Title Page
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Ward Area
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Conducted on
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Prepared by
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Location
Condition of Waste Receptacles
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Are there color-coded waste bins for bio-medical wastes available in the ward?
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Are bags securely fitted with the bin?
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Are waste bins covered?
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Is there a biohazard symbol imprinted over waste bags?
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Are there posters displayed near the waste bins to guide staff and/or users?
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Take or attach photo evidence of waste bins available in the ward
Segregation of Waste
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Do each colored waste-bin contain items assigned to it?
Mutilation of Recyclable Waste
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Are used hypodermic needles destroyed, re-capped or bent?
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Are used plastic bottles cut?
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Is nozzle of syringes destroyed?
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Are used plastic tubings cut?
Disinfection of Plastics and Sharps
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Is a disinfectant solution put into waste bins?
Completion
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Additional comments
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Name & Signature of Assigned Personnel