Run Emergency Preparedness Plan Biennial Review for Clinic — Free

Inspection Details and Review Scope

Review period and facility identification are documented

Record the clinic name, site address, review date, and the two-year review period covered by this biennial inspection.

Reviewer confirms this is a biennial emergency preparedness plan review critical (required)

Verify the review is being completed at least every two years and is not overdue.

Yes No N/A

Applicable plan version and last update date are identified

Document the current emergency preparedness plan version, approval date, and most recent revision date.

All-Hazards Risk Assessment and Plan Content

All-hazards risk assessment is current and documented critical (required)

Confirm the plan includes a current all-hazards risk assessment addressing likely natural, technological, and human-caused emergencies relevant to the clinic.

Yes No N/A

Emergency response procedures address evacuation, shelter-in-place, and lockdown critical (required)

Verify the plan contains specific procedures for evacuation, shelter-in-place, and lockdown or other protective actions as applicable.

Yes No N/A

Patient, staff, and visitor protection measures are defined critical (required)

Confirm the plan identifies how patients, staff, and visitors will be protected during an emergency, including mobility assistance and special needs considerations.

Yes No N/A

Emergency communication methods are documented and current critical (required)

Verify internal and external communication methods are listed, including primary and backup contact methods for staff, patients, emergency services, and leadership.

Yes No N/A

Utility interruption and continuity procedures are included critical (required)

Confirm the plan addresses loss of power, water, HVAC, telecommunications, and other essential utilities, including continuity or relocation steps.

Yes No N/A

Emergency Contacts, Resources, and Accessibility

Emergency contact list is complete and current critical (required)

Verify contact information for leadership, medical director, facility management, local emergency management, fire, police, EMS, utility providers, and alternate sites is current.

Yes No N/A

Staff call tree or notification roster is maintained

Confirm there is a current staff notification process or call tree with alternates and after-hours coverage.

Yes No N/A

Emergency supplies and equipment list is documented

Verify the plan identifies emergency supplies, backup power sources, medical supplies, water, flashlights, radios, and other essential items as applicable.

Yes No N/A

Plan is accessible to staff during normal and after-hours operations critical (required)

Confirm the emergency preparedness plan and related procedures are available in a format staff can access during an emergency, including electronic and/or hard copy access.

Yes No N/A

Training, Testing, and Drill Documentation

Required emergency training is documented for staff critical (required)

Verify staff training on emergency procedures, roles, and reporting expectations is documented and current.

Yes No N/A

Tabletop or functional exercises are documented critical (required)

Confirm emergency preparedness exercises have been completed and documented according to the clinic’s testing schedule.

Yes No N/A

Exercise findings and lessons learned were reviewed critical (required)

Verify after-action findings, gaps, and lessons learned from drills or actual events were incorporated into the plan review.

Yes No N/A

Corrective actions from prior exercises are closed or tracked

Confirm outstanding corrective actions are documented with owners and due dates, or are otherwise resolved.

Yes No N/A

Evacuation, Shelter, and Patient Tracking Procedures

Evacuation routes and assembly points are documented critical (required)

Verify evacuation routes, exits, assembly areas, and relocation points are identified and current.

Yes No N/A

Shelter-in-place procedures include location-specific instructions critical (required)

Confirm shelter-in-place procedures identify where staff and patients should go and what supplies or actions are required.

Yes No N/A

Patient tracking and transfer procedures are documented critical (required)

Verify the plan includes a method for accounting for patients, visitors, and staff during evacuation or relocation, including transfer documentation if applicable.

Yes No N/A

Special population and mobility assistance procedures are included

Confirm the plan addresses patients requiring mobility assistance, language support, medical equipment, or other special accommodations.

Yes No N/A

Review Findings, Deficiencies, and Approval

Deficiencies and non-conformances are documented

Record any deficiencies, non-conformances, or missing elements identified during the review.

Yes No N/A

Note (optional)

Corrective action plan is assigned for each deficiency critical (required)

Verify each deficiency has an assigned corrective action, responsible owner, and target completion date.

Yes No N/A

Plan update approval is documented critical (required)

Confirm the updated emergency preparedness plan is approved by appropriate leadership, such as the administrator or designee.

Yes No N/A

Inspector signature is captured critical (required)

Signature of the reviewer completing the biennial inspection and plan review.

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Run: Emergency Preparedness Plan Biennial Review for Clinic

Inspection Details and Review Scope

All-Hazards Risk Assessment and Plan Content

Emergency Contacts, Resources, and Accessibility

Training, Testing, and Drill Documentation

Evacuation, Shelter, and Patient Tracking Procedures

Review Findings, Deficiencies, and Approval

Get your results