Title Page

  • Conducted on

  • Prepared by

  • Facility Name

  • Campus

  • SPD Location

  • Campus

  • Campus

  • SPD Location

  • SPD Location

Decontamination Receiving Risk Event

  • Name of Tray/Instrument and Number

  • Instrument /Tray contained no visible gross soil

  • Instrument/Tray sprayed with pretreatment

  • Sharps/Disposables Removed

  • Instruments Restrung

  • Instruments in correct tray

  • What trays were affected? (Must have tray names and numbers)

  • How much time did it take to correct? (In Minutes)

  • Which department did the Instruments/Trays come from?

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.