Unit Observed

Hand washing observed and soap available

Paper towels available

Employee verbalized location of eye wash station

Area Clean

PPE available

Medication room clean

Equipment Clean

Soiled Linen handled with gloves

Infectious waste disposed of in biohazard container

Sharps containers secured

Sharps container replaced when 3/4 full

Clean linen supply covered and stored to avoid contamination (ie. solid bottom and curtain covered)

Crash cart clean and free of dust

Proper attire worn

Ceiling vents clean

Correct isolation signs on doors if appropriate

Infectious waste covered

Biohazard labels in appropriate areas

Refrigerator temp logged daily or auto temp monitor

36-45 degrees F for meds
32-41 degrees F for food
0-20 degrees F for freezer

Clean and dirty supplies seperated

Universal Precautions observed

Hand washing

PPE worn if indicated

Soiled linen if indicated

Infectious waste disposed of in biohazard container

High level dusting appropriate

Oxygen tanks stored properly

Storage room cleanliness and baby isolet clean and covered


Issues Identified
Return to me on the date below with resolutions please
Completed by

handoff given to

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.