| Date | Inspector | ||
|---|---|---|---|
| Location | Time |
| No. | Item | Status (Yes/No/NA) | Remarks |
|---|---|---|---|
| 1 | Signage at entry is clearly visible and legible | ||
| 2 | Entry is free of obstructions and accessible | ||
| 3 | Hand sanitization facility available at entry | ||
| 4 | Security/checkpoint staff present | ||
| 5 | Temperature screening equipment functional | ||
| 6 | Queue management system in place (if needed) | ||
| 7 | Patient guidance (information boards/directions) | ||
| 8 | Waste bins available and appropriately placed | ||
| 9 | Appropriate ventilation at entry point | ||
| 10 | Cleanliness and hygiene maintained |