Managers - Infection Prevention performed an inspection of your unit. Please review your survey and document your Plan of Correction next to each opportunity.
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Employee Compliance

Employees Monitored

8.0. Isolation Rooms

8.1. Appropriate signage in place?

8.2. Supplies and PPE's available?

8.3. Trash and linen handled per policy?

8.4. Appropriate PPE's used by staff?

8.5. Door closed as appropriate?

8.6. Negative pressure is being supplied as required?

8.8. Patient with proper attire when being transported?

8.9. Is this section free of additional findings?

Additional Comments

Additional Comments

Surveyor's Signature
Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.