EVS - Daily Touring/Observations

• Location

• Prepared by

Customers Feedback 1st Tour/Observation

• 1st Tour/Observation Time

  Date

• Touchbase with?

• Is everything going ok?

  Yes

  No

• Is there anything I can help you with at this time?

  No

  Yes

• Is there anyone you would like recognize from our department?

  Yes

  No

EVS Observation:

• Is EVS staff in assigned area and productive?

  Yes

  No

• Is area clean and in satisfaction condition?

  Yes

  No

• Any projects to be scheduled:

EVS Staff Feedback:

• How is everything going?

• Are you able to complete your assignment as scheduled?

  Yes

  No

• Any issues or concerns with nursing?

  No

  Yes

Customers Feedback 2nd Tour/Observation

• 2nd Tour/Observation Time

  Date

• Touchbase with?

• Is everything going ok?

  Yes

  No

• Is there anything I can help you with at this time?

  No

  Yes

• Is there anyone you would like recognize from our department?

  Yes

  No

EVS Observation:

• Is EVS staff in assigned area and productive?

  Yes

  No

• Is area clean and in satisfaction condition?

  Yes

  No

• Any projects to be scheduled:

EVS Staff Feedback:

• How is everything going?

• Are you able to complete your assignment as scheduled?

  Yes

  No

• Any issues or concerns with nursing?

  No

  Yes

Projects:

• Projects Completed: