Falls Prevention Audit Form
Comprehensive assessment of falls-prevention readiness and issues. Complete all fields to evaluate current practices and identify areas for improvement.
Audit Date
*
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Month
-
Day
Year
Date
Facility Name
*
Area/Unit Audited
*
Are all high-risk areas clearly identified and marked?
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Yes
No
Partially
Are floors free from hazards (e.g., spills, clutter, uneven surfaces)?
*
Yes
No
Partially
Are handrails and grab bars installed and in good condition?
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Yes
No
Not Applicable
Are staff trained in falls-prevention protocols?
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Yes
No
Some Staff
Is there a process for regular risk assessments?
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Yes
No
In Development
Are falls incidents documented and reviewed?
*
Yes
No
Occasionally
List any immediate actions taken or recommendations for improvement.
*
Auditor Name
*
First Name
Last Name
Submit Audit
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