Daily AVG Chute Room Audit

• Conducted on

  Date

• Audit completed by:

AVG Trash Chute:

• Assigned To:

• All Personal Protective Equipment (PPE) is present, clean and functioning properly?

  Yes

  No

  N/A

• Entrance Door Closed? (No Wedge or Tape preventing door from locking)

  Yes

  No

  N/A

• Chutes, Carts & Chute Room Kept Cleaned?

  Yes

  No

  N/A

• Is AVG Cart parked? (properly aligned with censor’s)

  Yes

  No

  N/A

• Is AVG Carts not overflowing?

  Yes

  No

  N/A

• Is all Safety features working?

  Yes

  No

  N/A

• Additional Comments:

• Auditors Signature:

  Sign

AVG Linen Chute:

• Assigned To:

• All Personal Protective Equipment (PPE) is present, clean and functioning properly?

  Yes

  No

  N/A

• Entrance Door Closed? (No Wedge or Tape preventing door from locking)

  Yes

  No

  N/A

• Chutes, Carts & Chute Room Kept Cleaned?

  Yes

  No

  N/A

• Is AVG linen Cart parked? (properly with the back of linen carts facing each other)

  Yes

  No

  N/A

• Is the shelves properly locked in placed on the linen carts?

  Yes

  No

  N/A

• Is AVG linen Carts not overflowing?

  Yes

  No

  N/A

• Is all Safety features working?

  Yes

  No

  N/A

• Additional Comments:

• Auditors Signature:

  Sign