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ABC _ Health and Safety-2024

1.Today's Date(Required.)
Date
2.Location(Required.)
3.Reviewer's Name and Title(Required.)
4.Date of Last Fire Extinguisher Inspection(Required.)
Date
5.Fire Exits Cleared?(Required.)
6.Smoke detectors checked and are operating properly?(Required.)
7.Emergency Lighting: Unobstructed, operational, emergency lights, and flashlights available?(Required.)
8.Combustibles stored near heat source/water heater(Required.)
9.Exits are unobstructed(Required.)
10.Evacuation maps are accurate and properly located at height of viewing(Required.)
11.Non-Approved Items (Candles, Warmers, Unapproved Space Heaters, etc.) observed(Required.)
12.Kitchen exhaust hood: maintained, clean & free of grease, inspected (oven clean)(Required.)
13.Kitchen hood extinguishing system: operational, inspected (oven and stove working properly)(Required.)
14.Proper storage in refrigerator / freezer (no mixing of meds/food/blood products)(Required.)
15.Is there food that has past expiration dates?(Required.)
16.Refrigerator/Freezers/Ice Machines: clean, maintained in good repair(Required.)
17.Kitchen: area clean, appropriately furnished; appliances are clean and in good working order(Required.)
18.The organization stores and disposes of infectious waste (such as used sharps and body fluids) in a
manner that minimizes the risk of infection(Required.)
19.Chemicals are properly stored in locked closets/cabinets(Required.)
20.All sharps, including knives and scissors, are disposed of properly and locked.(Required.)
21.The organization uses standard precautions, including the use of personal protective equipment (such as
gloves and face shields), to reduce the risk of infection.(Required.)
22.Latex free gloves are available(Required.)
23.Adequate separation of clean and soiled supplies(Required.)
24.Hand Hygiene procedures properly performed by staff during rounds (all sinks have hand soap, paper
towels)(Required.)
25.Non-Alcohol Gel/Soap dispensers available and utilized(Required.)
26.Medication is placed in a safe or filling cabinet etc. and is locked(Required.)
27.First Aid Kits are current with no dates expired(Required.)
28.Over-the-counter medication are current (within one year)(Required.)
29.Medications are current and do not need to be destroyed(Required.)
30.The organization provides outside areas for use by clients, based on the individual’s needs and are
suitable to the individual’s age or other characteristics(Required.)
31.Landscaping: appropriate, good overall appearance, free of debris, lawn mowed, shrubs trimmed, raked,
free of weeds(Required.)
32.Walkways and patios: are clean and uncluttered, used appropriately, in good condition, and resistant to
trips and falls(Required.)
33.Fencing / Gates: appropriate, in good condition, secured as appropriate(Required.)
34.Exterior doors, windows, screens, etc. in good repair and operational(Required.)
35.Exterior building condition: appropriate and in good repair (paint, stucco, etc.)(Required.)
36.Exterior furniture: appropriate and in good condition(Required.)
37.Exterior lighting: appropriate and functional(Required.)
38.All windows close and open properly (they do not get stuck), if any windows are fire exits are they
accessible(Required.)
39.Areas used by individuals served are safe, clean, and comfortable and are maintained in an orderly
fashion.(Required.)
40.Floor covering: appropriate, clean, vacuumed, and in good repair(Required.)
41.Walls: in good repair(Required.)
42.Client beds: have mattress cover, pillow with cover, sheets, blankets, as appropriate. Beds are made,
and clean for new intake.(Required.)
43.Stairs: unobstructed, clean, in good repair, not storage in stairwells(Required.)
44.Furnishings and equipment reflect the ability and needs of the individual served.(Required.)
45.The organization keeps furnishings and equipment safe and in good repair.(Required.)
46.Furniture: appropriate, clean, free of tears, breakage, and free of odor.(Required.)
47.Shelves / Bracketing: appropriate and in good repair(Required.)
48.Washer & Dryers: clean, in good repair(Required.)
49.Restrooms: clean, odor free, non-slip devices in tub/shower(Required.)
50.The organization provides storage space to meet the needs of the individual served.(Required.)
51.Lighting: appropriate and functioning; is controlled by the individuals served, consistent with care, treatment, or services provided(Required.)
52.The organization maintains ventilation, temperature, and humidity levels suitable for the care, treatment, or
services provided.(Required.)
53.Vehicles meet state and city legal requirements (insurance, current registration are in vehicles)(Required.)
54.Vehicle is properly maintained and has service checks, as appropriate(Required.)
55.Vehicle drivers have completed driver safety training(Required.)
56.Vehicle drivers are listed as a driver in HR and copy of DL & Insurance is on file with HR manager(Required.)
57.What are your recommendations for any areas needing improvement?(Required.)
58.What actions have been taken to respond to the recommendations?(Required.)