ENVIRONMENTAL ROUNDS -

LABORATORY INSPECTION CHECKLIST

LABORATORY INSPECTED:

INSPECTOR(S) NAMES: DATE:

A. DOCUMENTS & TRAINING Y N N/A Room # Notes

A1 Lab safety manual accessible to all laboratory personnel and staff know where it is located*
Employee injury forms available
A2 • Incident Report & Referral for Medical Treatment (313323- rev 5/2014)
• Workers' Compensation Claim Form DWC 1 (rev 1/2016)
Initial Safety training given*
A3 • Department Orientation form
Annual Safety training given*
• Annual education guide
A4 • Fire Safety Training
• Chemical Safety
Training for revisions to Laboratory Safety Manual given* __________________________________________

Biohazard Material Shipment Training (required every 2 years if person packages diagnostic or infectious material for
A5 shipment) Location of training records:
A6 Annual safety inspection documented* Location of inspection records:
B. HAZARD COMMUNICATION
B1 SDS available*
B2 SDS location known to employees*C
B3 Containers labeled with contents (full name, no conflicting labels)
B4 Secondary chemical containers properly labeled. (contents, physical and health hazards, date of transfer/prep)
B5 Containers labeled with hazard warning
B6 Current chemical inventory accessible* Location of chemical inventory:
C. EMERGENCY & SAFETY INFORMATION
C1 Emergency assistance information posted in labC
C2 Disaster and Emergency Response Manual (DERM) available
C3 DERM contains Department Disaster Plan
C4 Department Disaster Plan has been annually reviewed
C5 NFPA fire diamond posted
C6 Emergency contacts listed on NFPA fire diamond
Precautionary labels present on all hazardous chemicals containers (flammable liquids Classes I, II & IIIA; corrosives;
C7 irritants; asphyxiants; potential carcinogens; etc.), indicating hazard type and what to do in case of accidental contact.

C8 Evacuation routes posted in laboratory

C9 Emergency lighting present and tested monthly
D. FIRE SAFETY
D1 Flammable storage cabinet present/ used to store flammables. Doors are self closing.
D2 Storage clearance from ceiling: 18” with sprinklers, 24” without sprinklers
D3 Fire extinguisher present/charged/accessibleC
D4 Area around fire extinguisher(s) and pull stations clearC
D5 Fire extinguisher inspection date documented (within 1 month)
D6 Fire doors close and latch (doors that open into corridor)
D7 Exit and evacuation signs visible and/or illuminated (not blocked)
D8 Aisles, exits, stairwells clear and unobstructed
D9 Smoke detectors / sprinklers clean and unobstructed

Revised November, 2017 1

 ENVIRONMENTAL ROUNDS -
LABORATORY INSPECTION CHECKLIST

E. GENERAL SAFETY Y N N/A Room # Notes

E1 Exits/aisles/corridors are not blocked (24” minimum width)
E2 Laboratory doors kept closed when room is unoccupied
E3 Second exit from lab maintained (applies to rooms >1000 sq feet)
C
E4 Eyewash present or available in 10 seconds
E5 Eyewash records documenting weekly inspection are available (stand alone eyewash stations only)
E6 Emergency shower inspection documented monthly by Facilities
E7 Area around shower kept clearC
E8 First-aid kit present and stocked
E9 Chemical spill material or kit available. Kit has expiration date or date placed into service.
E10 Chemical spill protocol known
E11 Gas cylinders secured to wall with double chains
E12 Gas cylinder valve protection cap in place when not in use
E13 Refrigerators/freezers labeled with food and drink specifications
E14 Noise level in laboratory acceptable
E15 The room temperature and humidity are adequately controlled in all seasons.
E16 UV light sources have warning signage on source equipment.
F. PERSONAL PROTECTIVE EQUIPMENT (PPE)
PPE requirements specified by job task or work area (For laboratories under a New York State license, Form 22.1 must
F1 be signed by the medical director)
F2 Fluid resistant lab coats worn in laboratoryC
F3 Gloves worn when handling hazardous materials
F4 Facial protection worn in lab if required
F5 Closed-toe shoes worn in lab at all timesC
F6 Long hair restrained
G. HOUSEKEEPING
G1 No food or drink found in lab areas
G2 Gloves, lab coat not worn in common areas (hallways, elevators)
G3 Glass bottles, outside of secondary containers, not stored on floorC
G4 Minimal glassware on bench top, in sink, or in fume hood
G5 Area is clean, not cluttered, dust free
G6 Ceiling, walls, floors, windows, furniture, air vents, light fixtures are clean and in good condition
G7 Sink, soap, and paper towels available for hand washing
G8 Sinks, faucets, and showers do not leak
G9 No storage under sinks (nothing in pat. care, cleaning solutions in non-pat. care areas OK)
G10 Proper waste disposal of glass (vial, pipettes, etc.)
G11 Proper waste disposal of sharps (containers less then 2/3 full)
G12 Proper medical waste disposal (red bags, tied, rigid red containers with labels, tight fitting lid)
G13 Medical waste containers clean and in good working order
G14 No live plants in lab areas
G15 Boxes not stored directly on floor

Revised November, 2017 2

 ENVIRONMENTAL ROUNDS -
LABORATORY INSPECTION CHECKLIST

H. CHEMICAL STORAGE AND COMPATABILITY Y N N/A Room # Notes

2
Up to 1 gallon of Class I, II and IIIA liquids may be stored outside of fire-resistant cabinets for each 100 ft of
space defined by fire-resistant walls/doors. Up to 2 gallons of Class I, II, and IIIA liquids may be stored in
H1 2
safety cans and safety cabinets for each 100 ft . These amounts may be doubled if there is an automatic fire
C
suppression system (e.g. sprinklers)

H2 Maximum of 60 gallons flammable liquids per labC

H3 Flammables kept in refrigerator/freezer approved for storage of flammables
H4 No excess acids stored outside acid/corrosive cabinet
H5 Strong acids and bases stored in secondary containers
Supplies of Acids/Bases must be stored segregated and are stored below eye level. Storage near the floor is
H6
recommended
H7 Chemicals stored safely on bench tops, shelves (e.g. not crowded)
H8 Incompatible chemicals and materials stored segregated (e.g. cardboard, paper, plastic, Styrofoam)
H9 Chemical storage areas clearly labeled
C
H10 Corrosives stored separately and in designated areas
I. BIOSAFETY CABINETS
I1 Biosafety cabinets present in lab Number: _____
I2 Certified within one yearC
I3 Room cross drafts and turbulence controlled (no fans near biosafety cabinets)
J. FUME HOODS
J1 Fume hoods present in lab Number: _____
J2 Certified within one yearC
J3 Proper sash height indicated
J4 Sash at or below marked approval level
J5 Sash stoppers functional
J6 Hood illumination functional
J7 Audible/visual alarm functional
J8 Minimal clutter in hood (equipment, chemicals)C
J9 Proper equipment placement in fume hood
J10 Fume hood clean
J11 Functional fume hood not used for storage
J12 Chemical containers within fume hoods kept closed
J13 Room cross drafts and turbulence controlled (no fans near fume hood)
K. CHEMICAL WASTE DISPOSAL AND TRANSPORT
K1 Safety cans available for disposal of solvents
K2 Containers available for disposal of hazardous waste
K3 Waste manifests or tags attached to waste cans, containersC
K4 Chemical waste containers in good condition and kept closed (i.e. no funnels in place)
K5 Chemicals in deteriorating containers tagged as hazardous waste
K6 Chemical waste disposal procedures available
K7 Bottle carrier available for transport of chemicals
K8 Secondary containers used for storage of waste containers
K9 Designated areas for waste storage containers
K10 Chemical waste disposed when full or within 90 days, whichever is sooner
K11 Dry waste double-bagged (transparent bags are optimal; red, yellow, and black bags are not allowed)

Revised November, 2017 3

 ENVIRONMENTAL ROUNDS -
LABORATORY INSPECTION CHECKLIST

L. SEISMIC SAFETY Y N N/A Room # Notes

L1 Heavy or critical equipment and furniture anchored or restrained according to risk assessment
L2 Storage shelves have seismic restraints (e.g. lips, bars, bungee cords)
L3 High overhead storage is secured
M. MECHANICAL AND ELECTRICAL SAFETY
M1 Movable parts guarded on equipment
M2 Electric panel accessible and nothing posted on panel
M3 Medical equipment has current inspection label by clinical engineering
M4 Plugs, cords, outlets in good conditionC
M5 No overloaded outletsC
M6 Extension cords or other cords out of the way
M7 Power strips secured away from liquids
M8 No cords under doors, carpets, or on ceilings
M9 Power strips & extension cords not daisy chained
N. SECURITY
N1 Staff wearing photo ID badges
N2 Locking mechanisms work properly
N3 Personal belongings/valuables in secure area
MISC.

Explanation of Ratings
*Denotes Administrative Deficiency
C
Denotes Critical Violation that must be corrected within 48 hours or less, depending on severity of violation

Laboratory Director Signature: ________________________________

Date: ___________________________

Revised November, 2017 4