HEALTHCARE CONTROLLED SUBSTANCE INVENTORY & SECURITY CHECKLIST 2026

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--- PRE-SHIFT VERIFICATION & CUSTODY TRANSFER ---
[ ] Verification Date
[ ] Shift Start Time
[ ] Shift Type (Day Shift, Evening Shift, Night Shift)
[ ] Outgoing Custodian Name
[ ] Incoming Custodian Name
[ ] Outgoing Custodian Signature
[ ] Incoming Custodian Signature
[ ] Pre-Transfer Security Checks Completed (Safe/Cabinet Lock Inspected, Tamper-Evident Seals Verified, Access Logs Reviewed)

--- PHYSICAL SECURITY & STORAGE INSPECTION ---
[ ] Safe/Cabinet Lock Status (Securely Locked, )
[ ] Security Features Inspected (Biometric Access Scanner, CCTV Camera Coverage, Motion Sensors, Reinforced Door Seals)
[ ] Observed Vulnerabilities
[ ] Inspection Date
[ ] Security Officer Verification

--- INVENTORY COUNT & RECONCILIATION ---
[ ] Inventory Audit Date
[ ] Audit Start Time
[ ] Storage Unit/Vault ID
[ ] Physical Count of Schedule II Drugs
[ ] System/Log Recorded Quantity
[ ] Discrepancy Variance (Difference)
[ ] Reconciliation Status (Match Confirmed, Discrepancy Found, Action Required)
[ ] Auditor Signature
[ ] Witness/Supervisor Signature

--- DOCUMENTATION & LOG MAINTENANCE ---
[ ] Log Entry Date
[ ] Log Entry Time
[ ] Inventory Log Reference Number (Daily Log, Weekly Audit Log, Monthly Reconciliation Log)
[ ] Drug Name & Strength
[ ] Quantity Verified
[ ] Authorized Custodian Signature
[ ] Witness/Supervisor Signature
[ ] Upload Scanned Inventory Log

--- DRUG WASTAGE & DISPOSAL PROTOCOL ---
[ ] Date of Disposal
[ ] Time of Disposal
[ ] Medication Name & Strength
[ ] Quantity to be Disposed
[ ] Disposal Method (Chemical Neutralization, Witnessed Destruction (Sharps Container), Return to Pharmacy, Reverse Distributor Pickup)
[ ] Primary Clinician Signature
[ ] Witness Signature
[ ] Photo Evidence of Destruction/Waste Container

--- DISCREPANCY IDENTIFICATION & REPORTING ---
[ ] Date of Discrepancy Discovery
[ ] Time of Discrepancy Discovery
[ ] Medication Name & Strength
[ ] Quantity Missing or Discrepant
[ ] Discrepancy Severity Level (Low (Minor Log Error), Medium (Unexplained Variance), High (Potential Diversion/Theft))
[ ] Detailed Description of Incident
[ ] Immediate Actions Taken (Secured Storage Area, Notified Supervisor, Initiated Internal Audit, Secured Surveillance Footage)
[ ] Reporting Officer Signature

--- ENVIRONMENTAL & TEMPERATURE MONITORING ---
[ ] Inspection Date
[ ] Inspection Time
[ ] Current Refrigerator Temperature (°C)
[ ] Current Freezer Temperature (°C)
[ ] Temperature Range Status (Within Range, Out of Range (Alert Required))
[ ] Temperature Deviation Notes
[ ] Responsible Officer Signature

--- POST-AUDIT REVIEW & REGULATORY COMPLIANCE ---
[ ] Audit Completion Date
[ ] Compliance Status (Fully Compliant, Minor Discrepancies Found, Non-Compliant - Immediate Action Required)
[ ] Regulatory Standards Verified (DEA Regulations, State Board of Pharmacy Requirements, Internal Policy Compliance, Joint Commission Standards)
[ ] Summary of Findings & Corrective Action Plan
[ ] Auditor/Supervisor Digital Signature
[ ] Upload Incident Report (if applicable)

--- END OF TEMPLATE ---
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