Title Page

  • Site conducted

  • Conducted on

  • Prepared by

  • Location


  • 1. Staff wearing hair net

  • 2. Appropriate fingernail length. (1/4")

  • 3. Hand hygiene is being performed correctly.

Work stations

  • 1. Clean and free of clutter

  • 2. Trash is not overflowing

  • 3. Floors are swept and clean.

  • 4. All horizontal surfaces are clean

  • 5. No stained ceiling tiles.


  • 1. PPE supplies are available.

  • 2. Linen handled according to specific isolation situation.

  • 3. Appropriate PPE being used by staff.

Soiled Sort Area

  • 1. Soil Sort Employees are trained in the BBP regulations

  • 2. Routine disinfection and cleaning performed in this area

  • 3. Soiled area separated from clean area.

  • 4. If low temp washed, chemicals designed for low temps

  • 5. Specific hand hygiene sink available with eye wash station.

  • 6. Universal precaution sign present at entrance

  • 7. Staff wearing gown and gloves when sorting soiled linens

  • 8. Soiled area door is closed at all times.

Finish Area (Drying, Ironing, Folding)

  • 1. There is no lint build-up on equipment, floors and ceilings

  • 2. Area is clean and free of clutter

  • 3. All horizontal surfaces are clean

  • 4. Soiled and clean carts are not coming into contact with each other

  • 5. Freshly washed linens are brought from the washer side in clean tubs .

  • 6. Drying times are followed per policy guideline.

  • 7. Dryers are cleaned of lint, wet linens covered with plastic, floors swept, and tables cleaned at the end of the day.

Staging and Storage Area

  • 1. Carts are clean

  • 2. Clean linens ready for transport are covered

  • 3. Linens are not stored for more than 72 hours.

  • 4. There is documentation of cleaning schedule for transport carts.


  • 1. Fire extinguishers not obstructed from easy access

  • 2. No electrical panels are blocked

  • 3. Countertop/doors are in good condition with no chipping to laminate

  • 4. No supplies stored under sinks

  • 5. Paper is not present on fire-rated doors

  • 6. Maintains the integrity of egress throughout the department

  • 7. There is at least 18" of open space maintained below a sprinkler deflector to the top of storage

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.