Facility Checklist

Facilities/Advanced Patient Care

Layout and potential use of former advanced care areas for general surge. Aspects being evaluated for general surge capacity, not for original purposes.

Date: ____________  Location: _______________________  Team member: __________________________

Operating Rooms

 

Observations:

 

General Condition:

 

Description of Structural Components

Floors:
Ceilings:
Windows:
Doors:
Missing, Damaged Structural Components (Note Location):

 

Pests/Mold

Description and location:

 

Communications

Nurse call system?
Other?
Telemetry system?

 

Lighting

Regular:
Emergency:

 

HVAC and Air Flow (ducts, vents, and radiators)

General condition:

 

Air Flow:

Y	N	Sinks?
Y	N	Floor drains?

 

Fire Suppression:

Y	N	Sprinkler heads?
Y	N	Extinguishers?

 

Waste Management and Hazardous Materials:

Y	N	Containment and storage capability?
Y	N	On-site treatment/management set-ups?

 

Hazardous Materials Management (storage, use):

Y	N	Segregated hazardous wastes storage?
Y	N	Shielded radioactives storage?
Y	N	Eye washes, drench showers?
Y	N	Flammables cabinets?
Y	N	Compressed gases chains?

 

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