Free Nursing Home Safety Checklist Form

Please provide all the necessary information below to customize this form.
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:
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Ensure a secure environment for residents with this comprehensive Nursing Home Safety Checklist Form Template. Designed to streamline safety evaluations, this template provides a structured guide for identifying and managing potential risks. Easily editable with our AI Editor Tool, it simplifies customization, allowing you to tailor each checklist to meet specific safety standards.