Facility Checklist

Medical/Patient Care

Availability of other space for ancillary services. Examine general condition of facilities. Other experts will look at these areas from a different perspective.

Date: ____________  Location: _______________________  Team member: __________________________

General

 

Observations:

 

Rooms

Number of floors:
Number of rooms per floor by type:
Single:
Double:
Ward:
General layout:
Applicability of use:
Existing fixed and removable equipment:
Medical gas outlets description:

 

Communications

Nurse call system?
Other?
Telemetry system?
Applicability for use:

 

Medical/patient care issues:

 

Licensing/accreditation issues:

 

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