Information

  • Document No.

  • Morrison Organizational Quality | Sanitation Audit VOC

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Infection Control Practices

  • Dirt/debris not observed behind or around equipment.

  • Are pans air dried prior to stacking?

  • Are clean towels stored neatly? Is it sanitary?

  • Are street clothes kept in area away from kitchen?

  • Does all hand washing Sinks have availability of soap, paper towels, hot water (110+F) and trash can?<br>

  • Are restrooms clean, nothing on floor, all supplies are stocked, lockers dusted?

  • Are all trashcans free of debris on outside and all have lids?

  • Are hairnets available at each entrance and used by staff?

  • Are Ecosan temperatures <164 F and concentration 50-100 ppm?

  • Is there a maintenance schedule for cleaning coffee spouts, scoops, and soda fountains?

  • Does pot wash sink meet temperature and sanitizer standards? Are these being logged 3x/day? Can associate verbalize if concentration is high what they would do?

  • Are pans stored in clean and dry area. Is bottom shelf solid (prevent contamination from dirty mop water)?

  • All floor sinks are clean and free of debris? There is a one inch air gap, when applicable? Nothing stored under sink?

Patient Care/Infection Control Practices

  • Are staff using gloves correctly and washing hands frequently?

  • Staff observed are they washing hands and can they the speak policy?

  • In the dish room is there a clear separation of clean and dirty? Are temps logs present, current, and reconciled? Are dishes air dried? Can staff speak on dish machine standards and how to reconcile temps below standards?

Patient Care

  • Is Food contact surfaces and utensils properly cleaned, sanitized, and in good condition?

  • Is eating, drinking and smoking restricted to designated areas?

  • Dented cans clearly marked and in a designated area?

  • Is sanitizing solutions available at proper concentration and temperature?

  • Is wiping clothes stored in approved sanitizer and appropriately used?

  • Are floor mats surrounding the entire dish machine?

  • Is Victory wash concentration checked daily and recorded? Do strips meet standards 60-80 ppm?

  • Is refrigerator/freezer temperature logs checked daily : are actions taken on deviant temperatures?

  • Does HACCP receiving log meet standards? Were actions taken when stds not met?

Environment of Care

  • Freezers Have no ice accumulation, all items covered, labeled, and dated.

  • Are chemicals stored only in areas away from food and marked "chemicals"?

  • Is chemical room clean and tidy?

  • Does concentration of red bucket meet standards?

  • Are CO2 cylinders secured?

  • Are hazardous/flammable chemicals stored and labeled properly?

  • No visible water on floors?

  • All floors are free of major debris and grease? Wet floors have signs?

  • Does elevator doors open/close appropriately?

  • Are walls and ceilings free of damage/stains?

  • There are no damaged carpet, tiles, and tripping hazards?

  • Is sterno stored in fire retardant container and locked?

  • Is MSDS book available? Does MSDS book have Quat 146, Orange Force 137? Do all chemicals have correct labels?

  • Are mop buckets free of dirty water and all mops hung neatly?

Life Safety

  • Are all items stored in kitchen have 18" clearance from fire sprinklers and 6" from floor?

  • Can staff verbalize what do you do in case of a fire? Can staff verbalize RACE/SAFE or PASS? Is signage poster for RACE/PASS?

  • Can staff verbalize how to use a fire extinguisher (PASS) and where extinguishers located?

  • Can staff locate where Hood Suppression System pull located? (Standard UL300) and what should it is used for?

  • Fire doors not obstructed?

  • Is electrical equipment grounded and safe?

  • Is eye wash stations operational & checked weekly?

  • Hallways and exists are not obstructed and preventing egress?

  • Are ventilation, heating and cooling systems in good repair and clean?

  • Can staff verbalize what K fire extinguisher is used for and what comes out? (Wet chemical system - not foam or powder)

  • There are no penetrations in structures?

Emergency Management

  • During interviews can staff verbalize emergency procedures?

Human Resources

  • Does associates have competency test for each mandatory in-service?

  • Is 100% of staff attending mandatory in-services? Is signage available to verify attendance?

  • Is in-services available for clinical staff at least 2x/year noted on the calendar?

Signature

  • NOTES

  • SIGNATURE

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