ICRA Risk Class: I. II. III. IV.

Class - I, II, III, or IV


Inspected by:

Post-Construction, Preoccupancy

Wet-mop area with disinfectant.

Barriers not removed until area thoroughly cleaned.

Barriers not removed until area inspected by Safety and Infection Control.

Renovation units thoroughly cleaned before admitting patients.

Utility Services

Water lines have been flushed thoroughly in newly renovated and adjacent areas before occupancy. This also applies to areas that have been vacant for a period of time and are being put back into service.

Provide documentation of correct procedures following re-establishment of interrupted utility services, including but not limited to:

Domestic water

Sewage system

HVAC System

Medical Gasses

Air Quality

If air ducts were not completely sealed, filters were removed & changed.

Remove isolation of HVAC system in areas where work is being performed.

Additional Comments and/or photos


Development & Construction Rep:
Facilities Services Rep:
Safety Rep:
Infection Prevention Rep:
Contractor/Vendor Rep:
Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.