the life safety surveyor facility tour checklist for the facility building tour (continued)...

The Life Safety Surveyor Facility Tour

Checklist for the Facility Building Tour (continued)

Electrical and Communication Closets

Check: All vertical penetrations properly sealed, and horizontal

penetrations sealed for rated rooms; electrical panels

properly labeled for correct circuits; arc flash labels on

electrical panels and disconnects

Healthcare Engineering Consultants



Clean Utility Rooms

Check: 1) Locked if sharps or medications stored

2) Compressed gas cylinders properly secured,

physically segregated and labeled FULL / EMPTY

3) No original shipping containers

4) No dirty supplies or equipment

5) No supplies on floor

6) Lower supply shelf covered




Dirty Utility Rooms

Check: 1) No food or consumable items

2) Only clean supplies and equipment present

3) Locked if required by AHJ

4) Risk assessment recommended if the room is

unlocked

5) Normally no need for eyewash stations unless

corrosives are present and evaluated through risk

assessment



Checklist for the Facility Building Tour (continued) Linen or Trash Chutes

Check: Room or chute locked; chute door rated at least 1.5 hours;

sprinkler in chute every other floor; door self-closing and

latching

Linen or Trash Chute Receiving Room

Check: Chute door closed or fusible link; room and door rated the same as

required for the chute; door self-closing (see NFPA 82 - 5.2.4.2)



Checklist for the Hospital Building Tour (cont’d)

Hazardous Areas

Check: Storage of flammables, room rating, door closer

Clean Linen Rooms

Check: Carts provide 18” sprinkler head clearance; room at

positive pressure; no dirty linen present; door self-closing




Soiled Linen Rooms

Check: 1) Sprinkler head clearance >18” vertically, 4” horizontally

2) Dirty linen separated from “clean”

3) Room at negative pressure relative to corridor

4) Room and door rated for hazardous area

5) Door closer

Fire Extinguishers

Check: Log sheets, test tags and dates (surveyor may ask about

extinguisher “HEFT” check




Eyewashes, Showers and Bottles

Check: 1) Log sheets, test tags and dates

2) Tempered water (60 – 100 F)

3) Placement: < 55 feet from chemicals

4) Risk assessment performed?

5) Policy for testing

6) Bottles are considered “first aid”

stations, not eyewash stations!

7) Reference: ANSI Z358.1




Medical Waste Storage

Check: Locked area, secure, sharps not accessible

Loading Dock

Check: Smoking violations, improper storage, powered

equipment that can be energized (compactors,

balers, autoclaves)




Kitchen Area

Check: Cleanliness; dry storage room fire-rated with self-

closing door; sprinkler head clearance; CO2 tanks secured;

refrigerator temps, K-type portable extinguishers within 30’ of

fat fryer, sterno or butane cans properly stored




Mechanical Equipment Rooms

Check: Storage, unlabeled containers, cigarettes; rated walls

and doors; properly sealed penetrations




Emergency Generators

Check: In “auto” mode, batteries/ charger, fuel leaks;

emergency battery lights




Medical Gas Systems

Check: Manifolds, flexible connectors, medical air (dew point

and CO), vacuum pumps, compressed tanks, ventilation




Compressed Gas Storage Rooms

Check: 1) Full and Empty separation

2) Chained, secured or on racks

3) Room rating (gas volume)

4) Door signage

5) Active exhaust grille placed

12” from floor




Egress Corridor Ceilings

Check: Stained ceiling tiles, dirty or corroded sprinkler heads,

escutcheon plates missing, <3 feet clearance from smoke

detectors to air supply or exhaust vents




Fire Pump

Check: Controls turned “on”, valves open, tampers “OK”, water

leaks on floor

Fire Annunciator Panel

Check: Bypass, trouble, ground fault, supervisory, actual

alarm condition, other coded messages, power “off”




ILSM Verification

Check: Construction areas for interim measures

PFI Verification Check: Verify that previous PFI’s have been resolved

Chapel

Check: Candles, open flames



Questions?


the life safety surveyor facility tour checklist for the facility building tour (continued)...

Documents

facility building tour

room check

bottles check

extinguishers check

locked chute door

dates surveyor

trash chutes check

chute door selfclosing