FHMMC Bin Placement Verification

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

FHMMC 12th Floor Administration

• 40" / 31.5g Exec Console Conf Doc -restroom lobby

  Yes

  No

  N/A

• 40" / 31.5g Exec Console- Conf. Doc.- Copy Room

  Yes

  No

  N/A

• "0" containers larger than 32 gallons

  Yes

  No

  N/A

• Containers not closer than 8'

  Yes

  No

  N/A

FHMMC 11th Floor Classroom

• "0" containers larger than 32 gallons

  Yes

  No

  N/A

FHMMC 10th Floor - Education

• 40" / 31.5g Exec Console- Conf. Doc.- Reception Area

  Yes

  No

  N/A

• "0" containers larger than 32 gallons

  Yes

  No

  N/A

FHMMC 10th Floor Nursing Unit

• 40" / 31.5g Exec Console- Nurses Station

  Yes

  No

  N/A

• 40" / 31.5g Exec Console- Conf. Doc.- Equipment Room

  Yes

  No

  N/A

• Containers not closer than 8'

  Yes

  No

  N/A

• 24"/ 15g Exec Console- Conf. Doc.- Nurse Station 2ea

  Yes

  No

  N/A

• Large Soiled Carts- trash, linen & bio waste- located in properly rated rooms only

  Yes

  No

  N/A

FHMMC 9th Floor Department of Clinical Effectiveness

• 40" / 31.5g Exec Console Conf Doc 1

  Yes

  No

  N/A

• 40" / 31.5g Exec Console Conf Doc 2

  Yes

  No

  N/A

• Containers not closer than 8'

  Yes

  No

  N/A

• "0" containers larger than 32 gallons

  Yes

  No

  N/A

FHMMC 9th Floor Mother Baby Unit

• 40" / 31.5g Exec Console Conf Doc - Nurse Station

  Yes

  No

  N/A

• Large Soiled Carts- trash, linen & bio waste- located in properly rated rooms only

  Yes

  No

  N/A

FHMMC 9th Floor Hospice

• 40" / 31.5g Exec Console Conf Doc - Nurse Station

  Yes

  No

  N/A

• Large Soiled Carts- trash, linen & bio waste- located in properly rated rooms only

  Yes

  No

  N/A

FHMMC 8th Floor Employee Health/Diabetes

• 40" / 31.5g Exec Console Conf Doc - Workroom

  Yes

  No

  N/A

• "0" containers larger than 32 gallons

  Yes

  No

  N/A

FHMMC 8th Floor Rehab Office

• 40" / 31.5g Exec Console Conf Doc

  Yes

  No

  N/A

• "0" containers larger than 32 gallons

  Yes

  No

  N/A

FHMMC 8th Floor Nursing Unit

• 24"/ 15g Exec Console- Conf. Doc.- Nurse Station 1

  Yes

  No

  N/A

• 24"/ 15g Exec Console- Conf. Doc.- Nurse Station 2

  Yes

  No

  N/A

• 24"/ 15g Exec Console- Conf. Doc.- Nurse Station 3

  Yes

  No

  N/A

• 40" / 31.5g Exec Console Conf Doc

  Yes

  No

  N/A

• Containers not closer than 8'/ or 32g within 64 sq.ft. In non protected space

  Yes

  No

  N/A

• Large Soiled Carts- trash, linen & bio waste- located in properly rated rooms only

  Yes

  No

  N/A

FHMMC 7th Floor Nursing Admin

• 40" / 31.5g Exec Console Conf Doc 1

  Yes

  No

  N/A

• 40" / 31.5g Exec Console Conf Doc 2

  Yes

  No

  N/A

• 40" / 31.5g Exec Console Conf Doc 3

  Yes

  No

  N/A

FHMMC 7th Floor Nursing Unit

• 40" / 31.5g Exec Console Conf Doc 1 Nurse Station

  Yes

  No

  N/A

• 40" / 31.5g Exec Console Conf Doc 2 Nurse Station

  Yes

  No

  N/A

• 24"/ 15g Exec Console- Conf. Doc.- Nurse Station 1

  Yes

  No

  N/A

• 24"/ 15g Exec Console- Conf. Doc.- Nurse Station 2

  Yes

  No

  N/A

• Containers not closer than 8'/ or 32g within 64 sq.ft. In non protected space

  Yes

  No

  N/A

• Large Soiled Carts- trash, linen & bio waste- located in properly rated rooms only

  Yes

  No

  N/A

FHMMC 6th Floor Nursing Unit

• 40" / 31.5g Exec Console Conf Doc 1 Nurse Station

  Yes

  No

  N/A

• 40" / 31.5g Exec Console Conf Doc Equipment Room

  Yes

  No

  N/A

• 24"/ 15g Exec Console- Conf. Doc.- Nurse Station 1

  Yes

  No

  N/A

• 24"/ 15g Exec Console- Conf. Doc.- Nurse Station 2

  Yes

  No

  N/A

• Containers not closer than 8'/ or 32g within 64 sq.ft. In non protected space

  Yes

  No

  N/A

• Large Soiled Carts- trash, linen & bio waste- located in properly rated rooms only

  Yes

  No

  N/A

FHMMC 5th Floor Case Management

• 40" / 31.5g Exec Console Conf Doc

  Yes

  No

  N/A

• "0" containers larger than 32 gallons

  Yes

  No

  N/A

FHMMc 5th Floor Nursing Unit ICU

• 40" / 31.5g Exec Console Conf Doc - Nurse Mgr Office

  Yes

  No

  N/A

• 24"/ 15g Exec Console- Conf. Doc.- Nurse Station 1

  Yes

  No

  N/A

• 24"/ 15g Exec Console- Conf. Doc.- Nurse Station 2

  Yes

  No

  N/A

• Large Soiled Carts- trash, linen & bio waste- located in properly rated rooms only

  Yes

  No

  N/A

FHMMC 4th Floor Information Svcs

• 40" / 31.5g Exec Console Conf Doc 1

  Yes

  No

  N/A

FHMMC 4th Floor Nursing Unit Birth Care

• 40" / 31.5g Exec Console Conf Doc 1- Front Desk

  Yes

  No

  N/A

• 40" / 31.5g Exec Console Conf Doc 2- Nurse Station

  Yes

  No

  N/A

• 24"/ 15g Exec Console- Conf. Doc.- Nursery

  Yes

  No

  N/A

• Large Soiled Carts- trash, linen & bio waste- located in properly rated rooms only

  Yes

  No

  N/A

FHMMC 3rd Floor Nursing Unit CSDU

• 95g Wheeled Container conf doc.- Soiled Holding by Central Monitor Room

  Yes

  No

  N/A

• 40" / 31.5g Exec Console- Conf. Doc.- Central Monitor Rm

  Yes

  No

  N/A

• 40" / 31.5g Exec Console- Conf. Doc. 1 - Nurse Station

  Yes

  No

  N/A

• 40" / 31.5g Exec Console- Conf. Doc. 2 - Nurse Station

  Yes

  No

  N/A

• 24"/ 15g Exec Console- Conf. Doc.- Nurse Station

  Yes

  No

  N/A

• "0" containers larger than 32 gallons

  Yes

  No

  N/A

• Large Soiled Carts- trash, linen & bio waste- located in properly rated rooms only

  Yes

  No

  N/A

• Containers not closer than 8'/ or 32g within 64 sq.ft. In non protected space

  Yes

  No

  N/A

FHMMC Nursing Unit Cardio- CVICU, CPU, Cath Lab, Admin

• 40" / 31.5g Exec Console- Conf. Doc. CVOR Holding

  Yes

  No

  N/A

• 40" / 31.5g Exec Console- Conf. Doc. CVICU Nurse Station

  Yes

  No

  N/A

• 40" / 31.5g Exec Console- Conf. Doc. - Dr Lounge

  Yes

  No

  N/A

• 40" / 31.5g Exec Console- Conf. Doc. 1 CPU Nurse Station#1

  Yes

  No

  N/A

• 40" / 31.5g Exec Console- Conf. Doc. 2 CPU Nurse Station #2

  Yes

  No

  N/A

• 24"/ 15g Exec Console- Conf. Doc. - Admin Rob Grant Ofc.

  Yes

  No

  N/A

• 24"/ 15g Exec Console- Conf. Doc. - Office next to CV Education classroom

  Yes

  No

  N/A

• 24"/ 15g Exec Console- Conf. Doc. 1 Cath Lab

  Yes

  No

  N/A

• 24"/ 15g Exec Console- Conf. Doc. 2 Cath Lab

  Yes

  No

  N/A

• 24"/ 15g Exec Console- Conf. Doc. 3 Cath Lab

  Yes

  No

  N/A

• 24"/ 15g Exec Console- Conf. Doc. 4 Cath Lab

  Yes

  No

  N/A

• 24"/ 15g Exec Console- Conf. Doc. .?

  Yes

  No

  N/A

• 24"/ 15g Exec Console- Conf. Doc. ?

  Yes

  No

  N/A

• Containers not closer than 8'/ or 32g within 64 sq.ft. In non protected space

  Yes

  No

  N/A

• Large Soiled Carts- trash, linen & bio waste- located in properly rated rooms only

  Yes

  No

  N/A

FHMMC 2nd Floor Pharmacy

• 40" / 31.5g Exec Console- Conf. Doc. 1

  Yes

  No

  N/A

• 40" / 31.5g Exec Console- Conf. Doc. 2

  Yes

  No

  N/A

• 40" / 31.5g Exec Console- Admin Office

  Yes

  No

  N/A

• 24"/ 15g Exec Console- Conf. Doc. . Coordinator Office

  Yes

  No

  N/A

• Containers not closer than 8'/ or 32g within 64 sq.ft. In non protected space

  Yes

  No

  N/A

• "0" containers larger than 32 gallons

  Yes

  No

  N/A

FHMMC 2nd Floor SPD

• 40" / 31.5g Exec Console- Conf. Doc.

  Yes

  No

  N/A

• Large Soiled Carts- trash, linen & bio waste- located in properly rated rooms only

  Yes

  No

  N/A

FHMMC 2nd Floor PreOp Testing

• 95g Wheeled Container - doc. Soiled Holding

  Yes

  No

  N/A

• Large Soiled Carts- trash, linen & bio waste- located in properooms only

  Yes

  No

  N/A

FHMMC 2nd Floor ASU

• 95g Wheeled Container/ conf doc.- Soiled Holding

  Yes

  No

  N/A

• 40" / 31.5g Exec Console- Conf. Doc. Nurse Station

  Yes

  No

  N/A

• Large Soiled Carts- trash, linen & bio waste- located in properly rated rooms only

  Yes

  No

  N/A

FHMMC 2nd Floor Recovery

• 40" / 31.5g Exec Console- Conf. Doc. Nurse Station

  Yes

  No

  N/A

• 24"/ 15g Exec Console- Conf. Doc. 1 Nurse Station

  Yes

  No

  N/A

• 24"/ 15g Exec Console- Conf. Doc. 2 Nurse Station by Docs

  Yes

  No

  N/A

• 24"/ 15g Exec Console- Conf. Doc. PreOp Holding

  Yes

  No

  N/A

• Large Soiled Carts- trash, linen & bio waste- located in properly rated rooms only

  Yes

  No

  N/A

• Containers not closer than 8'/ or 32g within 64 sq.ft. In non protected space

  Yes

  No

  N/A

FHMMC 2nd Floor OR

• 95g Wheeled Container- conf. doc.

  Yes

  No

  N/A

• Large Soiled Carts- trash, linen & bio waste- located in properly rated rooms only

  Yes

  No

  N/A

FHMMC 1st Floor Admitting- Registration

• 40" / 31.5g Exec Console- Conf. Doc. Behind main registration

  Yes

  No

  N/A

• 40" / 31.5g Exec Console- Conf. Doc. Behind ED registration

  Yes

  No

  N/A

• 40" / 31.5g Exec Console- Conf. Doc. Office by ED registration

  Yes

  No

  N/A

• "0" containers larger than 32 gallons

  Yes

  No

  N/A

• Containers not closer than 8'/ or 32g within 64 sq.ft. In non protected space

  Yes

  No

  N/A

FHMMC 1st Floor ED

• 40" / 31.5g Exec Console- Conf. Doc. Admin Suite Conf Room

  Yes

  No

  N/A

• 40" / 31.5g Exec Console- Conf. Doc. Doctors Lounge

  Yes

  No

  N/A

• 24"/ 15g Exec Console- Conf. Doc. Fast Track

  Yes

  No

  N/A

• 24"/ 15g Exec Console- Conf. Doc. Triage workroom

  Yes

  No

  N/A

• 24"/ 15g Exec Console- Conf. Doc. Nurse Station Main

  Yes

  No

  N/A

• 24"/ 15g Exec Console- Conf. Doc. Nurse Station #2

  Yes

  No

  N/A

• Large Soiled Carts- trash, linen & bio waste- located in properly rated rooms only

  Yes

  No

  N/A

FHMMC 1st Floor Cardio

• 95g Wheeled Container- conf. doc. Clean Utility

  Yes

  No

  N/A

• Large Soiled Carts- trash, linen & bio waste- located in properly rated rooms only

  Yes

  No

  N/A

FHMMC 1st Floor Imaging

• 40" / 31.5g Exec Console- Conf. Doc. Reception

  Yes

  No

  N/A

• 40" / 31.5g Exec Console- Conf. Doc. Rad Workroom Ultrasound

  Yes

  No

  N/A

• 40" / 31.5g Exec Console- Conf. Doc. Rad Workroom Nuc Med

  Yes

  No

  N/A

• 40" / 31.5g Exec Console- Conf. Doc. Rad Workroom CT

  Yes

  No

  N/A

• 40" / 31.5g Exec Console- Conf. Doc. Radiologists Reading Room

  Yes

  No

  N/A

• Large Soiled Carts- trash, linen & bio waste- located in properly rated rooms only

  Yes

  No

  N/A

FHMMC 1st Floor LAB

• 40" / 31.5g Exec Console- Conf. Doc. 1

  Yes

  No

  N/A

• 40" / 31.5g Exec Console- Conf. Doc. 2

  Yes

  No

  N/A

• 40" / 31.5g Exec Console- Conf. Doc. 3

  Yes

  No

  N/A

• 40" / 31.5g Exec Console- Conf. Doc. 4

  Yes

  No

  N/A

• 24"/ 15g Exec Console- Conf. Doc.- Supervisor office Blood Draw

  Yes

  No

  N/A

• Containers not closer than 8'/ or 32g within 64 sq.ft. In non protected space

  Yes

  No

  N/A

• "0" containers larger than 32 gallons

  Yes

  No

  N/A

FHMMC 1st Floor Med Staff, Mail rm

• 40" / 31.5g Exec Console- Conf. Doc. - Mail Room

  Yes

  No

  N/A

• 40" / 31.5g Exec Console- Conf. Doc. - Doctors Lounge

  Yes

  No

  N/A

• 40" / 31.5g Exec Console- Conf. Doc. - Physician Workroom

  Yes

  No

  N/A

• Containers not closer than 8'/ or 32g within 64 sq.ft. In non protected space

  Yes

  No

  N/A

• "0" containers larger than 32 gallons

  Yes

  No

  N/A

FHMMC 1st Floor MED Records

• 95g Wheeled Container- conf. doc. 1 Storage

  Yes

  No

  N/A

• 95g Wheeled Container- conf. doc. 2 Storage

  Yes

  No

  N/A

• 95g Wheeled Container- conf. doc. 3 Storage

  Yes

  No

  N/A

• 40" / 31.5g Exec Console- Conf. Doc. 1- Near Main Entry

  Yes

  No

  N/A

• 40" / 31.5g Exec Console- Conf. Doc. 2 - Center Hall

  Yes

  No

  N/A

• 40" / 31.5g Exec Console- Conf. Doc. 3 - Near Main Entry

  Yes

  No

  N/A

• Containers not closer than 8'/ or 32g within 64 sq.ft. In non protected space

  Yes

  No

  N/A

• Large Soiled Carts- trash, linen & bio waste- located in properly rated rooms only

  Yes

  No

  N/A

FHMMC 1st Floor MM, Engineering

• 40" / 31.5g Exec Console- Conf. Doc. Materials Mgt

  Yes

  No

  N/A

• 40" / 31.5g Exec Console- Conf. Doc. Security Office

  Yes

  No

  N/A

• 40" / 31.5g Exec Console- Conf. Doc. Engineering office

  Yes

  No

  N/A

• 40" / 31.5g Exec Console- Conf. Doc. FANS Kitchen

  Yes

  No

  N/A

• 24"/ 15g Exec Console- Conf. Doc.- EVS Supervisor office

  Yes

  No

  N/A

• 24"/ 15g Exec Console- Conf. Doc.- EVS AsstD office

  Yes

  No

  N/A

• "0" containers larger than 32 gallons

  Yes

  No

  N/A

• Containers not closer than 8'/ or 32g within 64 sq.ft. In non protected space

  Yes

  No

  N/A

Starr Rehab

• 95g Wheeled Container- conf. doc.

  Yes

  No

  N/A

• Large Soiled Carts- trash, linen & bio waste- located in properly rated rooms only

  Yes

  No

  N/A

• "0" containers larger than 32 gallons outside properly rated storage area

  Yes

  No

  N/A

FHO 3rd Floor

• 95g Wheeled Container- conf. doc. - Copier closet

  Yes

  No

  N/A

• 64g Wheeled Container- conf. doc. - Case Mgrs Office

  Yes

  No

  N/A

• 40" / 31.5g Exec Console- Conf. Doc. Nurse Station

  Yes

  No

  N/A

• 24"/ 15g Exec Console- Conf. Doc. - doctors office

  Yes

  No

  N/A

• "0" containers larger than 32 gallons outside properly rated storage area

  Yes

  No

  N/A

• Large Soiled Carts- trash, linen & bio waste- located in properly rated rooms only

  Yes

  No

  N/A

FHO 2nd Floor

• 40" / 31.5g Exec Console- Conf. Doc. Rehab Gym

  Yes

  No

  N/A

• "0" containers larger than 32 gallons outside properly rated storage area

  Yes

  No

  N/A

FHO 1st Floor

• 95g Wheeled Container- conf. doc. 1 Med Records

  Yes

  No

  N/A

• 95g Wheeled Container- conf. doc. 2- Med Records

  Yes

  No

  N/A

• 95g Wheeled Container- conf. doc. 3- Med Records

  Yes

  No

  N/A

• 95g Wheeled Container- conf. doc. FANS- kitchen

  Yes

  No

  N/A

• 40" / 31.5g Exec Console- Conf. Doc. - Health Care Partners

  Yes

  No

  N/A

• 40" / 31.5g Exec Console- Conf. Doc. - Pharmacy

  Yes

  No

  N/A

• 40" / 31.5g Exec Console- Conf. Doc. 1- ED

  Yes

  No

  N/A

• 40" / 31.5g Exec Console- Conf. Doc. 2- ED

  Yes

  No

  N/A

• 40" / 31.5g Exec Console- Conf. Doc. 1- LAB

  Yes

  No

  N/A

• 40" / 31.5g Exec Console- Conf. Doc. 2- LAB

  Yes

  No

  N/A

• 40" / 31.5g Exec Console- Conf. Doc. - Cardio

  Yes

  No

  N/A

• "0" containers larger than 32 gallons outside properly rated storage area

  Yes

  No

  N/A

• Large Soiled Carts- trash, linen & bio waste- located in properly rated rooms only

  Yes

  No

  N/A

• Containers not closer than 8'/ or 32g within 64 sq.ft. In non protected space

  Yes

  No

  N/A

FH Imaging

• Need info:

  Yes

  No

  N/A

Additional Comments

• Additional Comments

• Signature of person completing report

  Sign

• Type name of person completing report