SHIBH AL JAZIRA CONTRACTING COMPANY Reference: F-24/IMS-PR-06

QHSE DEPARTMENT Rev: 00

Clinic Daily Checklist Dated: July 15th, 2018

Date from: …………………… Date to: ………………

Name of nurse on duty: ………………………………………………………. ID#.......................

SAT SUN MON TUE WED THU FRI

ITEMS
y n y n y n y n y n y n y n
Is the area tidy?
Access free from
obstruction?
Lights working
properly?
Emergency contact
numbers available
inside the clinic?
No expired supplies or
medications?
Electrical connections
and equipment are
inspected and color
coded?
Is clinic log book
maintained?
Is oxygen cylinder
secured and working?
Oxygen Cylinder Gage
working properly?
Medication cabinet
locked?
Is toilet tidy?
Is water heater
available / working?
Biohazard bin
maintained?
Are wastes disposed
properly?
Bed and beddings are
cleaned?
AC unit is available and
working?
Medical equipment
sterilized?
Fire extinguisher
inspected and color
coded?
Male Nurse
signature.

F-24/IMS-PR-06, Rev. 00