Day of Survey: Double Check the following:

1. Day of Survey:Double Check the following: • All employees have visible name badges • COWs/WOWs are clean and sani-wipes available • Portable computers are free of medication and patient information (check any drawers for medication) • Patient Fridge/Nourishment area: • No expired foods • No staff food or drink • No open containers • Crash Cart Checked daily (documented on log) • Adult/Pediatric devices on Crash Cart (as needed) • No HIPAA violations/patient info left out • No food/drink at the Nurses’ Station • No cardboard boxes on floor • Nothing stored within 18” of ceiling • No paper signs • No blocked fire extinguishers • No blocked fire pulls • No blocked exits • No blocked hallways or doorways • Check fire extinguisher tags (mo. notation) • Call lights answered promptly • Staff know where MSDS are located • Staff know all the Emergency Conditions • Housekeeping carts and chemicals secure • No door stops or door props present • All 02 Tanks are properly stored • Nothing stored under the hand sanitizers • Appropriate Hand Hygiene • Appropriate PPE (Check all isolation cabinets are stocked) • Proper signage for Isolation displayed (as needed) • Fall Signage properly displayed (as needed) • Linen carts covered (clean and soiled) • Soiled linen and trash are stored in the appropriate places (no soiled linen on top of the linen cart or on floor) • All utility rooms have clear access to doorway, hopper sink, etc. • No trash overflowing • No meds stored inappropriately or left out • No dietary carts left in hallway • Daily chart audits completed • Staff know at least one “PI activity” (i.e. core measures, falls, call lights, etc.) • Staff know contact time for disinfection • Check supply expiration dates (spot check) • Check expiration dates of glucose strips and sterile water