ISPT Housekeeping Dietary& Laundry/ Waste Disposal CHECKLIST

• Conducted on

  Date

• Prepared by

• Location
  Address

A. HOUSEKEEPING, DIETARY AND LAUNDRY SECTIONS ( for cleaning and disinfection of reusable gowns / cover-alls and goggles )

• 1. Health Care Worker ( HCW) drops used gown/ cover-all and goggles on designated bins

  Yes

  No

  N/A

• 2. HCW sprays/ disinfects used gowns/ cover alls and goggles

  Yes

  No

  N/A

• 3. Wardman ( Level IV -PPE) collects used items

  Yes

  No

  N/A

• 4. House Keeping staff ( Level III PPE ) will do the following in a designated area

• * For Goggles , removes and wipes visible contaminants

  Yes

  No

  N/A

• * Soaked used Items

  Yes

  No

  N/A

• * Rinse with water

  Yes

  No

  N/A

• * Wash with detergent

  Yes

  No

  N/A

• * Hangs and colects items

  Yes

  No

  N/A

• * Placed in a bag for UVC Irradiation

  Yes

  No

  N/A

• * Collects and fold items and placed in a container

  Yes

  No

  N/A

• 5. Housekeeping Staff/ Nursing Attendant label the items as follows:

• * Number of Items

• * Description

• * Date Cleaned

  Date

• 6. Checks and deliver items to logistics for storage

  Compliant

  Non-Compliant

  N/A

B. WASTE DISPOSAL CHECKLIST

• Segregation of waste products

  Yes

  No

  N/A

• Treatment/ Disinfection of waste products

  Yes

  No

  N/A

• Sealing of waste products

  Yes

  No

  N/A

Labelling of Waste products

• Date

  Yes

  No

  N/A

• Solid Waste

  Yes

  No

  N/A

• Liquid Waste

  Yes

  No

  N/A

• Transport using designated wheeled trolleys

  Yes

  No

  N/A

• Storage in designated locations

  Yes

  No

  N/A

Transport of designated landfill within:

• 48 hours – cold season

  Yes

  No

  N/A

• 24 hours – cold season

  Yes

  No

  N/A

• Cleaning and disinfection of wheeled trolleys

  Yes

  No

  N/A