Checklist template

Home health care and medical device display for pharmacies

A ready-to-use checklist with 106 items in 6 sections, covering Assortment, Display, Fitting area, Pricing, Demonstration units, Staff knowledge. Use it as-is in InspectLoop, or adapt it to your own standards in minutes.

  • 6 Sections
  • 106 Items
  • 91 Yes / No checks
  • 6 Scored ratings
  • 121 Points

Use this template How audits work

1. Assortment 20 items

  1. Size of the home health care department Choice
    • Dedicated department or showroom
    • Several bays in the aisle
    • One bay or less
  2. The department carries the assortment tier assigned to this store on the home health care planogram Yes / No 1 pt
  3. Mobility aids on hand include canes, crutches and at least one rollator or walker Yes / No 1 pt
  4. Wheelchairs or transport chairs are in stock or available to order, as the assortment tier requires Yes / No 1 pt
  5. Blood pressure monitors are stocked in upper-arm models with at least two cuff sizes Yes / No 1 pt
  6. A wrist blood pressure monitor is stocked where the planogram lists one Yes / No 1 pt
  7. Blood glucose meters are stocked with matching test strips and lancets for each meter brand Yes / No 1 pt
  8. Pulse oximeters are in stock Yes / No 1 pt
  9. Digital thermometers are in stock in at least two types (oral, ear or forehead) Yes / No 1 pt
  10. Braces and supports are stocked for the knee, ankle, wrist, elbow and back Yes / No 1 pt
  11. Each brace style is stocked in the sizes listed on the planogram (small to extra-large, left and right where they differ) Yes / No 1 pt
  12. Brace sizes out of stock among 15 size locations checked Number
  13. Compression stockings are stocked in the compression levels and sizes listed on the planogram Yes / No 1 pt
  14. Bathroom safety items (raised toilet seat, bath bench, grab bar) are in stock Yes / No 1 pt
  15. Incontinence products are stocked by absorbency and size Yes / No 1 pt
  16. Replacement parts (cane tips, crutch pads, blood pressure cuffs) are stocked next to the device they fit Yes / No 1 pt
  17. Store-brand alternatives are stocked for monitors and supports where the planogram lists them Yes / No 1 pt
  18. The special-order catalog and price list for items not stocked are at the department or the pharmacy counter Yes / No 1 pt
  19. Discontinued models have been removed or marked for clearance Yes / No 1 pt
  20. Fit of the assortment to the store's planogram tier Rating
    • Complete 5 pts
    • Minor gaps in sizes or models 3 pts
    • Major categories missing 1 pt

2. Display 18 items

  1. The home health care department is located next to or within sight of the pharmacy counter Yes / No 1 pt
  2. A department header or aisle sign identifies home health care Yes / No 1 pt
  3. Products are grouped by need (mobility, bathroom safety, monitoring, braces and supports, incontinence) Yes / No 1 pt
  4. Braces and supports are organized by body part, then by size Yes / No 1 pt
  5. Body-part icons or header strips mark each brace section Yes / No 1 pt
  6. A sizing chart is displayed at the brace section Yes / No 1 pt
  7. A sizing chart is displayed at the compression stocking section Yes / No 1 pt
  8. One assembled sample of each walker and rollator model is on the floor Yes / No 1 pt
  9. Assembled mobility aids on display have every bolt and height-adjustment pin secured Yes / No 1 pt
  10. Display wheelchairs and rollators are parked with the brakes on Yes / No 1 pt
  11. Canes hang or stand in a rack sorted by style and handle type Yes / No 1 pt
  12. Large boxed items (commodes, bath benches) are on lower shelves or the floor base, not above shoulder height Yes / No 1 pt
  13. Boxed stock is directly behind or below its display sample Yes / No 1 pt
  14. Monitors are displayed at eye level with the feature card facing the customer Yes / No 1 pt
  15. A display wheelchair or rollator was pushed through the department aisles and turned around without touching stock or fixtures Yes / No 1 pt
  16. Display samples are dusted and free of scuffs or missing parts Yes / No 1 pt
  17. No opened or re-taped box is on the shelf as sale stock Yes / No 1 pt
  18. Presentation of the home health care department Rating
    • Organized, signed and accessible 5 pts
    • Organized but hard to shop 3 pts
    • Cluttered or unsigned 1 pt

3. Fitting area 17 items

  1. A seat with armrests is available for customers being measured or fitted Yes / No 1 pt
  2. The fitting area or consultation room gives privacy from the aisle Yes / No 1 pt
  3. A flexible measuring tape is kept at the fitting area Yes / No 1 pt
  4. A full-length mirror is available in the fitting area Yes / No 1 pt
  5. Fitting-room samples of braces are available in each size for trying on Yes / No 1 pt
  6. Try-on samples are cleaned or covered between customers as company policy requires Yes / No 1 pt
  7. Hand sanitizer and disinfecting wipes are in the fitting area Yes / No 1 pt
  8. Compression stocking measurements are taken by an employee trained as a fitter Yes / No 1 pt
  9. A measurement record card is filled in for each compression stocking fitting Yes / No 1 pt
  10. The floor of the fitting area is clear, dry and free of loose mats Yes / No 1 pt
  11. A cane or walker can be adjusted to the customer's height in the fitting area, with the tools at hand Yes / No 1 pt
  12. The fitting area is free of stored cartons and overstock Yes / No 1 pt
  13. Fitting appointments or fitter availability hours are posted Yes / No 1 pt
  14. Employees at this store trained to fit compression stockings and braces Number
  15. Date of the most recent fitter training or certification on file Date
  16. The return and exchange rules for fitted and hygiene items are posted in the fitting area Yes / No 1 pt
  17. Suitability of the fitting area Rating
    • Private, equipped and clean 5 pts
    • Usable but lacking privacy or equipment 3 pts
    • No workable fitting area 1 pt

4. Pricing 16 items

  1. Every shelf location in the department has a shelf tag Yes / No 1 pt
  2. Each floor sample carries a price card showing the model and the price Yes / No 1 pt
  3. The shelf price matched the register for 10 items scanned Yes / No 1 pt
  4. Items out of the 10 scanned with a price difference Number
  5. Size variants of the same brace that share a price are tagged individually Yes / No 1 pt
  6. Rental rates for wheelchairs, walkers or crutches are posted where the store rents equipment Yes / No 1 pt
  7. The rental deposit and the late-return terms are stated on the rental sign or agreement Yes / No 1 pt
  8. Special-order items are quoted from the current catalog price list Yes / No 1 pt
  9. Promotional prices on monitors or mobility aids are signed with an end date Yes / No 1 pt
  10. Signs explain which items may be covered by insurance or a health spending account, in the company's approved wording Yes / No 1 pt
  11. Receipts for home health care items show the detail needed for an insurance claim (item description, date) Yes / No 1 pt
  12. Clearance items show the reduced price on the item or the shelf Yes / No 1 pt
  13. Store-brand monitors and supports are tagged with a "Compare to" reference where the company uses one Yes / No 1 pt
  14. Warranty length is shown on the price card or box for monitors and mobility aids Yes / No 1 pt
  15. Price cards on floor samples are printed, not handwritten Yes / No 1 pt
  16. Price and coverage information in the department Rating
    • Clear and accurate 5 pts
    • Present with gaps or errors 3 pts
    • Largely missing 1 pt

5. Demonstration units 18 items

  1. A demonstration blood pressure monitor is out of its box and powered Yes / No 1 pt
  2. The demonstration blood pressure monitor gave a reading when tested during the visit Yes / No 1 pt
  3. The cuff of the demonstration monitor is clean and free of cracks Yes / No 1 pt
  4. The demonstration glucose meter kit is complete, with control solution in date Yes / No 1 pt
  5. Demonstration units are labeled "Demo, not for sale" Yes / No 1 pt
  6. Spare batteries for demonstration units are kept at the department or the pharmacy counter Yes / No 1 pt
  7. Demonstration units are wiped with disinfectant after each customer use Yes / No 1 pt
  8. The in-store blood pressure kiosk, where installed, is switched on and working Yes / No 1 pt
  9. The blood pressure kiosk shows a service or calibration date within the interval set by the supplier Yes / No 1 pt
  10. Service or calibration date shown on the blood pressure kiosk Date
  11. The kiosk seat and cuff are clean and undamaged Yes / No 1 pt
  12. Instructions for taking a reading are posted at the kiosk or demonstration station Yes / No 1 pt
  13. The demonstration rollator folds and unfolds as intended, so staff can show it to a customer Yes / No 1 pt
  14. Demonstration bathroom safety items are assembled according to the manufacturer's instructions Yes / No 1 pt
  15. Demonstration units are the current model sold, not a discontinued one Yes / No 1 pt
  16. Demonstration units found not working during the visit Number
  17. A replacement request is on file for each demonstration unit taken off the floor as faulty Yes / No 1 pt
  18. Condition of demonstration units Rating
    • All working, clean and labeled 5 pts
    • Some not working or unlabeled 3 pts
    • Most not working or absent 1 pt

6. Staff knowledge 17 items

  1. An employee trained in home health care is scheduled during the pharmacy's busiest hours Yes / No 1 pt
  2. A staff member asked could show how to choose the correct blood pressure cuff size Yes / No 1 pt
  3. A staff member asked could explain how to measure for a knee brace using the sizing chart Yes / No 1 pt
  4. A staff member asked could adjust a cane to the correct height for a customer Yes / No 1 pt
  5. A staff member asked could explain the difference between a walker and a rollator Yes / No 1 pt
  6. A staff member asked knew to refer questions about a medical condition or a reading to the pharmacist Yes / No 1 pt
  7. A staff member asked knew that compression stockings above the level set by company policy need a prescription or a fitter Yes / No 1 pt
  8. A staff member asked could explain how to place a special order and the expected delivery time Yes / No 1 pt
  9. A staff member asked knew the return rules for opened monitors and for hygiene items Yes / No 1 pt
  10. Staff asked knew how to complete a rental agreement where the store rents equipment Yes / No 1 pt
  11. Product training from suppliers is recorded for department staff Yes / No 1 pt
  12. Quick-reference guides for monitors and mobility aids are kept at the department Yes / No 1 pt
  13. The pharmacist asked could name the blood pressure monitors the store stocks and where they are displayed Yes / No 1 pt
  14. A staff member asked described showing the customer how to use a monitor or mobility aid before it leaves the store Yes / No 1 pt
  15. Name of the home health care lead or pharmacist on duty Short text
  16. Overall standard of the home health care department Rating
    • Assortment complete, samples working and staff able to fit 5 pts
    • Shoppable, with gaps in sizes, prices or demonstration units 3 pts
    • Major categories missing, or no trained staff 1 pt
  17. Corrections required and items to order Comments

About this template

This checklist is part of the InspectLoop template library. Yes / No checks score 1 point when met; ratings score the points shown for each option. The overall score is the percentage of points earned, with N/A answers excluded. In InspectLoop you can add photos, assign corrective actions, require sign-off and compare results across sites.

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