QUALITY INSPECTION REPORT - CLEANING

• INSPECTION DATE

  Date

• WARD /AREA

• RISK LEVEL

  Select

• SUPERVISOR

  Select

• IS THE CLEANER PRESENT DURING THE AUDIT?

  Select

• CLEANER NAME AND SURNAME

• undefined

• NURSE OFFICER NAME AND SURNAME

ITEMS LIST GENERAL - ALL ITEMS HAVE TO BE VISIBLY CLEAN. WITH NO BLOOD OR BODY SUBSTANCES, DUST DIRT DEBRIS AND SPILLAGES.

• CS1 - DOOR

  Yes

  No

  N/A

• CS2 - BINS

  Yes

  No

  N/A

• CS3 - BED

  Yes

  No

  N/A

• CS4 - BEDSIDE TABLE

  Yes

  No

  N/A

• CS5 - CUPBOARD

  Yes

  No

  N/A

• CS6 - WINDOWS AND CURTAINS

  Yes

  No

  N/A

• CS7 - CHAIRS

  Yes

  No

  N/A

• CS8 - SHELVES

  Yes

  No

  N/A

• CS9 - VERTICAL SURFACE

  Yes

  No

  N/A

• CS10 - FLOOR

  Yes

  No

  N/A

• CS11 - HIGH TOUCH SURFACES (HANDRAIL.DOORNOBS, SWITCHES,PATIENT REMOTE CONTROL, TELEPHONE,ETC..

  Yes

  No

  N/A

• CS12 - BEDLIGHT UNIT

  Yes

  No

  N/A

• CS13 - SINK

  Yes

  No

  N/A

• CS14 - HAND SOAP/ALCOHOL DISPENSER

  Yes

  No

  N/A

• CS15 - HAND TOWEL DISPENSER

  Yes

  No

  N/A

Bathroom

• CP21 - STARTS WITH HIGHEST SURFACE AND PROCEEDS DOWNWARDS

  Yes

  No

  N/A

• CP22 - CLEANS SINK AND SINK FIXTURES

  Yes

  No

  N/A

• CP23 - CLEANS SHOWER FIXTURES AND SHOWER FLOOR

  Yes

  No

  N/A

• CP24 - CLEANS HANDRAILS

  Yes

  No

  N/A

• CP25 - CLEANS OUTER TOILET SURFACE

  Yes

  No

  N/A

• CP26 - CLEANS TOILET SEAT SURFACES

  Yes

  No

  N/A

• CP27 - SCRUBS INNER TOILET BOWL WITH DISINFECTANT

  Yes

  No

  N/A

• CP28 - USES DESCALING PRODUCT TWICE A WEEK

  Yes

  No

  N/A

• CP29 - REMOVES ANY STUBBORN STAINS

  Yes

  No

  N/A

• CP30 - REMOVES ANY WASTE FROM BATHROOM BIN

  Yes

  No

  N/A

• CP31 - WASHES BATHROOM FLOOR IN FIGURE OF 8 MOTION

  Yes

  No

  N/A

• CP32 - REMOVES GLOVES AND CLEANS HANDS

  Select Yes No N/A

  • Yes
  • No
  • N/A

WARD / AREA ENVIROMENT - THE AREAS ARE CLEAN,IN GOOD DECORATIVE CONDITION AND FREE FROM CLUTTER AND INAPPROPRIATE ITEMS WALLS FLOOR,CEILING,FURINTURE,FIXTURE, AND FITTINGS, LIGHT FITTINGS PICTURES CHAIR CURTAINS BLINDS, ARE ALL IN GOOD CONDITION, CLEAN AND FREE FROM STAINS.

• CS16 - RECEPTION

  Yes

  No

  N/A

• CS17 - WAITING AREAS

  Yes

  No

  N/A

• CS18 - CORRIDORS

  Yes

  No

  N/A

• CS19 - TREATMENT ROOMS

  Yes

  No

  N/A

• CS20 - CLEAN UTILITY ROOM

  Yes

  No

  N/A

• CS21 - DIRTY UTILITY ROOM

  Yes

  No

  N/A

• CS22 - STORES

  Yes

  No

  N/A

• CS23 - PANTRY

  Yes

  No

  N/A

• CS24 - PATIENT'S ROOMS

  Yes

  No

  N/A

• CS25 - DOCTOR'S OFFICE

  Yes

  No

  N/A

• CS26 - NO'S OFFICE

  Yes

  No

  N/A

• CS27 - STAFF ROOM

  Yes

  No

  N/A

• CS28 - EQUIPMENT ROOM

  Yes

  No

  N/A

• CS29 - CHANGING ROOMS

  Yes

  No

  N/A

• CS30 - OTHERS:

  Yes

  No

  N/A

• CS31 - OTHERS:

  Yes

  No

  N/A

• CS32 - OTHERS:

  Yes

  No

  N/A

• CS33 - OTHERS:

  Yes

  No

  N/A