Department Checkpoint Yes No Remarks

Fire Safety Inspect fire alarms

Fire Safety Check smoke detectors
Fire Safety Verify fire extinguisher locations
Fire Safety Ensure fire exits are clear
Emergency Exits Inspect emergency exit signs
Emergency Exits Check emergency lighting
Emergency Exits Ensure exits are accessible
Electrical Safety Inspect electrical panels
Electrical Safety Check wiring for wear
Electrical Safety Verify grounding and bonding
Medical Equipment
Safety Inspect power connections
Medical Equipment
Safety Check for dedicated circuits
Medical Equipment
Safety Verify equipment grounding
Chemical Safety Inspect chemical storage
Chemical Safety Check for proper labeling
Chemical Safety Verify safety data sheets availability
Patient Safety Inspect patient rooms for hazards
Patient Safety Check handrails and grab bars
Patient Safety Verify call button functionality
Workplace Safety Inspect work areas for hazards
Check personal protective equipment
Workplace Safety (PPE)
Workplace Safety Verify safety training records
Security Inspect security cameras
Security Check door locks and access control
Security Verify visitor check-in procedures
Environmental Safety Inspect waste disposal systems
Environmental Safety Check for hazardous waste handling
Environmental Safety Verify spill response procedures
Documentation Review safety logs and records
Documentation Update safety protocols and plans

Name:

Designation:

Signature: