Standards › Standard 16 › Forms
Form · PED-FRM-004 · Version 1.0 · Approved by the ASF Expert Committee
Supports: 16.5
Purpose
Records the safety check of waiting and treatment areas for children, the hazards found and how they were removed.
How to complete
- Walk through each area against the checklist.
- Record each hazard found and how it was removed or protected.
- Record the next check due.
Checks
| Check | Entry |
|---|---|
| Waiting area checked for child safety | Yes |
| Treatment area checked, hazards removed | Yes |
| Protection from injury in place (for example, socket covers, fixed furniture) | Yes |
| Checked by and date | Yes |
| Next check due | Yes |
Evidence
| Reference | Note |
|---|---|
| E-009 | Based on the WHO Pocket book of hospital care for children (2013) and the UN Convention on the Rights of the Child (1989). |
| E-006 | ASF Policy Framework v1.2. Adapted. |
| E-009 | ASF Expert Committee consensus. |
Change history
| Version | Date | What changed | Approval |
|---|---|---|---|
| 1.0 | the date of approval | First version | set Expert Committee approval |
E-learning for this document
- Pediatric Ambulatory Care (AMB-23)
References
- Accréditation Sans Frontières (2026). ASF Policy Framework v1.2. (E-006)
- Accréditation Sans Frontières (2026). ASF Expert Committee consensus on Standard 1. (E-009)