Adamus Resources Limited

Environmental Health & Safety Annual Clinic In

Date:
Re-inspection date:
Auditor:
Signs & Labels
Are the following labeled correctly?
Medical Waste Containers
Sharps Containers
Crash Cart
Clinic signs completed with emergency contact
All chemical containers
Engineering Controls Points
Are safety sharps available?
Is fire extinguisher checked monthly and serviced
annually?
Are gas cylinders secured properly?
Personal Protective Equipment Points
Are the following articles of PPE worn when required?
Is protective clothing (lab coat, scrubs) worn by staff?
Is eye protection worn/available as needed?
Are low protein, non-powdered latex gloves available to staff?
Is there an approved alternative to latex gloves available?
Is respiratory protection available to staff if needed?

Work Practices Points

Are the following work practices followed?
Handwashing gel,paper towels, alcohol foam, and approved lotion are available?
Food/drink are stored and consumed in designated area
No expired supplies or medications?

Waste Management/Sterilization/Disinfection Points

Are the following in place?
Proper separation of infectious and regular waste?
Sharps container not over 2/3 full?
Soiled linen stored in covered hamper/closed bag?
Clean linens stored covered?
Are dirty supplies separated from clean supplies?
Has mercury been eliminated from this clinic?

Emergency Procedures Points

Are all employees aware of these procedures?
Do clinical staff know where to evacuate in case of a fire?
Do clinic staff know how to use a fire extinguisher?
Does staff know the proper procedures if an
earthquake, tornado, hazardous spill, or injury
occurs?
Do clinical staff know who to call in the event of an
emergency?

HIDU(Highly infectious diseases Unit)

Are all the cells and work areas labelled?
Is chlorine stock available?
Have clinic staff been trained in the HIDU procedure?
Are there sufficient PPE in the HIDU?

Dispensary
Are optimum temperature levels(< 25 degrees) maintained?
Are stock levels monitored?
Are expired drugs monitored?
Are temperature -labile drugs refrigerated?

Ambulance and clinic checks

Is the weekly ambulance and clinic check carried out by staff?
(refer to the clinic and ambulance check list)

Resources Limited
& Safety Annual Clinic Inspection

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NO

REMARKS

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REMARKS

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REMARKS

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COMMENTS

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COMMENTS

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COMMENTS

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COMMENTS

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COMMENTS

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COMMENTS