Facility Self-Assessment (Mock Survey) Tool - Nursing Home Help
Facility Self-Assessment (Mock Survey) Tool - Nursing Home Help
Facility Self-Assessment (Mock Survey) Tool - Nursing Home Help
Create successful ePaper yourself
Turn your PDF publications into a flip-book with our unique Google optimized e-Paper software.
PHYSICAL PLANT ROUNDS - INITIAL TOUR (continued)<br />
TAG # STANDARD MET NOT MET COMMENTS<br />
INTERIOR OF BUILDING (cont)<br />
F-253 Personal care items separate, not co-mingled<br />
F-253 Urine graduates labeled for individual pt.<br />
F-253 Bedpans, urinals stored properly<br />
F-254 Linen<br />
F-253 Catheters off floor<br />
F-441 Oxygen tubing off floor<br />
F-253, F-441 Suction caths, machines<br />
LAUNDRY<br />
F-441,F-456 Ceiling filters<br />
F-441, F-456 Dryer filters<br />
F-441 Doors closed between clean and soiled area<br />
F-441 PPE available and used<br />
F-441 Shield/Goggles<br />
F-441 Gown (impervious gown or apron)<br />
F-441 Gloves<br />
F-254 Clean linen stain free and free from tears/holes<br />
F-323 Chemicals secure<br />
SAFETY<br />
F-456 Appropriate door closures<br />
F-517 Doors not propped open<br />
F-456 Fire extinguishers checked monthly<br />
F-456 Fire alarm panel has tag within last year marked<br />
“functional”<br />
F-455 Exit signs<br />
5.52
Change language