Unit Observed

Hand washing observed and soap available

Paper towels available

Employee verbalized location of eye wash station

Area Clean

Medication room clean

Equipment Clean

Infectious waste disposed of in biohazard container

Sharps containers secured

Sharps container replaced when 3/4 full

Proper attire worn

Ceiling vents clean

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

High level dusting appropriate

Storage room cleanliness


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.