BJH-EVS Lead Daily Touring Notes: - Patient Divisions - Gray

• Conducted on

  Date

• Prepared by

Daily Touring:

• Areas Toured:

  Select 13100 12100 12200 11100 11200 10100 10200 9100 9200

  • 13100
  • 12100
  • 12200
  • 11100
  • 11200
  • 10100
  • 10200
  • 9100
  • 9200

• Housekeeping Carts Stocked and Fully Functional?

  Select 13100 12100 12200 11100 11200 10100 10200 9100 9200

  • 13100
  • 12100
  • 12200
  • 11100
  • 11200
  • 10100
  • 10200
  • 9100
  • 9200

• Check in with Supervisor:

  9:15 AM

  11:15 AM

  1:15 PM

  2:15 PM

• 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

• Check in with Supervisor:

  9:15 AM

  11:15 AM

  1:15 PM

  2:15 PM

• Evidence of floor being maintained in Patient Rooms & Restroom?

  Yes

  No

  N/A

• Is the morning routine being performed in Patient Rooms?

  Yes

  No

  N/A

• Check in with Supervisor:

  9:15 AM

  11:15 AM

  1:15 PM

  2:15 PM

• # of HRO inspections Completed? & Location?

• Recommend Projects to be scheduled?

• Check in with Supervisor:

  9:15 AM

  11:15 AM

  1:15 PM

  2:15 PM

• Any issues or concerns in your area?

• Additional comments and pertinent information?

• Leads Signature:

  Sign