EOC ROUNDING. TEMPLATE

• Document No. July EOC

• Audit Title

• Client / Site

• Conducted on July 16,

  Date

• Prepared by. Debra Newland

• Location Home test on sick bed
  Address

• Personnel

• BEDS:
  
  RAISED AND DUSTED UNDERNEATH:
  BLUE ACCORDION UNDER THE BED:
  END OF BED FRAME:
  

Med rooms

HIGH DUSTING: Dust levels are good.

• Yes

  No

  N/A

VERTICAL DUSTING / CLEANING: Blinds are dusted. Seals are wiped clean Guest bed mattress is wiped and cleaned underneath

• Yes

  No

  N/A

HORIZONTAL DUSTING: Wall equipment is wiped and stages nicely

• Yes

  No

  N/A

REST ROOM: Shower drains. Shower doors /corners Commode in shower. Sink / toilet pipes Mirror: Supplies:

• Yes

  No

  N/A

Closets: Empty of all items.

• Yes

  No

  N/A

FLOOR CARE: Edges / Corners

• Yes

  No

  N/A