BJH-EVS Lead Daily Touring Notes: - Non Patient

• Conducted on

  Date

• Prepared by

Daily Touring:

• Areas Toured?

• Eyewash Station Check-List up to date & not blocked?

  Yes

  No

  N/A

• Is the EVS hopper room clean and organized?

  Yes

  No

  N/A

• Evidence of floor being maintained in Offices, Ancillary areas, Lobbies & Restroom?

  Yes

  No

  N/A

• Is the morning routine being performed in Patient Rooms?

  Yes

  No

  N/A

• # of HRO inspections Completed? & Location?

• Recommend Projects to be scheduled?

• Any issues or concerns in your area?

• Additional comments and pertinent information?

• Leads Signature:

  Sign