S. M. Wilson & Co. - Infection Control Audit

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

General Items

• Has an ICRA been performed prior to the start of work in all areas?

  Yes

  No

  N/A

• Have all ICRAs been filed, and made accessible to everyone necessary?

  Yes

  No

  N/A

• Have all ICRAs been reviewed by the Owner's Representatives (IC Officer), and S. M. Wilson Staff?

  Yes

  No

  N/A

• Have requirements of all active ICRAs been communicated to all Subcontractors performing work in the associated areas?

  Yes

  No

  N/A

• Have all Employees reviewed the Infection Control Video prior to starting work?

  Yes

  No

  N/A

Airflow & Monitoring

• Has a negative airflow been established in all areas of work?

  Yes

  No

  N/A

• Is a negative pressure indicator (ie manometer, etc) in place at each area of work?

  Yes

  No

  N/A

• Is airflow & air quality being monitored on a regular basis?

  Yes

  No

  N/A

• Are airflow & air quality reports being received & filed on a regular basis?

  Yes

  No

  N/A

• Are all Negative Air Machines functioning properly?

  Yes

  No

  N/A

• Have the appropriate Filters been installed and maintained in each Negative Air Machine?

  Yes

  No

  N/A

• Is the leading edge of all Duct sealed?

  Yes

  No

  N/A

• Are all Duct returns capped, terminated, or filtered?

  Yes

  No

  N/A

• Has all stored Duct been sealed appropriately?

  Yes

  No

  N/A

Housekeeping

• Are areas of work being kept clean/swept in order to minimize track-out?

  Yes

  No

  N/A

• Are all corridors and surrounding areas swept and clean (no track-out)?

  Yes

  No

  N/A

• Are all Trash Bins, Gondolas, Carts, etc covered when exiting areas of work?

  Yes

  No

  N/A

• Are the wheels of all Bins, Gondolas, Carts, etc cleaned prior to exiting areas of work?

  Yes

  No

  N/A

• Have walk-off Mats (sticky, damp, or other) been installed at the exit to each area of work?

  Yes

  No

  N/A

PPE

• Is appropriate PPE being worn when necessary (gowns, booties, masks, etc)?

  Yes

  No

  N/A

Area Isolation & Access Control

• Have sealed Partitions been installed around each area of work?

  Yes

  No

  N/A

• Do all Temp Doors into areas of work latch appropriately?

  Yes

  No

  N/A

• Have Closures been installed on all Temp Doors?

  Yes

  No

  N/A