Information
-
Conducted on
-
Prepared by
DIRECTIONS
-
Check all that apply and note if followup is needed. Complete this audit for each area weekly or for random audits as needed.
-
Audit Location
FLOORS
-
Floors are clean/vacuumed/free of dust
-
There is no wax buildup in corners or on baseboards
-
There are no stains on the floors?
LIGHTS/CEILING SPACES
-
Light fixtures are clean
-
Vents are clear from dust
-
Ceilings are clean and free from cobwebs
WINDOWS/WALLS
-
Walls are clean
-
Windows, window ledges, and screens are clean<br>
-
Window coverings are clean
-
Stainless steel is clean
-
Cubical curtains are clean
-
Doors and handles/knobs are clean
PATIENT SPACES
-
Bed rails and under mattress are clean
-
It is dust free under beds
-
Bedside table and over bed table are clean
-
Area is free from insects and pests
-
Waste baskets are empty
-
Furniture in room is clean and free of defects
BATHROOMS
-
Bathroom sink is clean
-
Bathroom mirror is clean
-
Shower is clean
-
Top of dispensers are clean
-
Toilet and plumbing/pipes are clean
-
Floor is clean
ALL OTHER QUESTIONS
-
Supplies are replenished
-
Handrails are clean
HOUSEKEEPING CLOSETS
-
Housekeeping closet is clean and orderly
-
Housekeeping closet is stocked appropriately
ADDITIONAL COMMENTS
-
Please enter any additional comments about this audit.
-
Date and Time of Audit
-
Please sign your name here to certify this audit as complete
-
Please email this audit to: Liz Grove lgrove@mcmcbr.com