Hospital Maintenance Checklist Form
Complete this checklist to log facility checks and report any maintenance issues in the hospital.
General Cleanliness (hallways, rooms, and public areas)
*
Clean
Needs Attention
Lighting (bulbs, emergency lights, and exit signs)
*
Operational
Needs Replacement/Repair
HVAC Systems (heating, ventilation, air conditioning)
*
Operational
Needs Maintenance
Fire Safety Equipment (extinguishers, alarms, sprinklers)
*
Checked and Functional
Needs Service
Plumbing (restrooms, sinks, drains, water supply)
*
No Issues
Needs Repair
Elevators and Lifts
*
Operational
Requires Attention
Electrical Systems (outlets, panels, backup power)
*
No Issues
Needs Maintenance
Medical Equipment (routine visual check for damage or malfunction)
*
No Visible Issues
Report Issue
Security (doors, locks, cameras, alarms)
*
Secure and Functional
Needs Attention
Additional Comments or Issue Details
Submit Checklist
Should be Empty: