On Site Evaluation

Please Select Houston Greater Good Clinic Humble Clinic Spring Clinic Tomball Clinic Resale Shop

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Rows	Grade	Comments
Front Windows	Pass Fail N/A
Smell	Pass Fail N/A
Bathrooms	Pass Fail N/A
Refrigerators	Pass Fail N/A
Lobby/Sales Floor	Pass Fail N/A
Employee Break Areas	Pass Fail N/A
Offices	Pass Fail N/A
Wellness Rooms	Pass Fail N/A
Surgery	Pass Fail N/A
Food Pantry	Pass Fail N/A
Front Desk/Wrap Desk	Pass Fail N/A
Personal Items are at a Minimum	Pass Fail N/A
Laundry area is clean and laundry is not backlogged (Dryer vents are being cleaned after each use, Machines are in working condition, etc.)	Pass Fail N/A

Rows	Grade	Comments
No Hand Printed Signage Displayed	Pass Fail N/A
Filming & Photography Policy Displayed	Pass Fail N/A
TVMA Disclaimer in Plain Sight	Pass Fail N/A
Licenses for Veterinarians on Staff are Current & in Plain Sight in Wellness and at Surgery Check-Out	Pass Fail N/A
Sales Tax Permit Displayed in Plain Sight	Pass Fail N/A
Emergency Exits are Not Blocked	Pass Fail N/A
No Tripping Hazards	Pass Fail N/A
Human Food in Designated Refrigerator/Freezer	Pass Fail N/A
Eye Wash Stations are Full and Not Expired	Pass Fail N/A
Fire Extinguishers in Place and Not Expired	Pass Fail N/A
Biological waste is being disposed of properly	Pass Fail N/A
Ear Protection is Available in the Dog Kennel	Pass Fail N/A
All bottles (medications and chemicals) are labeled properly	Pass Fail N/A
The MSDS is available	Pass Fail N/A
The Crash Cart is in the correct place	Pass Fail N/A
First Aid Kits are Stocked and in Date	Pass Fail N/A
Battery backups are in use at surgery and prep stations. ONLY oxygen concentrators and lights are plugged into the battery side.	Pass Fail N/A

Rows	Grade	Comments
Clients are Being Greeted	Pass Fail N/A
Staff is Moving Quickly to Avoid a Back Up of Animals in the Lobby	Pass Fail N/A
Clients are Being Asked if They Would Like to Make a Donation at Check-out	Pass Fail N/A

Rows	Grade	Comments
Idexx Machines are properly maintained and in working condition	Pass Fail N/A
Both autoclaves are working properly and regular cleaning and maintenance is being performed	Pass Fail N/A
Anesthesia Machines are being maintained and are working properly (Soda Lime and F Air Canisters are being changed properly)	Pass Fail N/A
No leaking toilets or dripping faucets.	Pass Fail N/A
Are there any equipment issues which need to be addressed	Pass Fail N/A

Rows	Grade	Comments
Pharmacy is being stocked properly	Pass Fail N/A
Drugs are being used in correct order by expiration date	Pass Fail N/A
Bathrooms are properly stocked with supplies	Pass Fail N/A
Cleaning supplies are at a good level	Pass Fail N/A
Office supplies are at a good level	Pass Fail N/A

Rows	Grade	Comments
Monthly Emergency Training is Taking Place	Pass Fail N/A
Power failure training is taking place	Pass Fail N/A
Employees can demonstrate picking up a pet taxi and trap	Pass Fail N/A
Employees know where the eye wash station(s) are located	Pass Fail N/A
Employees know where the first aid kits are located	Pass Fail N/A
Employees know what to do if someone is injured	Pass Fail N/A
Are there any training or personnel issues which need to be addressed	Pass Fail N/A