DENTAL REGULATORY COMPLIANCE CHECKLIST: STATE & FEDERAL GUIDELINES Created by ChecklistGuro (https://checklistguro.com) --- HIPAA COMPLIANCE --- [ ] Do you have a designated HIPAA Compliance Officer? (Yes, No) [ ] Describe your Business Associate Agreements (BAAs) process. [ ] Are all staff members trained on HIPAA regulations annually? (Yes, No) [ ] Last HIPAA training date. [ ] Describe your procedures for handling patient data breaches. [ ] Are patient portals secured with multi-factor authentication? (Yes, No, Not Applicable) [ ] Upload a copy of your HIPAA Privacy Notice. --- OSHA COMPLIANCE --- [ ] Last eyewash station inspection date [ ] Last sharps container replacement [ ] Type of PPE readily available (e.g., gloves, masks, gowns) (Gloves, Masks, Gowns, Face Shields) [ ] Hazard Communication Plan components reviewed? (Chemical Inventory, SDS Availability, Employee Training) [ ] Respiratory Protection Program in place? (Yes, No) [ ] Summary of recent OSHA training topics [ ] Date of last hazard assessment --- STATE DENTAL BOARD REGULATIONS --- [ ] Last License Renewal Date [ ] Continuing Education Credits Earned (Current Reporting Period) [ ] Current License Status (Active, Inactive, Suspended, Expired) [ ] Date of Last Board Audit (if applicable) [ ] Summary of any Disciplinary Actions (if applicable) [ ] Supervision Type (for Dental Hygienists/Assistants, if applicable) (Direct Supervision, General Supervision, No Supervision Required) [ ] Number of Registered Dentists in Practice (if group practice) --- DEA COMPLIANCE (IF APPLICABLE) --- [ ] DEA Registration Status? (Active, Inactive, Pending) [ ] Registration Number [ ] Registration Expiration Date [ ] Summary of Controlled Substances on Hand (as of last inventory) [ ] Inventory Count - Morphine (mg) [ ] Inventory Count - Hydrocodone (mg) [ ] Secure Storage Method? (Safe, Vault, Double-Locked Cabinet) [ ] Date of Last Physical Inventory --- MEDICARE/MEDICAID COMPLIANCE (IF APPLICABLE) --- [ ] Provider Enrollment Status (Enrolled, Pending, Not Enrolled) [ ] NPI Number [ ] Tax Identification Number (TIN) [ ] Last Medicare/Medicaid Audit Date [ ] Summary of Recent Audit Findings (if applicable) [ ] Claims Submission Method (Electronic, Paper) [ ] Copy of Current Enrollment Agreement --- ADA STANDARDS FOR ACCESSIBILITY --- [ ] Entrance Ramps: Verify presence and slope (max 1:12) [ ] Doorway Width: Measure clear width (minimum 32 inches) [ ] Exam Room Door Width: Measure clear width (minimum 32 inches) [ ] Accessible Parking: Is accessible parking available? (Yes, No, N/A) [ ] Accessible Restroom: Is an accessible restroom available? (Yes, No, N/A) [ ] Accessible Toilet Height: Record the height of the toilet seat (minimum 17-19 inches) [ ] Accessible Sink: Clearance beneath sink (minimum 28 inches) (Compliant, Not Compliant, N/A) [ ] Photos of Accessible Areas (Entrance, restroom, exam room) --- CONTROLLED SUBSTANCE MANAGEMENT --- [ ] Last Controlled Substance Inventory Date [ ] Starting Quantity of [Substance Name] [ ] Quantity Used/Dispensed During Period [ ] Quantity on Hand at End of Period [ ] Discrepancy Found? (Yes, No) [ ] Description of Discrepancy (if applicable) [ ] Method of Reconciliation (Investigated & Corrected, Reported to Authorities, Other) [ ] Notes/Comments --- ENVIRONMENTAL REGULATIONS --- [ ] Water Usage (Gallons/Month) [ ] Waste Volume (lbs/Month) [ ] Waste Disposal Method (Recycling, Incineration, Landfill) [ ] Last Wastewater Discharge Permit Review Date [ ] Hazardous Materials Stored (Mercury, X-ray Processing Chemicals, Anesthetics, Cleaning Solvents) [ ] Description of Waste Management Procedures --- INFECTION CONTROL PROTOCOLS --- [ ] Autoclave Cycle Count [ ] Last Instrument Reprocessing Validation Date [ ] Surface Disinfectant Used (Chlorhexidine Gluconate, Quaternary Ammonium Compound, Hydrogen Peroxide, Other (Specify)) [ ] PPE Used During Procedures (Gloves, Mask, Eye Protection, Gown) [ ] Notes on Unusual Issues/Deviations [ ] Date of last surface disinfection [ ] Type of Water System (City Water, Well Water, Reverse Osmosis System) --- RECORD KEEPING & DOCUMENTATION --- [ ] Record Retention Policy Review Date [ ] Number of Years Patient Records Retained (Digital) [ ] Number of Years Patient Records Retained (Physical) [ ] Record Storage Method (Digital/Physical) (Digital, Physical) [ ] Summary of Record Destruction Procedure [ ] HIPAA Business Associate Agreements Current? (Yes, No) [ ] Date of Last Audit of Patient Records [ ] Details of any Corrective Actions following Audit --- END OF TEMPLATE --- Transform this text into a digital, automated, and trackable mobile app! Visit: https://checklistguro.com/templates/dental-management/dental-regulatory-compliance-checklist-state-federal-guidelines (Click "Install Template" to launch your digital inspection tool immediately)