Title Page
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Document No.
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Birthing Room 244/246
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Client / Site
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Conducted on
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Prepared by
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Acute care
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Personnel
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Solid and bio hazardous waste
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Purell Dispenser and catcher
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Paper Towel Dispenser
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Glove Dispenser
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Mirror
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Sink
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Counter Top
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Cabinets
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Blood Pressure Cuffs
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Computer station
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Panda warmer
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X's 8 baby supplies on wall by sharps container
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Sharps Container and dispenser
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Bed
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Baby Crib
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Table
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Drawers
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IV pole
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Fan
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Exercise ball
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Closet/drawer
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Couch
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Window / window ceil
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Chair
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Rocking chair
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Eating table under tv
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Weigh scale
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Television- check for dust on wall mounts
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Stepping stool
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Portable table
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Bulletin board
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Lamp
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Handrails
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Shower walls
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Shower curtain
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Shower seat
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Toilet
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Toilet base/seat
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Handrails
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Sink
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Items on the brown wall
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Assure main walls are mopping
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Check floor and corners for dust
