Infection Control Monitoring and Provision Checklist Template Download as PDF Digitalize this paper form now
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Cut inspection time by 50% Uncover more issues and solve them 4x faster Select from over 4000 expert-proofed templates Infection Control Monitoring and Provision Checklist Template Audit 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
Please note that this checklist template is a hypothetical appuses-hero example and provides only standard information. The template does not aim to replace, among other things, workplace, health and safety advice, medical advice, diagnosis or treatment, or any other applicable law. You should seek your professional advice to determine whether the use of such a checklist is appropriate in your workplace or jurisdiction.