Checklist template

Medical Office

A ready-to-use checklist with 67 items in 6 sections, covering Patient Reception & Waiting Area, Clinical Exam Rooms, Lab & Specimen Management, Medication & Vaccine Handling, Staff Safety & Regulatory, Facility Operations & Fire Safety. Use it as-is in Bindy, or adapt it to your own standards in minutes.

  • 6 Sections
  • 67 Items
  • 60 Yes / No checks
  • 6 Scored ratings
  • 1790 Points

Use this template How audits work

1. Patient Reception & Waiting Area 11 items

  1. Is the entrance area clean, well-lit, and free of physical trip hazards? Yes / No 15 pts
  2. Are HIPAA-compliant privacy glass or barriers functional at the check-in desk? Yes / No 30 pts
  3. Is the patient waiting area tidy, with seating spaced for comfort and safety? Yes / No 10 pts
  4. Are "Patient Rights" and "Notice of Privacy Practices" clearly displayed? Yes / No 20 pts
  5. Is a hand sanitizing station available and stocked at the office entry? Yes / No 15 pts
  6. Are surfaces (chairs, counters, door handles) sanitized every 4 hours? Yes / No 25 pts
  7. Is the background music or noise level appropriate for patient privacy? Yes / No 10 pts
  8. Are public restrooms clean, stocked, and checked every 2 hours? Yes / No 15 pts
  9. Are there separate "Sick" and "Well" waiting zones if required by policy? Yes / No 20 pts
  10. Is the digital check-in kiosk or tablet sanitized after every use? Yes / No 10 pts
  11. Lobby/Reception Status: Rating
    • Professional/Safe 20 pts
    • Average 10 pts
    • Unprofessional 0 pts

2. Clinical Exam Rooms 11 items

  1. Is the exam table paper replaced and the table sanitized after every patient? Yes / No 40 pts
  2. Are all medical supplies in drawers/cabinets within their expiration dates? Yes / No 35 pts
  3. Is the room free of any patient-identifiable information from previous visits? Yes / No 50 pts
  4. Are sharps containers wall-mounted and less than 75% full? Yes / No 30 pts
  5. Is the sink area stocked with antimicrobial soap and paper towels? Yes / No 25 pts
  6. Are biohazard waste bins equipped with functional foot pedals and lids? Yes / No 25 pts
  7. Is the floor free of dust, debris, and medical waste (bandages, etc.)? Yes / No 15 pts
  8. Are diagnostic tools (otoscope, etc.) sanitized and in working order? Yes / No 20 pts
  9. Is the room temperature comfortable and the ventilation functional? Yes / No 10 pts
  10. Are cabinets containing medications or syringes kept locked when not in use? Yes / No 40 pts
  11. Exam Room Readiness: Rating
    • Sterile/Ready 30 pts
    • Minor Cleanup Needed 15 pts
    • At Risk 0 pts

3. Lab & Specimen Management 11 items

  1. Are all specimens properly labeled with two patient identifiers immediately? Yes / No 50 pts
  2. Is the lab refrigerator maintaining a temperature between 2°C and 8°C? Yes / No 50 pts
  3. Are temperature logs for the fridge and freezer updated twice daily? Yes / No 30 pts
  4. Are chemical reagents stored according to MSDS/manufacturer guidelines? Yes / No 25 pts
  5. Is the eyewash station unobstructed and tested weekly? Yes / No 40 pts
  6. Are centrifuges and other lab equipment clean and calibrated? Yes / No 20 pts
  7. Is the biohazard pickup log current and signed by the transporter? Yes / No 25 pts
  8. Are phlebotomy chairs and mats sanitized after every patient draw? Yes / No 30 pts
  9. Are gloves and alcohol swabs fully stocked at the draw station? Yes / No 15 pts
  10. Is there a clear separation between clean and "dirty" lab areas? Yes / No 35 pts
  11. Lab Safety Rating: Rating
    • Fully Compliant 40 pts
    • Minor Discrepancy 20 pts
    • Critical Hazard 0 pts

4. Medication & Vaccine Handling 11 items

  1. Are multi-dose vials dated when opened and discarded per policy? Yes / No 35 pts
  2. Is the "High-Alert" medication list posted and recognized by staff? Yes / No 30 pts
  3. Are vaccines stored in a dedicated unit (no food or lab specimens)? Yes / No 50 pts
  4. Is a digital data logger (DDL) monitoring vaccine temperatures 24/7? Yes / No 40 pts
  5. Are Look-Alike/Sound-Alike (LASA) medications physically separated? Yes / No 25 pts
  6. Are all medications stored in their original, labeled packaging? Yes / No 20 pts
  7. Is the backup power/generator plan for the vaccine fridge tested? Yes / No 40 pts
  8. Are "Near Miss" or medication errors logged and reviewed monthly? Yes / No 30 pts
  9. Are prescription pads or e-prescribing tokens secured in a locked safe? Yes / No 40 pts
  10. Is the medication prep area clean, dry, and well-lit? Yes / No 15 pts
  11. Med Safety Standards: Rating
    • High Standard 30 pts
    • Average 15 pts
    • High Risk 0 pts

5. Staff Safety & Regulatory 11 items

  1. Are current medical licenses for all providers displayed or on file? Yes / No 20 pts
  2. Have all staff completed annual Bloodborne Pathogen training? Yes / No 40 pts
  3. Is the "Exposure Control Plan" accessible to all staff members? Yes / No 35 pts
  4. Are staff using appropriate PPE (masks, gowns, shields) for clinical tasks? Yes / No 40 pts
  5. Are the "Hand Hygiene" posters visible at every sink and station? Yes / No 10 pts
  6. Are staff members wearing clean, professional scrubs and ID badges? Yes / No 10 pts
  7. Is the "Safety Data Sheet" (SDS) binder current and accessible? Yes / No 20 pts
  8. Are staff breaks and lunches taken in designated non-clinical areas? Yes / No 15 pts
  9. Is the "Staff Immunization" record current for all active employees? Yes / No 25 pts
  10. Are emergency spill kits available for body fluids or chemicals? Yes / No 20 pts
  11. Regulatory Compliance: Rating
    • Fully Licensed 25 pts
    • Missing Records 12 pts
    • Non-Compliant 0 pts

6. Facility Operations & Fire Safety 12 items

  1. Are all emergency exits completely unobstructed and clearly marked? Yes / No 50 pts
  2. Are fire extinguishers charged, tagged, and accessible? Yes / No 30 pts
  3. Is the office First Aid kit fully stocked for employee use? Yes / No 15 pts
  4. Are electrical panels clear (3ft clearance) and unobstructed? Yes / No 25 pts
  5. Are "Wet Floor" signs available and utilized for spills/cleaning? Yes / No 15 pts
  6. Are heavy charts or boxes stored on lower shelves to prevent falls? Yes / No 20 pts
  7. Is the office free of visible pests or evidence of pest activity? Yes / No 40 pts
  8. Are daily cleaning logs for the facility signed and up to date? Yes / No 20 pts
  9. Is the security/alarm system functional and tested recently? Yes / No 25 pts
  10. Are oxygen tanks (if applicable) secured in stands or chained? Yes / No 35 pts
  11. Facility Rating: Rating
    • Secure/Safe 30 pts
    • Minor Deficiencies 15 pts
    • Hazardous 0 pts
  12. Final audit summary: Comments

About this template

This checklist is part of the Bindy template library. Yes / No checks score 1 point when met; ratings score the points shown for each option. The overall score is the percentage of points earned, with N/A answers excluded. In Bindy you can add photos, assign corrective actions, require sign-off and compare results across sites.

Categories

Related templates

← All templates

Brand standards

At every site, every time

Start Free Contact us