Facility Checklist

Facilities/Patient Care

Overview information for the general patient care areas in the surge facility. More detailed information to be collected by medical, facility, and supplies experts. Section is divided into sub-sections according to previous patient care purpose. Medical, supply, and administrative experts will also tour this part of the facility.

Date: ____________  Location: _______________________  Team member: __________________________

General

 

Observations:

 

General Condition:

 

Description of Structural Components

Floors:
Ceilings:
Windows:
Doors:

 

Missing or damaged structural components (note location):

 

Pests/Mold

Description and location:

 

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