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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 />

F-431 Glucose strips dated when opened<br />

F-431 Narcotics double-locked<br />

F-431 All meds current/check expiration dates<br />

F-441 No employee food in refrigerator<br />

F-431 Opened meds stored separately from closed meds<br />

F-281 Blood glucose control log up to date<br />

F-431 Respiratory/Treatment meds stored appropriately<br />

F-281 E-Kit Policies & Procedures followed<br />

F-492 E-Kit contents posted in nurses’ station<br />

GENERAL COMMENTS<br />

5.56

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