Facility Self-Assessment (Mock Survey) Tool - Nursing Home Help
Facility Self-Assessment (Mock Survey) Tool - Nursing Home Help
Facility Self-Assessment (Mock Survey) Tool - Nursing Home Help
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PHYSICAL PLANT ROUNDS - INITIAL TOUR (continued)<br />
TAG # STANDARD MET NOT MET COMMENTS<br />
SAFETY (cont)<br />
F-323 Biohazardous Waste locked with appropriate signage<br />
F-468 Handrails<br />
F-323 Safety hazards<br />
F-323 Water temperature 105-120 degrees<br />
F-456 Emergency outlets red<br />
F-517 Corridors unobstructed<br />
F-323 Storage off floors/18 “below ceiling<br />
F-323 Chemicals labeled<br />
F-371 Chemicals stored properly/not left unattended<br />
F-253, F-456 Equipment inspected<br />
F-323 Oxygen signage<br />
F-323 Oxygen storage<br />
F-323 Liquid Oxygen (5 ft from electrical outlet)<br />
F-323 Tank storage<br />
F-323 Functional call lights<br />
F-431 Med carts secured<br />
F-431 Treatment carts secured<br />
F-257 Air temperature (71-81 degrees F)<br />
F-456 Penetration of smoke barrier<br />
F-323 Shut-off valves labeled<br />
F-456 Exhaust fans working<br />
F-464 Designated smoking area<br />
F-252, F-323 Extension cords 3-pronged<br />
F-463, F-241 Call system<br />
F-456, F-323 Cords not frayed<br />
F-456 Garbage cans fire rated<br />
F-246 Safe storage of patient items<br />
F-323 Wet floor signs<br />
5.53
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