https://eauditor.app/
Terminal Cleaning of Isolation Rooms Checklist
Section 1: Preparation And Setup
1. 1. Is the equipment prepared and is the High Security Cleaning Cart loaded with everything needed for the task?
Yes
No
N/A
2. 2. Are Clorox germicidal wipes with bleach prepared?
Yes
No
N/A
3. 3. Is hospital disinfectant mixed (2 oz per gallon of water)?
Yes
No
N/A
4. 4. Are disposable microfiber cloths available?
Yes
No
N/A
5. 5. Is a disposable microfiber mop ready?
Yes
No
N/A
6. 6. Is a disposable microfiber duster sleeve included?
Yes
No
N/A
7. 7. Is a disposable microfiber dust mop available?
Yes
No
N/A
8. 8. Is the extension pole included?
Yes
No
N/A
9. 9. Are gloves available?
Yes
No
N/A
10. 10. Is anti-microbial soap stocked?
Yes
No
N/A
11. 11. Is hand sanitizer ready?
Yes
No
N/A
12. 12. Is the HEPA vacuum included?
Yes
No
N/A
13. 13. Is the appropriate attire and Personal Protective Equipment (PPE) being worn?
Yes
No
N/A
14. 14. Is eye protection (safety glasses, goggles, or face shield) being used?
Yes
No
N/A
15. 15. Are disposable gloves on?
Yes
No
N/A
16. 16. Is a disposable gown, liquid-splash protective suit, or disposable suit being worn?
Yes
No
N/A
17. 17. Is an N95 respirator being used?
Yes
No
N/A
Section 2: Special Isolation Procedures
1. 1. Has hand hygiene been performed and gloves donned before entering the room, with gown cuffs pulled into gloves?
Yes
No
N/A
2. 2. Has the door sign for the isolation condition been reviewed?
Yes
No
N/A
3. 3. Are there special instructions included for the isolation procedure?
Yes
No
N/A
4. 4. Is the room confirmed to be in isolation mode with a reading of -0.019 negative pressure?
Yes
No
N/A
5. 5. Has the cleaning cart been left in the hall and a restricted access sign set up?
Yes
No
N/A
Section 3: Cross-Contamination Preventative Measures
1. 1. Are clean mop heads and cleaning cloths used for each space to prevent cross-contamination?
Yes
No
N/A
2. 2. Is the mop water and mop heads changed after leaving every space?
Yes
No
N/A
3. 3. Are used mop heads and rags placed in a containment bag and submitted to laundry service at the end of the shift?
Yes
No
N/A
4. 4. Are soiled gloves removed, hands sanitized or washed, eye protection cleaned and sanitized, and face masks assessed for safe functionality?
Yes
No
N/A
Section 4: Isolation Room Cleaning Procedures
1. 1. Has the room been surveyed, furnishings straightened, and loose debris picked up?
Yes
No
N/A
2. 2. Have tissue boxes been checked and replaced if needed?
Yes
No
N/A
3. 3. Have disposable cups been discarded?
Yes
No
N/A
4. 4. Have all objects on the floor been removed?
Yes
No
N/A
5. 5. Have waste containers been emptied and lined?
Yes
No
N/A
6. 6. Has the waste bag been handled from the top?
Yes
No
N/A
7. 7. Has the waste basket been cleaned?
Yes
No
N/A
8. 8. Has infectious waste been removed and discarded in the designated biohazard area?
Yes
No
N/A
9. 9. Have all soiled linens been removed, placed inside the biohazard bag, and requested for laundering?
Yes
No
N/A
10. 10. Has high dusting been performed using the microfiber flexible dusting wand?
Yes
No
N/A
11. 11. Have vents (supply & return) been dusted?
Yes
No
N/A
12. 12. Have light fixtures been dusted?
Yes
No
N/A
13. 13. Have sprinkler heads been dusted?
Yes
No
N/A
14. 14. Have high ledges been dusted?
Yes
No
N/A
15. 15. Has terminal cleaning been performed on all vertical surfaces, including walls and wall-mounted objects?
Yes
No
N/A
16. 16. Has an extension pole and flat surface mop been used to clean/disinfect from ceiling-to-wall and wall-to-floor areas?
Yes
No
N/A
17. 17. Have baseboards been cleaned?
Yes
No
N/A
18. 18. Have light switches been cleaned?
Yes
No
N/A
19. 19. Has the thermostat been cleaned?
Yes
No
N/A
20. 20. Have the blinds been cleaned?
Yes
No
N/A
21. 21. Have doors, door frames, and handles been cleaned?
Yes
No
N/A
22. 22. Have vital machines been disinfected?
Yes
No
N/A
23. 23. Have computers, mice, and keyboards been disinfected?
Yes
No
N/A
24. 24. Have dispensers been cleaned?
Yes
No
N/A
25. 25. Has the glove rack been disinfected?
Yes
No
N/A
26. 26. Have cabinets and handles been disinfected?
Yes
No
N/A
27. 27. Has terminal cleaning been performed on all horizontal surfaces?
Yes
No
N/A
28. 28. Has the exam bed (drawers/base) been cleaned?
Yes
No
N/A
29. 29. Have cabinets and handles been disinfected?
Yes
No
N/A
30. 30. Have countertops been wiped down?
Yes
No
N/A
31. 31. Have all hard surfaces been cleaned?
Yes
No
N/A
32. 32. Have windows been cleaned?
Yes
No
N/A
33. 33. Have ledges been wiped?
Yes
No
N/A
34. 34. Has the thermostat been wiped down?
Yes
No
N/A
35. 35. Have the blinds been cleaned?
Yes
No
N/A
36. 36. Have chairs (non-porous surfaces) been wiped down?
Yes
No
N/A
37. 37. Has vacuuming been performed on porous surfaces, followed by spraying with an EPA-approved disinfectant?
Yes
No
N/A
38. 38. Has the mattress been disinfected?
Yes
No
N/A
39. 39. Have the bed frame and rails been cleaned?
Yes
No
N/A
40. 40. Has the disinfectant been allowed to dwell according to the manufacturer's instructions?
Yes
No
N/A
41. 41. Has the disinfecting process been completed on all cleaned surfaces?
Yes
No
N/A
42. 42. Have all areas been sprayed and wiped down with disinfectant spray cleaner?
Yes
No
N/A
Section 5: Floor Cleaning And Disinfection
1. 1. Have safety signs been put out to indicate a floor hazard?
Yes
No
N/A
2. 2. Has the floor been dust mopped, beginning in the far corner away from the exit?
Yes
No
N/A
3. 3. Has the floor been damp mopped?
Yes
No
N/A
4. 4. Have used clothes and mops been disposed of in a facility-approved container?
Yes
No
N/A
5. 5. Has Personal Protective Equipment (PPE) been removed according to facility policies?
Yes
No
N/A
Section 6: Isolation Room Bathroom Cleaning
1. 1. Has the mirror been cleaned using a disposable microfiber cloth?
Yes
No
N/A
2. 2. Has the sink area, including the counter, faucet, handles, and basin, been cleaned with a clean disposable microfiber cloth?
Yes
No
N/A
3. 3. Have other surfaces in the bathroom been cleaned with a clean disposable microfiber cloth?
Yes
No
N/A
4. 4. Has the toilet been disinfected?
Yes
No
N/A
5. 5. Have all consumable supplies been restocked?
Yes
No
N/A
6. 6. Have waste containers been emptied and relined?
Yes
No
N/A
Section 7: Final Inspection
1. 1. Has the room been inspected and has the quality checklist been completed?
Yes
No
N/A
2. 2. Has PPE been removed before leaving the room?
Yes
No
N/A
3. 3. Has hand hygiene been performed and new gloves put on?
Yes
No
N/A
4. 4. Have all tools and equipment been cleaned and returned to the cart?
Yes
No
N/A
5. 5. Have gloves been removed and hand hygiene performed again?
Yes
No
N/A