CHECKLIST

Visit 1 Visit 2 Date:. Yes No Visit 3 Date: Yes No Visit 4 Date:. Yes No

Cleaning tasks
HD area Cleaning Used Needles and syringes Segregation of waste Hand washing technique NSG Station Cleaning Used Needles and syringes Segregation of waste Hand washing technique Laboratory Cleaning Used Needles and syringes Segregation of waste Hand washing technique Use of PPE CASUALITY Cleaning Used of Needles and syringes Segregation of waste Hand washing technique

Date:. Yes No