Elements Observed

Hand Hygiene

There is an adequate number of soaps and sanitiser dispensers are available in the unit

Hand hygiene demonstration posters are available where ever required

Staff are performed hand hygiene when required as per the 5 moments

Hand washing sinks and taps are clean and without an overflow hole

There is no storage noted under the sink

Waste Management

All waste bins are clean and pedal operated

No waste bins are overfilled

Proper waste segregation is observed in the unit

Linen Management

Proper linen management observed in the unit

Linens hampers are not overfilled

All linens are free of stains

All soiled linens hampers are kept covered and placed in the dirty utility room

Alginate liners were placed in red hamper bags

Sharp safety

Sharp containers were placed where ever required

No sharp containers overfilled more than 3/4 of the volume

All sharp containers are labelled

Sharp containers were placed at an adequate height

No used or contaminated sharps discarded anywhere other than the sharp container

Patient Care items

All patient care supplies are clean and dust-free

sterile supplies are stored separately

All equipment is clean and free of stain and dust

Clean tag is present on where ever required

No expired supplies were noted in the unit

All multiuse supplies were labelled as per the facility policy

Storage of Supplies

No items were stored on the floor

No shipping cartons were stored in th unit

Recommended distance from the floor, wall and ceiling observed while storing the supplies

FIFO is practised in the unit

Maintaining the Logs

Temperature /Humidity log was maintained daily

Differential air pressure log was maintained

Fridge /Freezer log is maintained

Adequate number of hygrometers are available and working in order

other related checklists were maintained if any specify ......................

Environmental Cleaning /Maintenance

The unit is clean, free of dust and clutter

wall, floor and ceiling, A/C vents are clean free of satins

All countertops, cabinets are dust-free

patient room and restrooms are well maintained

staff pantries are clean, maintained well

Curtains are free of satin laundered atleast monthly

Pneumatic stations are free of dust and canisters are clean

No food has seen in the clinical area

Disinfecting wipes are available where ever required

Recommended water /Air quality studies were conducted

The unit is free of pests

All equipment has periodic maintenance records

Clean /Dirty utilities

Biohazard spill kit is available in the unit

The unit has designated clean and dirty utility rooms

clean supplies are only stored in clean utility

DU only contains waste, soiled linen, contaminated CSSD instruments

Pre - foam is available in the DU room

Transporation boxes contain biohazard sticker

Colour coded mopes/towels are available

Automated chemical mixing available

All housekeeping chemicals are labelled

Eyewash station is available

Fridge /Freezers /ovens

The log is maintained for fridge and freezers

No food or other items were stored in a medication fridge

No medications stored in the food fridge

fridges are cleaned weekly / Defrosted periodically

Ovens are clean and stain-free

Isolation Precautions

precaution signage was placed in an isolation room

Negative air pressure within the reference range

Designated isolation cart is available

staffs observed with recommend PPE

No shortage for PPE in the unit

Designated equipment/supplies are available for the patient

Communicable disease was notified to DOH

Staff Awareness

Staff know 5 moments of hand hygiene and proper hand hygiene technique

Staff Know how to manage exposure to blood and body fluids and spill management

Satffs knows about HAI reporting and HAI prevention bundles

Staff know about Donning and Doffing of PPE

Staff knows about communicable disease notification to DOH

Staff able to locate the IC policies and forms

Covid -19

Unit observed the recommended covid - 19 Precautions

Daily staffs monitoring records available

Staffs are aware of the current updated Covid -19 guidelines


All staffs completed the infection control training at least annually

Staff offered Respiratory protection program

Additional Findings

Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.