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Round Check List

This facility report from G. P. Shekhawati Hospital in Jaipur, India documents the results of an inspection of the facility to check 25 points related to safety, fire prevention and emergency preparedness. Key items checked include the public address system, signage, electrical wiring, fire extinguishers, fire exits, safety equipment and alarms. Deficiencies are noted along with recommended actions. The report is signed off by the inspector after reviewing conditions.

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lokesh godara
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7K views2 pages

Round Check List

This facility report from G. P. Shekhawati Hospital in Jaipur, India documents the results of an inspection of the facility to check 25 points related to safety, fire prevention and emergency preparedness. Key items checked include the public address system, signage, electrical wiring, fire extinguishers, fire exits, safety equipment and alarms. Deficiencies are noted along with recommended actions. The report is signed off by the inspector after reviewing conditions.

Uploaded by

lokesh godara
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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G. P.

Shekhawati Hospital & Research Centre


Vidhyadhar Nagar, Jaipur (Rajasthan)

Facility Round Report

Date:

Department:

Sl. Points to be Checked Status Remarks


No
1 Public Addressable System Working Yes/No
Properly
2 All signage are properly fixed Yes/No
3 Any visible damage in signage Yes/No
4 Any loose wire visible Yes/No
5 Fire extinguisher available Yes/No
6 RACE & PASS pasted Yes/No
7 Fire Extinguisher easily accessible Yes/No
8 Date of refueling and date of expiry pasted Yes/No
on fire extinguisher
9 Does pressure point is in green zone Yes/No
10 Any visible damage to fire extinguisher Yes/No
11 Fire Exit clearly visible Yes/No
12 Any visible damage in Fire Exit Yes/No
13 Safety Belt in stretchers available Yes/No
14 Safety belt in wheel chair available Yes/No
15 Are cables are routed through conduits? Yes/No
16 Combustion items are placed far from Yes/No
potential source of fire
17 All electrical items are working in proper Yes/No
condition
18 Other fire fighting facility available Yes/No
(sprinklers, emergency light, smoke
detector, etc)

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G. P. Shekhawati Hospital & Research Centre
Vidhyadhar Nagar, Jaipur (Rajasthan)

Facility Round Report

Sl. No Points to be Checked Status Remarks

19 If safety alarm inside lift working Yes/No


20 Disaster codes displayed Yes/No
21 Phone available to call in case of disaster Yes/No
22 Any blockage in access to stairways Yes/No
(people gathering/sitting at staircase)
23 Proper illumination available Yes/No
24 Any visible damage in/ on wall Yes/No
25 Any visible damage in/on ceiling Yes/No

Remarks:

Action to be taken (if required):

Round taken by:

Signature

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