Title Page
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Site conducted
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Conducted on
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Prepared by
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Department ie dental. av med etc
Pantry
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Is the fridge free of old expired food?
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Is the fridge cleaned and emptied weekly?
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Is there a checklist for HK once weekly cleaning is complete? Take photo of checklist and list.
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Is under the sink clean and free of any materials?
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Are the kitchen worktops clean?
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Are inside the cupboards clean?
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Is the water filter in the pantry serviced?
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Is the coffee machine clean (if applicable)?
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Are the Drip trays empty and clean?
Watercoolers
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Watercoolers in the clinic waiting areas- serviced within 6months?
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Is it clean?
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Are the Drip trays clean and empty?
Environmental
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Furniture is clean and in good repair?
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Are the rooms free of food supplies and equipment?
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Are the rooms clean and dust free?
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Gloves, overalls and eye shields available in all rooms
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Curtains are clean and changed within 6 months? Tab on top of curtains with installation date.
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Used linen is stored in a dedicated hamper
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No expired items and/or materials found during inspection
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Are multi use items ie gels discarded within one month? Excluding hand sanitiser.
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Are single use items discarded after use?
Sharps bin
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Sharps bins are not filled above the fill line
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Sharps bins are free from protruding sharps
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Temporary closure mechanisms are used when bins are not in use
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Bins are assembled correctly and are clean
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Bins are stored correctly off the floor between waist and shoulder height
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Injection trays are clean
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Staff are knowledgeable on actions to take i event of a sharps injury
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Staff witnessed using safe sharp processes: disposal at point of use, safe disposal
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Used bins are sealed, locked, dated then placed in the biohazardous waste room for disposal.
Waste Bins
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General waste and Biohazard bins available in all rooms?
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Stickers clearly mark if biohazard or general waste or not?
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Appropriate waste in correct bin?
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Only bins with lids in clinical rooms?
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All waste bins are clean and in full working operation.- check the foot pedal.