University of Central Oklahoma

University of Central Oklahoma

Department of Funeral Services Education

Off Campus Clinical Site Visit

Date: _________________

Funeral Home:______________________________________________

Address:_________________________________________________________

City: __________________________ State:_____ Zip: ________

General Funeral Home Items:

	Satisfactory	Unsatisfactory	Not Observed
Establishment License posted
FD/Embalmer licenses posted
General Price List available
OSHA Manual
Method Used to obtain embalming authorization	Oral	Written
Orientation/training of preceptors

Preparation Room Items:

	Satisfactory	Unsatisfactory	Not Observed
Clean environment
No food or beverage in Prep room
Ventilation system
Sanitary waste receptacle/biohazard containers
Eye wash station
Table is clean when not in use
Bodies are covered while on table
Proper Embalming Equipment / Instruments
PPE’s available and being worn

UCO Funeral Services Faculty:________________________________________

Signature:_____________________________________________