Daily Cleaning and Personal Hygiene Inspection (COVID-19)

• Conducted on

  Date

• Prepared by

• Location
  Address

Cleaning and Disinfecting Surfaces

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

  Yes

  No

• 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?

  Yes

  No

• For disinfection, diluted household bleach solutions, alcohol solutions with at least 70% alcohol, and most common EPA-registered household disinfectants should be effective.

• Diluted household bleach solutions can be used on hard, non-porous surfaces. Ensure proper ventilation.
  
  Prepare a bleach solution by mixing:
  5 tablespoons (1/3rd cup) bleach per gallon of water or
  4 teaspoons bleach per quart of water

• Have you followed CDC guidance for cleaning and disinfecting soft (porous) surfaces?

  Yes

  No

• For soft (porous) surfaces such as carpeted floor, rugs, and drapes, remove visible contamination if present and clean with appropriate cleaners indicated for use on these surfaces.
  
  Use products with the EPA-approved emerging viral pathogens claims (list of products: https://www.americanchemistry.com/Novel-Coronavirus-Fighting-Products-List.pdf)

• Have appropriate items been laundered following CDC guidance?

  Yes

  No

• If the items can be laundered, launder items in accordance with the manufacturer’s instructions using the warmest appropriate water setting for the items and then dry items completely.
  
  Do not shake dirty laundry; this minimize the possibility of dispersing virus through the air.
  
  Clean and disinfect hampers or other carts for transporting laundry according to guidance above for hard or soft surfaces.

Personal Protective Equipment (PPE) and Hand Hygiene

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

  Yes

  No

• 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?

  Yes

  No

• 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.
  
  Cleaning staff should immediately report breaches in PPE (e.g., tear in gloves) or any potential exposures to their supervisor.

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

  Yes

  No

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

  Yes

  No

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

  Yes

  No

• 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 name tag?

  Yes

  No

  N/A

• Are all cleaners fully dressed in proper uniforms?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Are all cleaners wearing appropriate PPE when handling chemicals?

  Yes

  No

  N/A

General Inspection of Site

• Is the floor area clean?

  Yes

  No

  N/A

• Are all frames and wall fittings free of dust?

  Yes

  No

  N/A

• Is the ceiling free of cobwebs?

  Yes

  No

  N/A

• REFERENCE: The ceiling is free of cobwebs
  [This is an example of how you can use iAuditor to include best practice reference images in your templates to assist with inspections]

  

• Are all accessible facing windows clean?

  Yes

  No

  N/A

• Are all equipment clean?

  Yes

  No

  N/A

• Is the room clean and presentable?

  Yes

  No

  N/A

• Is the safety file in place and in order?

  Yes

  No

  N/A

• Is the waste receptacle clean and sanitized?

  Yes

  No

  N/A

Front Reception Area

• Is the seating area clean and presentable?

  Yes

  No

  N/A

• Are all areas free from dust and obstruction?

  Yes

  No

  N/A

• Is the entrance carpet clean and vacuumed?

  Yes

  No

  N/A

• Are all accessible windows clean and clear?

  Yes

  No

  N/A

Public restrooms

• Is the floor area clean?

  Yes

  No

  N/A

• Are toilets and urinals clean and sanitized?

  Yes

  No

  N/A

• Are all basins wiped?

  Yes

  No

  N/A

• Are all waste bins emptied?

  Yes

  No

  N/A

• Are all walls clean and sanitized?

  Yes

  No

  N/A

• Are all doors clean and sanitized?

  Yes

  No

  N/A

Comments and Sign-off

• Any comments or issues to report?

  Yes

  No

• Add comments or issues here:

• Overall rating

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• Name & Signature

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