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Housekeeping Check Lists-Updated

The document contains various cleaning checklists for different areas of a hospital including wards, ICU, OPD, casualty, lifts, toilets, pharmacy and more. It lists the cleaning tasks to be performed, their frequency, dates of completion and spaces for signatures of cleaning and nursing staff. The checklists track the daily, weekly and monthly cleaning of floors, surfaces, bathrooms and medical equipment to maintain hygiene standards in the hospital.

Uploaded by

tanisha
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as XLSX, PDF, TXT or read online on Scribd
1K views20 pages

Housekeeping Check Lists-Updated

The document contains various cleaning checklists for different areas of a hospital including wards, ICU, OPD, casualty, lifts, toilets, pharmacy and more. It lists the cleaning tasks to be performed, their frequency, dates of completion and spaces for signatures of cleaning and nursing staff. The checklists track the daily, weekly and monthly cleaning of floors, surfaces, bathrooms and medical equipment to maintain hygiene standards in the hospital.

Uploaded by

tanisha
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLSX, PDF, TXT or read online on Scribd
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DAILY CLEANING CHECKLIST

Sl. No Month: Location:

Date
Shift Frequency M E N M E N M E N M E N M E N M E N M E N M E N M E N M E N M E N M E N M E N

1 Dry Mop Each shift


2 Wet Mop Each shift
3 Cleaning cobwebs Each shift
4 Walls daily once
5 Door & Door Handle Each shift
6 Windows & window Case Each shift
7 Lights & Fan weekly once
8 Ceiling weekly once
9 Cardiac Table Each shift
10 Patient Trolley Each shift
11 Medication Trolley Each shift
12 Crash Cart Each shift
13 Wheel Chair Each shift
14 Strecher Each shift
15 IV Stand Each shift
16 BMW dustbin Each shift
Name and Signature
17 Dressing Trolley of Each shift
HSK staff
Name and Signature of
Nursing staff
FREQUENT TOUCH SURFACES CLEANING CHECK LIST

Month: Ward:
Sl. No Process Frequency-daily
Date 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
1 Phone
2 Computer
3 Nursing Counter
4 Chair
5 Table
6 Cupboards
7 Door Knobes
8 Fan Regulators
9 Switch Board

Sign of HSK Staff


Sign of Staff Nurse
Patient Care Equipment Checklist

Month: Location:
Sl. No Process Frequency Dates performed

1 Thermometer Each Shift


2 Glucometer
3 Stethescope
4 BP Apparatus with cuff
5 Pulse Oxymeter
6 ECG Machine
7 Cardiac Monitor
8 Defebrilater
9 Nebulizer
10 Humidifier
11 Suction Apparatus
12 Weighing Machine
13 Measuring Tape
14 Ventilator

Signature of Staff Nurse


Name of Nurse In charge
DAILY CLEANING CHECKLIST
Sl. No Process Month: Location: LAB
Date
Shift M E N M E N M E N M E N M E N M E N M E N
1 Dry Mop
2 Wet Mop
3 Cleaning cobwebs
4 Walls
5 Door & Door Handle
6 Windows
7 Lights & Fan
8 Ceiling
9
10 s
11
12

Signature of HSK staff


Signature of

HSK
Supervisor
Toilet Cleaning Checklist
Month:
Date Shift Time Cleaned By HSK Sup Sign
Morning
Afternoon
Evening
Morning
Afternoon
Evening
Morning
Afternoon
Evening
Morning
Afternoon
Evening
Morning
Afternoon
Evening
Morning
Afternoon
Evening
Morning
Afternoon
Evening
Morning
Afternoon
Evening
Morning
Afternoon
Evening
Morning
Afternoon
Evening
Morning
Afternoon
Evening
Morning
Afternoon
Evening
Morning
Afternoon
Evening
Morning
Afternoon
Evening
Morning
Afternoon
Evening
Lift Cleaning Checklist
Month: Disinfectant Used:
Date Shift Time Cleaned By HSK Sup Sign
Morning
Evening
Night
Morning
Evening
Night
Morning
Evening
Night
Morning
Evening
Night
Morning
Evening
Night
Morning
Evening
Night
Morning
Evening
Night
Morning
Evening
Night
Morning
Evening
Night
Morning
Evening
Night
Morning
Evening
Night
Morning
Evening
Night
Morning
Evening
Night
Morning
Evening
Night
BMW STORAGE ROOM & TROLLEY CLEANING CHECKLIST

Month: Disinfectant Used:


Date Shift Time Dumsters Cleaning Room Cleaning Cleaned By HSK Sup Sign
Morning
Evening
Night
Morning
Evening
Night
Morning
Evening
Night
Morning
Evening
Night
Morning
Evening
Night
Morning
Evening
Night
Morning
Evening
Night
Morning
Evening
Night
Morning
Evening
Night
Morning
Evening
Night
Morning
Evening
Night
Morning
Evening
Night
Morning
Evening
Night
Morning
Evening
Night
Morning
Evening
Night
ICN Sign:
Pharmacy Cleaning Checklist
Month:
Date Shift Time Cleaned By Pharmacist Sign HSK Sup Sign
Morning
Afternoon
Evening
Morning
Afternoon
Evening
Morning
Afternoon
Evening
Morning
Afternoon
Evening
Morning
Afternoon
Evening
Morning
Afternoon
Evening
Morning
Afternoon
Evening
Morning
Afternoon
Evening
Morning
Afternoon
Evening
Morning
Afternoon
Evening
Morning
Afternoon
Evening
Morning
Afternoon
Evening
Morning
Afternoon
Evening
Morning
Afternoon
Evening
Morning
Afternoon
Evening
FREQUENT TOUCH SURFACES CLEANING CHECK LIST

Month: Ward:
Sl. No Process Frequency-daily
Date 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
1 Phone
2 Computer
3 Nursing Counter
4 Chair
5 Table
6 Cupboards
7 Door Knobes
8 Fan Regulators
9 Switch Board

Sign of Staff
Sign of HSK Sup
Sign of Staff Nurse
Ambulance Cleaning Checklist
Month:
Date Time Cleaned By Driver Sign HSK Sup Sign
Department -Housekeeping cleaning check list
ICU
Surface Dustbin Cobweb Wall Co-oridoor Curtain
Activity Dry Mopping Wet Mopping Dusting Garbage Removing cleaning cleaning Cleaning cleaning cleaning washing

Frequency 7am 1pm 7pm 12am 7am 1pm 7pm 12am Daily 7am 1pm 7pm Daily Weekly Weekly Weekly Weekly Weekly

HSK sign
staff sign
Department -Housekeeping cleaning check list
Ground Floor-Casualty,OPD
Surface Dustbin Cobweb Wall Co-oridoor Curtain
Activity Dry Mopping Wet Mopping Dusting Garbage Removing cleaning cleaning Cleaning cleaning cleaning washing

Frequency 7am 1pm 7pm 12am 7am 1pm 7pm 12am Daily 7am 1pm 7pm Daily Weekly Weekly Weekly Weekly Weekly

HSK sign
staff sign
Department -Housekeeping cleaning check list
IST Floor

Activity Dry Mopping Wet Mopping Dusting Garbage Removing Surface Dustbin Cobweb Wall Co-oridoor Curtain
cleaning cleaning Cleaning cleaning cleaning washing

Frequency 7am 1pm 7pm 12am 7am 1pm 7pm 12am Daily 7am 1pm 7pm Daily Weekly Weekly Weekly Weekly Weekly

HSK sign
staff sign
Department -Housekeeping cleaning check list
2ND Floor
Surface Dustbin Cobweb Wall Co-oridoor Curtain
Activity Dry Mopping Wet Mopping Dusting Garbage Removing cleaning cleaning Cleaning cleaning cleaning washing

Frequency 7am 1pm 7pm 12am 7am 1pm 7pm 12am Daily 7am 1pm 7pm Daily Weekly Weekly Weekly Weekly Weekly

HSK sign
staff sign
Department -Housekeeping cleaning check list

Surface Dustbin Cobweb Wall Co-oridoor Curtain


Activity Dry Mopping Wet Mopping Dusting Garbage Removing cleaning cleaning Cleaning cleaning cleaning washing

Frequency 7am 1pm 7pm 12am 7am 1pm 7pm 12am Daily 7am 1pm 7pm Daily Weekly Weekly Weekly Weekly Weekly

HSK sign
staff sign
Department -Housekeeping cleaning check list
OT

Activity Dry Mopping Wet Mopping Dusting Garbage Removing Surface Dustbin Cobweb Wall Co-oridoor Curtain
cleaning cleaning Cleaning cleaning cleaning washing

Frequency 7am 1pm 7pm 12am 7am 1pm 7pm 12am Daily 7am 1pm 7pm Daily Weekly Weekly Weekly Weekly Weekly

HSK sign
staff sign

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