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DATE: LOCATION: SURVEYOR:
SAFETY AUDIT CHECKLIST
General Safety
YES NO N/A
1.
Are drawers kept closed at all times when not actually in use?
2.
Are chairs and other furniture in good condition?
3.
Are all compressed gas cylinders that may be in your area secured from falling over?
4.
During the survey, were all staff observed using proper body mechanics?
5.
In areas where items are stored or placed overhead, is there ready access to a suitable step
stool, stepladder, or similar device?
6.
In storage areas, are the heavier items stored at waist level, with the lightest objects placed on
the higher shelves?
7.
Are all vehicles (carts, wheelchairs, etc.) in good operating condition?
8.
Has personal protection equipment (as required by MSDS or other standards) been provided to
all employees needing it?
9.
Has staff been trained on how to inspect and use patient care equipment?
10.
Is the area free of clutter?
11.
Is excess paper and combustible material improperly stored creating a fire risk?
Fire & Disaster
YES NO N/A
12.
Are all fire alarm pull stations and fire extinguishers accessible?
13.
Does all staff know the locations of fire alarm pull stations?
14.
Does all staff know the locations of extinguishers in or near their work area?
15.
Does staff in the area know the proper reporting procedure if they find (or believe there may be)
a fire? (RACER)
16.
Is all storage kept at least 18" below the sprinkler head keeping sprinklers unobstructed?
17.
Are all containers of powders, liquids, and gases labeled as to contents?
18.
Are all areas in compliance with “No Smoking” policies?
19.
Are all areas, other than approved kitchens, free of Toasters or Toaster Ovens?
20.
If portable space heaters are used, are they the approved type?
(See Page ____ in the Safety Manual for approved heater type)
Hallways, Stairs, & Exit Paths
YES NO N/A
21.
Are the corridors kept clear of obstructions?
22.
Are all wet floors marked with "CAUTION, WET FLOOR" (or similar) signs?
23.
Is carpeting secure to the floor, unfrayed, free from tripping hazards, and generally in good
condition?
24.
Are hard floor surfaces secure and free of tripping and slipping hazards?
25.
Are floor surfaces uneven or in need of repair?
26.
Are all EXIT signs illuminated?
27.
When opened and then released, do all fire doors close and latch properly?
28.
Are stairwell handrails in good condition?
29.
Are stair treads in good condition?
30.
Are stairwells completely clear of obstructions and any objects?
(Stairwells may not be used for storage)
31.
Is the housekeeping in this area adequate?
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