping/tripping?
Do all newcomers receive fire, safety, training before starting to work?
Are all Safety procedures up to date and easily available?
Are staff members able to explain specific role/responsibilities in preparing for building evacuation?
Can personnel demonstrate location and proper use of equipment for evacuating or transporting patients to refuge?
Are annual fire drills evaluated and recorded properly?
Are employees part of a continuing training program?
Are self inspections conducted monthly and are actions taken, along with maintaining records?
Are defibrillators daily checked and recorded?
Are pre-holiday or pre-season safety briefings conducted and recorded properly?
Is there a proper monitoring to correct deficiencies that are discovered during fire & safety inspections?
Are accidents recorded and is an appropriate report prepared and forwarded to the Health Center Safety Manager in a timely manner?
Do supervisors investigate accidents and take corrective actions?
Do supervisors ensure that accident report forms are completed and sent to health care office?
Security of Oxygen container
Did you find "No Smoking" and "No Smoking Oxygen Tanks In Use" signs?
Are Oxygen cylinders stored separately from flammable and combustible material?
Is the storage of oxygen cylinders secured?
Are "Do Not Oil" signs displayed on oxygen tanks?
Are compressed gas cylinders properly labeled and secured to prevent falling?
Outside X-ray rooms, are all switches and operating devices in working condition?
Are lead aprons inspected and recorded?
In X-ray rooms, are radiation and pregnancy warning triangle posted?
Service System
Are utility system users able to explain about the utility system capabilities, limitations, and special applications?
Are utility system users able to explain about the emergency procedures in case of a system failure?
Are utility system users able to report utility systems management problems and errors?
Are utility system users able to explain about the location and use of emergency shut-off controls?
Are utility users able to describe who to contact in case of emergency?

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