Title Page
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Conducted on
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Med carts – items on ice, everything covered, wipes, no food or drinks, vials labeled, milk and crackers on cart, containers dated, LOCKED
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Treatment carts – no items on top, LOCKED
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Laptop screens have no resident information visible
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Med rooms – LOCKED, temp log, all meds are not out of date, emergency box present
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Tube feeding supplies are labeled, dated, bagged
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Linen carts covered at all times
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02 signs present, tubing labeled, dated, bagged
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Shower rooms clean, cabinet locked with only spray and wipes
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Shower stretcher and chair clean, mats are in good working order
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ADL bathroom clean with no storage
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Utility room neat, nothing on floor
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Tub rooms clean and neat, no resident clothes present
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Employee locker rooms neat, no storage present
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Dining rooms are neat, hand wipes present
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Nourishment rooms – temp logs, dates on all food/drinks in fridge, all trays are bagged
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No food or drinks at nurses station
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No cell phones at nurses station or on unit
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No doors are propped open
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Resident room check – all personal items labeled and stored properly, floor clear, bed in lowest position, call bell in reach, water and remote in reach, ID band in place
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Mask Compliance
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Eye Protection Compliance
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TBP Signage
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TBP Setup
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Donning/Doffing Compliance
