QUALITY OF CARE ROUNDS - Nursing Home Help
QUALITY OF CARE ROUNDS - Nursing Home Help QUALITY OF CARE ROUNDS - Nursing Home Help
Extended menusavailableDumpster lid closedWhen not in use,Garbage pails areclosed and storedaway from food prepareaCeiling is in goodrepair and appearsclean with clean,unbroken light fixtures,all bulbs working andall bulbs coveredHood is free ofgrease, operational lightswork, extinguishernozzles free of grease anddust and the filters arecleanWalk-in floors dry,fans clean, coveredlightingFood transportpreventscontaminationFrozen foods arethawed properlySlicer and mixerbowl are coveredwhen unusedAll refusecontainers are covered,clean and adequateThere is no sign ofpest infestationNon-food andchemicals are storedaway from food4.53
Environmental Services ToolCleaning Procedures for Residents RoomsPolicy: The resident rooms will be cleaned on a daily basis.1. Are housekeepers using gloves and safety glasses when needed /as well removing gloves asappropriate? YES/NO. If NO – EXPLAIN:2. Are housekeepers knocking before entering resident’s room? YES/NO. If NO – EXPLAIN:3. Are employees cleaning all horizontal surfaces of bed side tables, over-bed tables, foot andheadboards, side rails, desk, chairs, and resident’s personal belongings, TV, telephones, pictureframes, etc. and all other furniture in the room? YES/NO. If NO – EXPLAIN:4. Is housekeeping dust mopping and wet mopping the entire floor? YES/NO. If NO – EXPLAIN:5. Are housekeepers using wet floor signs at appropriate times? YES/NO. If NO – EXPLAIN:6. How often is mop water being changed/per procedure every three rooms or more often asneeded? YES/NO. If NO – EXPLAIN:7. Do housekeepers know the procedures when cleaning a transferred or discharged resident'sroom? YES/NO. If NO – EXPLAIN:Cleaning Procedures for RestroomsPolicy: Restrooms are to be cleaned daily and as needed1. Are the housekeepers cleaning from high to low areas within the restroom? YES/NO. If NO –EXPLAIN:2. Are housekeepers cleaning the following areas daily/using proper disinfectant/cleaner: walls,wall hangers, shelves, lights, mirror doors and frames, kick-plates, switch-plates, sink and faucet,any exposed pipes; toilet should be the last item in the restroom cleaned? YES/NO. If NO –EXPLAIN:3. Replenish supplies - paper towels, toilet paper, and hand soap when needed? YES/NO. If NO –EXPLAIN:4. Sweep and wet mop restroom floor; place wet floor sign down until floor is dry? YES/NO. IfNO – EXPLAIN:4.54
- Page 4 and 5: RR SS PE IC EP F-Tag Observations S
- Page 6 and 7: RR SS PE IC EP F-Tag Observations S
- Page 8 and 9: RR SS PE IC EP F-Tag Observations S
- Page 10 and 11: RR SS PE IC EP F-Tag Observations S
- 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 36 and 37: Yes No Cleaning schedules posted an
- 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
- Page 44 and 45: INFECTION CONTROL AND SAFETY SURVEI
- Page 46 and 47: INFECTION CONTROL AND SAFETY SURVEI
- Page 48 and 49: INFECTION CONTROL AND SAFETY SURVEI
- Page 50 and 51: INFECTION CONTROL AND SAFETY SURVEI
- Page 52 and 53: Yes No All wandering bracelets are
- 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
- Page 66 and 67: Figure A.7Survey tag assignment (co
- Page 68 and 69: Figure A.7Survey tag assignment (co
- Page 70 and 71: Figure A.7Survey tag assignment (co
- Page 72: Figure A.7Survey tag assignment (co
Environmental Services ToolCleaning Procedures for Residents RoomsPolicy: The resident rooms will be cleaned on a daily basis.1. Are housekeepers using gloves and safety glasses when needed /as well removing gloves asappropriate? YES/NO. If NO – EXPLAIN:2. Are housekeepers knocking before entering resident’s room? YES/NO. If NO – EXPLAIN:3. Are employees cleaning all horizontal surfaces of bed side tables, over-bed tables, foot andheadboards, side rails, desk, chairs, and resident’s personal belongings, TV, telephones, pictureframes, etc. and all other furniture in the room? YES/NO. If NO – EXPLAIN:4. Is housekeeping dust mopping and wet mopping the entire floor? YES/NO. If NO – EXPLAIN:5. Are housekeepers using wet floor signs at appropriate times? YES/NO. If NO – EXPLAIN:6. How often is mop water being changed/per procedure every three rooms or more often asneeded? YES/NO. If NO – EXPLAIN:7. Do housekeepers know the procedures when cleaning a transferred or discharged resident'sroom? YES/NO. If NO – EXPLAIN:Cleaning Procedures for RestroomsPolicy: Restrooms are to be cleaned daily and as needed1. Are the housekeepers cleaning from high to low areas within the restroom? YES/NO. If NO –EXPLAIN:2. Are housekeepers cleaning the following areas daily/using proper disinfectant/cleaner: walls,wall hangers, shelves, lights, mirror doors and frames, kick-plates, switch-plates, sink and faucet,any exposed pipes; toilet should be the last item in the restroom cleaned? YES/NO. If NO –EXPLAIN:3. Replenish supplies - paper towels, toilet paper, and hand soap when needed? YES/NO. If NO –EXPLAIN:4. Sweep and wet mop restroom floor; place wet floor sign down until floor is dry? YES/NO. IfNO – EXPLAIN:4.54
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