Title Page
-
Conducted on
-
Prepared by
GFCI Outlets
-
8 - Exam/Consultation Room
-
33 - Staff Break Room/Women's Locker Room
-
36 - Staff Break Room at Sink
-
38 - Staff Break Room/Men's Locker Room
-
41 - Pre-Op Bay 1
-
46- Pre-op Bay 1
-
55 - Pre-Op Under Desk
-
56 - Pre-Op Bay 3
-
60 - Pre-Op Bay 3
-
85 - Patient Restroom Pre-Op
-
86 - Patient Restroom Pre-Op
-
157 - Endo Decon Room
-
176 - General Surgery Decon Room
-
184 - Anethesia
-
188 - Post-Op Nurse's Station
-
248 - Staff Restroom Post-Op
-
250 - Patient Restroom Post-Op
-
251 - Patient Restroom Post-Op
-
253 - Drink Station Post-Op
Signature
-
This signature certifies that I have reviewed and completed the inspection.
