Healthcare Facility Audit Review Checklist Form
Use this Healthcare Facility Audit Review Checklist Form to document your audit findings, review key facility areas, and provide actionable feedback.
Facility Name
*
Audit Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Auditor Name
*
First Name
Last Name
Area/Department Reviewed
*
Please Select
Patient Rooms
Nursing Station
Operating Room
Laboratory
Pharmacy
Cafeteria
Reception
Other
Overall Cleanliness
*
Excellent
Good
Fair
Poor
Equipment Status
*
Fully Operational
Some Issues
Needs Immediate Attention
Safety Compliance
*
Compliant
Minor Issues
Non-Compliant
Staff Preparedness
*
Excellent
Good
Needs Improvement
Additional Comments
Recommendations for Improvement
Submit Review
Should be Empty: