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Cleaning and Disinfecting Surfaces

  • Have you reviewed the cleaning measures to ensure that high risk contact areas and touch points are being regularly disinfected?

  • You should ensure that public surfaces such as counters, doorknobs, handles and light switches are regularly disinfected

  • Have you followed CDC guidance for cleaning and disinfecting hard surfaces?

Personal Protective Equipment (PPE) and Hand Hygiene

  • Are staff members following the CDC recommended hand washing protocol?

  • Follow these five steps every time.

    1. Wet your hands with clean, running water (warm or cold), turn off the tap, and apply soap.
    2. Lather your hands by rubbing them together with the soap. Lather the backs of your hands, between your fingers, and under your nails.
    3. Scrub your hands for at least 20 seconds. Need a timer? Hum the “Happy Birthday” song from beginning to end twice.
    4. Rinse your hands well under clean, running water.
    5. Dry your hands using a clean towel or air dry them.

  • Are staff members wearing disposable gloves and gowns for all tasks in the cleaning process, including handling trash?

  • Gloves and gowns should be removed carefully to avoid contamination of the wearer and the surrounding area. Be sure to clean hands after removing gloves.

  • Are staff members following normal preventive actions while at work including cleaning hands and avoiding touching eyes, nose, or mouth with unwashed hands?

  • Do you have readily available access to Hand Sanitizer for all staff members?

  • Does the Hand Sanitizer contain at least 60% alcohol content?

  • An alcohol-based hand sanitizer that contains 60%-95% alcohol should be used. However, if hands are visibly dirty, always wash hands with soap and water.

Employees

  • Are all employees wearing their face shield?

  • Are all employees fully dressed in proper uniforms?

  • Are all staff trained on proper chemical handling, storage, and disposal?

  • Are all staff wearing appropriate PPE when handling chemicals?

General Inspection of Facility

  • Is the floor in the welfare area clean? (Should be last task at end of every day)

  • Is the facility clean and presentable?

  • Name & Signature

Upstairs

  • Is the floor clean?

  • Are toilets and urinals clean and sanitized?

  • Are all Sinks and Sink Faucets clean and sanitized?

  • Doors, Door Handles, Door Surfaces, Door Frames clean and sanitized?

  • Are all handrails clean and sanitized? ( Includes Employee Entrance Stairs)

  • Are all soap and sanitizer dispensers clean and sanitized?

  • Are the Microwave, Toaster and Coffee Maker clean and sanitized?

  • Are all the light switches clean and sanitized?

  • Is the lunch room table clean and sanitized?

  • Name & Signature

Main Floor

  • Is the floor clean?

  • Are toilets and urinals clean and sanitized?

  • Are all Sinks and Sink Faucets, Hose Bibs and Handles clean and sanitized?

  • Doors, Door Handles, Door Surfaces, Door Frames clean and sanitized?

  • Are all soap and sanitizer dispensers clean and sanitized?

  • Maintenance room workbench clean and sanitized?

  • Are all the light switches clean and sanitized?

  • Are all desk and table surfaces clean and sanitized?

  • Are all cart handles clean and sanitized? ( Grey and Blue)

  • Are all Pallet Jack handles clean and sanitized?

  • Is the Forklift Steering Wheel/ Control Handles clean and sanitized?

  • Name & Signature

Comments and Sign-off

  • Any comments or issues to report?

  • Add comments or issues here:

  • Overall rating

  • Name & Signature

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.