Engineering issues

Lighting is in good condition

Light Pull Chord in working condition

Plumbing in working condition

Ceiling tiles and tbar are clean with no stains, cracks, or missing

Paint is in good condition

Doors are in working condition including all hinges

Bathroom door in working order

Shower door in working order

Patient Room door in working order

All outlets in working order

Vents are in working order and are clean of debris and dust

Nurse Call working properly?

TV working properly in correlation to the Nurse Call System?

Are there any holes in the walls?

No Penetrations in the corridors or stairwell

All fire doors latch and close properly

All exit signs are properly working

All stairwell passage lights are working properly?

Are all means of egress free of obstruction both internal and external?

Is flooring in good condition?


Housekeeping Issues

Floor dust/dirt free corners/edges

Floor under furniture dust/dirt free

Walls dust/dirt free including corners

Window ledges dust/dirt free

Overbed light dust/dirt free

Closets are dust/dirt free

Call light control dust/dirt free

Patient bed rails cleaned

TV set dust/dirt free

Bedside cabinet clean

Over bed table clean

Cubicle curtain clean

Air vents clean

Waste containers clean

Room is odor free

Restroom floor corners/edges clean

Restroom walls dust/dirt free

Toilet cleaned including around and on the bottom

Sink cleaned including bottom

Paper towel dispenser supplied

Soap dispenser supplied

Toilet paper dispenser filled

Hand Sanitizer is in working order and filled

Sharp Container is less than 3/4 full and clean


Approval of these rounds are accepted by:

Clinical Unit Director/CSM
Engineering Representative:
EVS Representative:
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.