Physical Setting and Safety Standards

1. Office is accessible to the disabled: parking, entrance, restrooms, hallways, elevators

2. Office appearance is clean and organized

3. Appearance of office staff is neat and professional

4. Waiting area is comfortable with adequate seating

5. Exam room/consulting office design ensures privacy

6. Exam rooms have adequate lighting, sink w/running water or 60% alcohol-based hand solution.

7. There are provisions for appropriate disposal of bio-hazardous materials/waste

8. Controlled drugs are properly handled; locked cabinet, log maintained

9. Evidence that vaccines are refrigerated and maintained as per recommendations.

10. Evidence of staff training to manage emergencies, i.e., environmental/medical

11. Visible, charged fire extinguisher

12. Fire/disaster evacuation routes posted

13. Exit signs visible

14. The clinic has a preventive maintenance program to ensure that all essential mechanical, electrical, and patient-care equipment is maintained and in safe operating condition.

15. Emergency carts and/or kits are up to date with log maintained.

Provision of Services

16. The clinic’s policies include a description of the services the clinic furnishes directly (scope of service) and those furnished through agreement or arrangement.

17. The clinic’s policies include guidelines for the medical management of health problems and include treatment protocols.

Program Evaluation

18. The clinic carries out, or arranges for, an annual evaluation of its total program to include evaluation of appropriate utilization of services.  

Complaint Monitoring

19. Evidence of files maintained and investigated with results and resolution.

Lab On Site (Yes)

20. Current CLIA certificate is displayed

21. Written policies and procedures

22. Equipment maintenance log available

Lab On Site (No)

23. Certificate of CLIA waiver available

24. Written policies and procedures

Radiology On Site (Yes)   

25. Current Oklahoma state radiation certificate

26. Written Policy and procedures

27. Safety badges available

28. Lead protective shields available

29. Pregnancy notices posted

Pharmacy On Site (Yes)

30. Registered pharmacist oversees the pharmacy

31. If no registered pharmacist, written policies/procedure or process for oversight