QUALITY OF CARE ROUNDS - Nursing Home Help
QUALITY OF CARE ROUNDS - Nursing Home Help QUALITY OF CARE ROUNDS - Nursing Home Help
Yes No Cleaning schedules posted and followed.Yes No Dietary Personnel wash hands appropriately and wear gloves when serving food.Yes No All hand washing facilities are properly stocked with soap and paper towels.Yes No Hair nets are worn by all dietary employees and uniforms are clean.Yes No Food temps are taken daily and logged and are within acceptable range:Hot foods > 140 degrees;Cold foods = or < 41 degreesYes No All garbage containers and dumpsters in good condition with no leaking and wasteis contained with lids closed.Yes No Kitchen and dining area are pest free.Yes No Dietary employees are in-serviced annually and understand and follow StandardPrecautions / Infection Control and Safety Rules.Yes No Dietary employees can locate blood spill kit and verbalize correct usage of kit.Yes No Employees have been instructed on proper lifting and handling techniques.Yes No All machines are securely anchored and properly guarded.Yes No Sharp tools are correctly handled, cleaned and storedYes No Loading docks, ramps and stairways are in good repair.Yes No There are separate waste receptacles for garbage, trash and glass.Yes No Employees are trained in use of fire extinguishers.Yes No MSDS & Safety Manuals are available in each department.Yes No Floors do not have any slip, trip or fall hazards.Corrective action and/or follow-up required:4.35
INFECTION CONTROL AND SAFETY SURVEILLANCE:Responsible Person:REHABILITATION DEPARTMENTDate:Yes No All work areas are cleaned and disinfected after each resident’s use.Yes No Service area is clean and free of peeling paint, chips, and cracked equipment/.Yes No All equipment is cleaned and disinfected after each resident’s use.Yes No Linens or towels are cleaned and stored in a cupboard when not in use.Yes No Sink is cleaned and disinfected after each resident’s use.Yes No Chemicals are properly labeled and stored in a closed, locked area.Yes No Proper hand washing is performed after each procedure.YesNoCorrective action and/or follow-up required:Rehab employees are in-serviced annually and understand and follow StandardPrecautions/Infection Control and Safety Rules.Yes No Gloves, gowns and eye protection are used appropriately.Yes No Rehab employees can locate blood spill kit and verbalize correct usage of kit.Yes No MSDS & Safety Manuals are available in each department.Yes No Floors do not have any slip, trip or fall hazards.4.36
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- Page 12 and 13: Exit lightsRESIDENT ROOMS “U”
- Page 14 and 15: OTHER AREAS “U” “S” COMMENT
- Page 16 and 17: Thawing foods put in refrigerator c
- Page 18 and 19: SS follows upon discharge needs of
- Page 20 and 21: - re-feeding/walk and dine- bowel/b
- Page 22 and 23: Pumps/poles and equipment cleanWEIG
- Page 24 and 25: No expired medications on handSharp
- Page 26 and 27: Medical Director review of all repo
- Page 28 and 29: MDS/CARE PLAN TRACKING FORMName: Ro
- Page 30 and 31: HOT HOLDINGHot holding unit / steam
- Page 32 and 33: Step ladders are sturdy and in good
- Page 34 and 35: Yes No Buckets, tubs and pans are i
- Page 38 and 39: INFECTION CONTROL AND SAFETY SURVEI
- Page 40 and 41: Yes No Electric cords for lights, r
- Page 42 and 43: INFECTION CONTROL AND SAFETY SURVEI
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- Page 52 and 53: Yes No All wandering bracelets are
- Page 54 and 55: Extended menusavailableDumpster lid
- Page 56 and 57: Housekeeping Carts, Equipment, and
- Page 58 and 59: Facility InspectionFacility _______
- Page 60 and 61: Facility Inspection ReportPossibleA
- Page 62 and 63: Facility Inspection ReportAREAScore
- Page 64 and 65: Figure A.7Survey tag assignment (co
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Yes No Cleaning schedules posted and followed.Yes No Dietary Personnel wash hands appropriately and wear gloves when serving food.Yes No All hand washing facilities are properly stocked with soap and paper towels.Yes No Hair nets are worn by all dietary employees and uniforms are clean.Yes No Food temps are taken daily and logged and are within acceptable range:Hot foods > 140 degrees;Cold foods = or < 41 degreesYes No All garbage containers and dumpsters in good condition with no leaking and wasteis contained with lids closed.Yes No Kitchen and dining area are pest free.Yes No Dietary employees are in-serviced annually and understand and follow StandardPrecautions / Infection Control and Safety Rules.Yes No Dietary employees can locate blood spill kit and verbalize correct usage of kit.Yes No Employees have been instructed on proper lifting and handling techniques.Yes No All machines are securely anchored and properly guarded.Yes No Sharp tools are correctly handled, cleaned and storedYes No Loading docks, ramps and stairways are in good repair.Yes No There are separate waste receptacles for garbage, trash and glass.Yes No Employees are trained in use of fire extinguishers.Yes No MSDS & Safety Manuals are available in each department.Yes No Floors do not have any slip, trip or fall hazards.Corrective action and/or follow-up required:4.35
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