Information
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Conducted on
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Prepared by
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Swipe the screen to the left to start audit
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Are men/women shaved?
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Is oral care adequate?
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Are residents wearing their glasses?
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Are safety devices clean? (Lap buddy, seat belt, etc..)
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Are wheelchairs clean?
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Wheelchair armrests not cracked?
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Are residents wearing approprite footwear?
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Is attire approprite, clean, and in good repair?
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If resident is a smoker, no burn holes in clothing?
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Are call lights answered promptly?
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Is fresh water with ice available and within reach?
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Is resident privacy protected?
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Does the room smell clean and fresh?
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Do staff knock and wait for an answer before entering the room?
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Is the room tidy and clean?
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Is the floor clean?
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Are the beds made properly?
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Are personal items labeled and stored properly?
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Are any bed pans/urinals properly labeled and covered?
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Catheter tubing is not on floor and is in privacy bag?
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Are paper towels available?
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Is soap available?
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Is there an O2 magnet on the door if required?
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O2 tubing not on floor and in plastic bag?
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Is the nebulizer mask in a bag?
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Is the portable O2 filled?
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There are no sharps in room?
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Are skid strips in place and in good condition?
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Is the call light within reach?
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Is the call light positioned correctly?
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Are splints/multi-podus boots on?
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Is the bed in the lowest position?
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Is the room clear of old room trays?
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Do residents with room trays have adequate assistance?
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Is the lighting adequate?
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Is the refrigerator temp log current?
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Is all the food in the fridge dated and current?
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Extension cords are absent from the room?
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No meds in drawers? Check after permission given
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No meds at bedside?
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Are O2 tanks in mesh bads and tubing not dragging?
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Select date