Physician and medical practitioner safety checklist
Date: |
Inspected by: |
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Bloodborne pathogens |
Pass |
Fail |
N/A |
Action required |
Completion date |
Is a bloodborne pathogen plan in place? |
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Are all employees trained on the bloodborne pathogen plan? |
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Is regulated waste discarded according to applicable laws and regulations? |
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Are medically approved first-aid kit and sharps containers adequately supplied? |
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Compressed gas storage |
Pass |
Fail |
N/A |
Action required |
Completion date |
Are cylinders legible marked to clearly identify the contents? |
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Are cylinders stored in areas that are protected from external heat sources? |
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Are cylinders located or stored in areas where they will not be damaged by passing or falling objects or tampered with by unauthorized persons? |
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Are cylinders stored or transported in a manner to prevent them from creating a hazard by slipping, falling or rolling? |
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Are valve protectors/caps in place on cylinders that are not in use? |
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Elevators |
Pass |
Fail |
N/A |
Action required |
Completion date |
Are inspection certificates up to date and available for inspection? |
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Do elevators provide sufficient space for moving passengers, equipment or cargo between floors? |
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Exam rooms |
Pass |
Fail |
N/A |
Action required |
Completion date |
Are warning labels properly posted for all medical equipment? |
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Are sufficient supplies available for safe operations? (gloves, hand washing facilities, etc.) |
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Hazard communications/chemical handling |
Pass |
Fail |
N/A |
Action required |
Completion date |
Are eyewash fountains and safety showers provided and in working order where corrosive chemicals are handled? |
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Are chemical containers labeled properly? |
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Is proper PPE available when necessary to handle chemicals? |
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Are flammable and toxic chemicals properly stored in closed containers when not in use? |
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Are chemical piping systems clearly marked as to content? |
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Are adequate means readily available for containing spills or overflows properly and safely? |
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Are hazardous substances handled only in properly designed and exhausted locations? |
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Is there a list of hazardous substances that are used in your workplace? |
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Is the written hazard communication plan up to date? |
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Are all Material Safety Data Sheets up to date and readily available? |
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Are all containers of hazardous substances labeled properly with the product identity and any applicable hazard warnings? |
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Is the master list of chemicals used up to date? |
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Housekeeping |
Pass |
Fail |
N/A |
Action required |
Completion date |
Is a first aid kit available and adequately stocked? |
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Are all exits clearly marked, unlocked and free of obstruction? |
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Are work areas properly illuminated? |
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Are caution labels and signs used to warn of hazardous substances and biohazards? |
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Is there safe clearance for equipment through all aisles and doorways? |
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Are aisles properly marked and kept clear? |
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Are hand trucks maintained in safe operating condition? |
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Are shelves secured and constructed to withstand the maximum designated storage weight? |
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Are shelves secured to prevent tipping or falling? |
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Are floors free of clutter that might cause slips, trips and falls? |
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Are signs used to identify slippery floors when wet or during clean-up? |
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Do stairs have handrails that are in good condition? |
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Material handling |
Pass |
Fail |
N/A |
Action required |
Completion date |
Do employees carry loads in excess of 50 lbs by hand? |
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Are mechanical means provided to carry heavy or awkward loads safely? |
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Are aisles and pathways clear of debris and clearly marked? |
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Office |
Pass |
Fail |
N/A |
Action required |
Completion date |
Are all aisles, passageways and doorways clean and clear of obstruction? |
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Are chairs, benches and other seating surfaces clean, in good condition and lacking undue signs of wear or fatigue? |
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Are adjustable chairs provided for employees that spend significant time seated? |
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Is sufficient lighting provided in all work areas? |
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Are monitors positioned comfortably, with employee eye level near the top of each screen? |
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Are cords arranged such that they do not cause a tripping hazard to employees? |
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Are office supplies stored such that they are easily accessible without undue employee strain? |
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Are floor coverings in good condition, free of slip or trip hazards? |
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Parking/Sidewalks |
Pass |
Fail |
N/A |
Action required |
Completion date |
Are paved surfaces smooth and free of large cracks or unevenness? |
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Are all surfaces free of ice and snow? |
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Are parking spaces clearly marked and sufficiently sized? |
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Are outdoor areas sufficiently lit at night? |
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Personal protective equipment |
Pass |
Fail |
N/A |
Action required |
Completion date |
Are protective goggles or face shields provided and worn where there is a danger of flying particles or corrosive materials? |
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Are approved safety glasses worn at all times in areas where there is a risk of eye injuries? |
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Are protective gloves, aprons, shields or other means provided where employees could be cut or where there is reasonably anticipated exposure to; corrosive liquids, chemicals, blood or other potentially dangerous materials? |
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Is PPE maintained in a sanitary condition and ready for use? |
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Are adequate work procedures and PPE provided and used when cleaning up spilled toxic or hazardous materials or liquids? |
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Are appropriate hypoallergenic gloves, glove liners, powderless gloves, or other similar alternatives readily available? |
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Recordkeeping |
Pass |
Fail |
N/A |
Action required |
Completion date |
Are OSHA 300/300A logs maintained? |
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Are employee medical and exposure records maintained as required? |
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Are training records maintained? |
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Are employee records maintained? |
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Are all operating permits and records up-to date? |
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Are current Motor Vehicle Records available for all employee drivers? |
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Are records kept of all safety inspections? |
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Are records kept of safety meetings? |
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Are records kept of accident investigations? |
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Are records kept of any emergency response drills? |
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Restroom |
Pass |
Fail |
N/A |
Action required |
Completion date |
Are toilet and sink surfaces clean? |
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Are adequate provision made for hand-washing (hot water, soap, towels or hand-dryers) |
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Are floor surfaces clean and dry? |
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Is a record of cleaning and resupply dates/times clearly displayed? |
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Stairways |
Pass |
Fail |
N/A |
Action required |
Completion date |
Are stairways clearly marked? |
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Are stairwells well lit? |
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Are stairwells clean and free of debris? |
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Are handrails secure and in good repair? |
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Are stairwell exit doors unlocked as appropriate? |
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Storage areas |
Pass |
Fail |
N/A |
Action required |
Completion date |
Are shelves secured and constructed to withstand the maximum designated storage weight? |
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Are shelves secured to prevent tipping or falling? |
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Waiting room |
Pass |
Fail |
N/A |
Action required |
Completion date |
Are all chairs, booths and other seating surfaces in good condition, without bent or broken legs or damaged seats? |
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Are floors clear of debris and moisture? |
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Is sufficient lighting provided? |
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Workplace postings |
Pass |
Fail |
N/A |
Action required |
Completion date |
Are OSHA and state required posters prominently displayed? |
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Are safety/warning signs properly posted where appropriate? |
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Are emergency phone numbers posted prominently? |
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Is a first aid kit available and adequately stocked? |
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Are emergency evacuation routes identified and prominently posted? |
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Radiation |
Pass |
Fail |
N/A |
Action required |
Completion date |
Are registration/inspection forms clearly posted near all licensed radiation sources? |
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Is adequate shielding provided for patients? (lead aprons, etc.) |
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Is adequate distance or shielding provided for employees that are potentially exposed to ionizing radiation? |
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Are dosimeters (badges, rings, etc) provided for employees who are likely to be exposed to significant long term doses of radiation? (> 5 mSv/year) |
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Are special protections in place for employees who are or may be pregnant? |
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Are all radiation sources tested regularly by a competent person to assure that x-rays and other types of radiation are not "leaking" outside the intended beam path? |
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Are employees adequately trained on the operation of radiation sources and the dangers associated with high radiation doses? |
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Is an emergency cut-off switch clearly labeled and readily accessible to employees working near radiation sources? |
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