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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 5 times.

Initial Assessment & Preparation

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Pre-cleaning tasks to ensure safety and effective cleaning.

Patient Room Number

Date of Cleaning

Start Time of Cleaning

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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

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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

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Room Number/Location

Dusting & Surface Cleaning (High to Low)

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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

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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:

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Bathroom Cleaning & Disinfection

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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

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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

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Ensuring completeness and recording completion of the cleaning process.

Date of Cleaning

Time of Cleaning Start

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1:00
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Time of Cleaning End

0:00
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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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