TX HHS Form 5405. Life Safety Code Facility Observation Program

The TX HHS Form 5405, Life Safety Code Facility Observation Program, is a checklist designed to help newly hired Regulatory Services surveyors conduct a comprehensive observation of a facility's operations. This form provides a framework for identifying areas of focus during the ten-day long-term care experience.

This form is intended to be used by surveyors to ensure that facilities are in compliance with life safety codes and regulations. The checklist covers various aspects of a facility's operations, including administration and systems review, fire alarm and sprinkler system maintenance reports, emergency procedures, and staff knowledge on the use of portable extinguishers. It also includes sections for observing general safety, interior finishes, and vertical openings.

The form is designed to be flexible, allowing surveyors to accommodate specific observation opportunities and facility needs. The checklist format provides a guide for newly hired surveyors to focus their observations, ensuring that all necessary areas are reviewed during the ten-day experience. By using this form, surveyors can ensure that facilities meet life safety code requirements and regulations.