Nursing Home Safety Checklist Form

Nursing Home Safety Checklist Form

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Facility Name

    Date of Inspection

      Inspector Name

        Location

          General Safety and Environment

          Lighting

            • Adequate lighting in all common areas and resident rooms

            • Emergency lighting operational

            Flooring and Walkways

              • Floors are clean, dry, and free of obstructions

              • Handrails and guardrails are secure and in good condition

              Fire Safety

                • Fire extinguishers are accessible, properly labeled, and inspected

                • Smoke detectors and alarms are functioning

                • Emergency exit routes are clearly marked and unobstructed

                Security Measures

                  • Doors and windows lock properly

                  • Entry points have restricted access

                  Health & Sanitation

                  Cleanliness

                    • Common areas are sanitized regularly

                    • Restrooms are clean and stocked with supplies

                    Waste Disposal

                      • Medical and general waste bins are clearly labeled and regularly emptied

                      • Hazardous waste is handled and stored per regulatory guidelines

                      Emergency Preparedness

                      Evacuation Plans

                        • Evacuation routes and procedures are posted and updated

                        • Staff is trained in emergency response

                        First Aid

                        • First aid kits are stocked and accessible in each unit

                        • Staff is trained in basic first aid and CPR

                        Inspector Manager

                        Date: Date:

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