Patient Room Cleaning & Disinfection Checklist
Ensure spotless patient rooms & prevent healthcare-acquired infections! Download our comprehensive Patient Room Cleaning & Disinfection Checklist - a vital Facility Management tool for maintaining hygiene, safety, and compliance. Free checklist for hospitals, clinics, and care facilities.
This Template was installed 2 times.
Initial Assessment & Preparation
Pre-cleaning tasks to ensure safety and effective cleaning.
Patient Room Number
Date of Cleaning
Start Time of Cleaning
Room Status (Prior to Cleaning)
Notes on Room Condition (e.g., spills, biohazards)
Type of Isolation (if applicable)
Photo of Room Condition (Before Cleaning - Optional)
Room Entry & Safety
Ensuring proper personal protective equipment (PPE) and room safety.
PPE Donned?
Room Status (Occupied/Vacant/Isolation)
Patient/Resident Information (if occupied)
Biohazard Risk Assessment?
Entry Time
Room Number/Location
Dusting & Surface Cleaning (High to Low)
Cleaning surfaces from highest to lowest to prevent re-contamination.
Dust Ceiling Fixtures (lights, vents)
Dust Window Sills and Frames
Dust Top of Furniture (dressers, nightstands)
Wipe Down Wall Surfaces (if applicable)
Wipe Down/Dust Blinds or Curtains
Clean Picture Frames/Decorations
Wipe Down Bed Frame
Clean Baseboards
Disinfection of High-Touch Surfaces
Targeted disinfection of frequently touched items.
Disinfectant Used (Refer to approved list)
If 'Other' disinfectant used, please specify:
Contact Time Achieved?
If 'No' to Contact Time, explain why:
High-Touch Surfaces Disinfected (Check all that apply)
If 'Other' High-Touch Surfaces, please specify:
Concentration of Disinfectant (if applicable)
Disinfection Start Time:
Bathroom Cleaning & Disinfection
Detailed cleaning and disinfection of the bathroom area.
Toilet Bowl Condition (Pre-Cleaning)
Shower/Tub Condition (Pre-Cleaning)
Specific Issues Noted (e.g., mold, stains)
Sink Cleanliness
Disinfectant Used (Bathroom)
If 'Other' disinfectant selected, please specify:
Contact Time (Seconds)
Mirror Cleanliness
Cleaner Signature
Floor Cleaning
Cleaning and disinfection of the room's flooring.
Floor Type:
Cleaning Method:
Detergent Concentration (ppm):
Notes on Soil or Spills:
Rinsing Performed?
Floor Dried?
Area Covered (sq ft):
Final Inspection & Documentation
Ensuring completeness and recording completion of the cleaning process.
Date of Cleaning
Time of Cleaning Start
Time of Cleaning End
Room Status After Cleaning
Any Issues Encountered During Cleaning?
Concentration of Disinfectant Used (%),
Competency Check Completed?
Cleaner Signature
Cleaner Name (Printed)
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