72 lines
1.3 KiB
Markdown
72 lines
1.3 KiB
Markdown
# Internal Audit Checklist
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| Form ID | FRM-006 | Revision | 1.0 |
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|---------|---------|----------|-----|
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---
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## Section 1: Audit Information
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| Field | Entry |
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|-------|-------|
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| Audit Date | |
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| Auditor Name | |
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| Area/Process Audited | |
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| Audit Type | [ ] Process [ ] Document [ ] Compliance [ ] Mock Survey |
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## Section 2: Audit Scope
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**Standards/Requirements:**
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**Documents Reviewed:**
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**Personnel Interviewed:**
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## Section 3: Audit Checklist
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| Item # | Requirement | Compliant | Finding | Evidence |
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|--------|-------------|-----------|---------|----------|
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| 1 | | [ ] Y [ ] N [ ] NA | | |
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| 2 | | [ ] Y [ ] N [ ] NA | | |
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| 3 | | [ ] Y [ ] N [ ] NA | | |
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| 4 | | [ ] Y [ ] N [ ] NA | | |
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| 5 | | [ ] Y [ ] N [ ] NA | | |
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| 6 | | [ ] Y [ ] N [ ] NA | | |
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| 7 | | [ ] Y [ ] N [ ] NA | | |
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| 8 | | [ ] Y [ ] N [ ] NA | | |
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| 9 | | [ ] Y [ ] N [ ] NA | | |
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| 10 | | [ ] Y [ ] N [ ] NA | | |
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## Section 4: Findings Summary
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### Critical Findings (Immediate patient safety risk)
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### Major Findings (Significant non-compliance)
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### Minor Findings (Documentation or procedural deviation)
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### Observations (Opportunities for improvement)
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## Section 5: Positive Observations
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## Section 6: Signatures
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| Role | Name | Signature | Date |
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|------|------|-----------|------|
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| Auditor | | | |
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| Auditee | | | |
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---
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*Form FRM-006 Rev 1.0*
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