Title Page
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
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FT lab/Supply Room
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Ft Med Room
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FT Patient Room
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ED Exam & Trauma Rooms<br>
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Nurses Station
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Public Bathrooms
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Unoccupied Patient Rooms
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Patient waiting area
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Sweep/mop Hallways
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Triage Room
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Soiled Utility