| Facility Name | Inspection Date | ||
|---|---|---|---|
| Address | |||
| Inspector Name | Position | ||
| No. | Checklist Item | Compliant | Notes |
|---|---|---|---|
| 1 | All resident rooms are equipped with functional call alarms | ||
| 2 | Alarm system is audible and visible at nurse station | ||
| 3 | All alarm systems have backup power source | ||
| 4 | Alarms are tested and recorded monthly | ||
| 5 | Staff are trained to respond to alarms promptly | ||
| 6 | Maintenance logs for alarms are up to date | ||
| 7 | Hallways and common areas have accessible emergency alarms | ||
| 8 | Alarms are free from obstruction and easily accessible |