Title Page
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Conducted on
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Prepared by
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Location of Audit
- Admin Hall
- Cove
- Game Room
- Rehab Gym
- Maintenance Hallway
- Coho
- Main SNF Hall
- Dining Room
- Willow
- Hatcher
- Denali
- Susitna
Mask Interaction 1
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Staff Type
- CNA
- Nurse
- Dietary Aid
- Office Staff
- Activity Staff
- Housekeeping
- Resident
- Maintenance
- Visitor
- Other
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Was the Mask Worn Properly
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Was Education Done?
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Was Education Done?
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Was Education Done?
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Was the Mask Worn During The Entire Interaction
Mask Interaction 2
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Staff Type
- CNA
- Nurse
- Dietary Aid
- Office Staff
- Activity Staff
- Housekeeping
- Resident
- Maintenance
- Visitor
- Other
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Was the Mask Worn Properly
-
Was Education Done?
-
Was Education Done?
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Was Education Done?
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Was the Mask Worn During The Entire Interaction
Mask Interaction 3
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Staff Type
- CNA
- Nurse
- Dietary Aid
- Office Staff
- Activity Staff
- Housekeeping
- Resident
- Maintenance
- Visitor
- Other
-
Was the Mask Worn Properly
-
Was Education Done?
-
Was Education Done?
-
Was Education Done?
-
Was the Mask Worn During The Entire Interaction
Mask Interaction 4
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Staff Type
- CNA
- Nurse
- Dietary Aid
- Office Staff
- Activity Staff
- Housekeeping
- Resident
- Maintenance
- Visitor
- Other
-
Was the Mask Worn Properly
-
Was Education Done?
-
Was Education Done?
-
Was Education Done?
-
Was the Mask Worn During The Entire Interaction
Mask Interaction 5
-
Staff Type
- CNA
- Nurse
- Dietary Aid
- Office Staff
- Activity Staff
- Housekeeping
- Resident
- Maintenance
- Visitor
- Other
-
Was the Mask Worn Properly
-
Was Education Done?
-
Was Education Done?
-
Was Education Done?
-
Was the Mask Worn During The Entire Interaction
