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  • Disinfection Checklist

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    surdesh kumar
    20 views9 pages
    The document appears to be a checklist for disinfecting high-touch surfaces in offices and restrooms on a daily basis to prevent the spread of disease. It lists various surfaces, items, and equipment in offices and restrooms that should be disinfected after each shift including door handles, phones, computers, printers, pens, thermometers, trash cans, sink handles, toilets, stall doors and more. The checklist is to be signed after completing disinfection for each area and shift over a period of 61 days.

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    The document appears to be a checklist for disinfecting high-touch surfaces in offices and restrooms on a daily basis to prevent the spread of disease. It lists various surfaces, items, and equipment in offices and restrooms that should be disinfected after each shift including door handles, phones, computers, printers, pens, thermometers, trash cans, sink handles, toilets, stall doors and more. The checklist is to be signed after completing disinfection for each area and shift over a period of 61 days.

    Copyright:

    © All Rights Reserved
    Download as XLS, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as xls, pdf, or txt
    20 views9 pages

    Disinfection Checklist

    Uploaded by

    surdesh kumar
    The document appears to be a checklist for disinfecting high-touch surfaces in offices and restrooms on a daily basis to prevent the spread of disease. It lists various surfaces, items, and equipment in offices and restrooms that should be disinfected after each shift including door handles, phones, computers, printers, pens, thermometers, trash cans, sink handles, toilets, stall doors and more. The checklist is to be signed after completing disinfection for each area and shift over a period of 61 days.

    Copyright:

    © All Rights Reserved
    Download as XLS, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as xls, pdf, or txt
    of 9

    Office Shift-End Disinfection Checklist HF-2

    Pandemic Preparedness

    Offices (Main and Plant) DAY 1 DAY 2 DAY 3 DAY 4 DAY 5


    1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift
    Door knobs/handles
    Shared phones
    Shared computers (mouse, keyboards, touch screens, etc.)
    Shared file drawers
    Shared desktops
    Shared copy machines and printers
    Shared markers, pens, pointers, staplers, etc.
    Thermnal Scanning
    Coffee makers, carafes, etc.
    Common trash receptacles
    File cabinet handles
    All interior and exterior door knobs/handles
    Machine buttons and touch screens
    Shared goggles, glasses, and other PPE
    Shared inspection tools and gages
    Shared carts, handtrucks, forklifts, etc.
    SIGN

    Offices (Main and Plant) DAY 6 DAY 7 DAY 8 DAY 9 DAY 10


    1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift
    Door knobs/handles
    Shared phones
    Shared computers (mouse, keyboards, touch screens, etc.)
    Shared file drawers
    Shared desktops
    Shared copy machines and printers
    Shared markers, pens, pointers, staplers, etc.
    Thermnal Scanning
    Coffee makers, carafes, etc.
    Common trash receptacles
    File cabinet handles
    All interior and exterior door knobs/handles
    Machine buttons and touch screens
    Shared goggles, glasses, and other PPE
    Shared inspection tools and gages
    Shared carts, handtrucks, forklifts, etc.
    SIGN

    Offices (Main and Plant) DAY 11 DAY 12 DAY 13 DAY 14 DAY 15


    1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift
    Door knobs/handles
    Shared phones
    Shared computers (mouse, keyboards, touch screens, etc.)
    Shared file drawers
    Shared desktops
    Shared copy machines and printers
    Shared markers, pens, pointers, staplers, etc.
    Thermnal Scanning
    Coffee makers, carafes, etc.
    Common trash receptacles
    File cabinet handles
    All interior and exterior door knobs/handles
    Machine buttons and touch screens
    Shared goggles, glasses, and other PPE
    Shared inspection tools and gages
    Shared carts, handtrucks, forklifts, etc.
    SIGN

    504033903.xls Page 1
    Office Shift-End Disinfection Checklist HF-2
    Pandemic Preparedness

    Offices (Main and Plant) DAY 47 DAY 48 DAY 49 DAY 50 DAY 51


    1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift
    Door knobs/handles
    Shared phones
    Shared computers (mouse, keyboards, touch screens, etc.)
    Shared file drawers
    Shared desktops
    Shared copy machines and printers
    Shared markers, pens, pointers, staplers, etc.
    Thermnal Scanning
    Coffee makers, carafes, etc.
    Common trash receptacles
    File cabinet handles
    All interior and exterior door knobs/handles
    Machine buttons and touch screens
    Shared goggles, glasses, and other PPE
    Shared inspection tools and gages
    Shared carts, handtrucks, forklifts, etc.
    SIGN

    Offices (Main and Plant) DAY 52 DAY 53 DAY 54 DAY 55 DAY 56


    1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift
    Door knobs/handles
    Shared phones
    Shared computers (mouse, keyboards, touch screens, etc.)
    Shared file drawers
    Shared desktops
    Shared copy machines and printers
    Shared markers, pens, pointers, staplers, etc.
    Thermnal Scanning
    Coffee makers, carafes, etc.
    Common trash receptacles
    File cabinet handles
    All interior and exterior door knobs/handles
    Machine buttons and touch screens
    Shared goggles, glasses, and other PPE
    Shared inspection tools and gages
    Shared carts, handtrucks, forklifts, etc.
    SIGN

    Offices (Main and Plant) DAY 57 DAY 58 DAY 59 DAY 60 DAY 61


    1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift
    Door knobs/handles
    Shared phones
    Shared computers (mouse, keyboards, touch screens, etc.)
    Shared file drawers
    Shared desktops
    Shared copy machines and printers
    Shared markers, pens, pointers, staplers, etc.
    Thermnal Scanning
    Coffee makers, carafes, etc.
    Common trash receptacles
    File cabinet handles
    All interior and exterior door knobs/handles
    Machine buttons and touch screens
    Shared goggles, glasses, and other PPE
    Shared inspection tools and gages
    Shared carts, handtrucks, forklifts, etc.
    SIGN

    504033903.xls Page 2
    Restroom Shift-End Disinfection Checklist HF-2
    Pandemic Preparedness

    Restrooms DAY 1 DAY 2 DAY 3 DAY 4 DAY 5


    1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift
    Door knobs/handles and/or any surface on
    door(s) that require touching
    Stall door handles
    Stall door locks
    Toilets
    Toilet handles
    Toilet paper dispenser
    Sinks and sink handles
    Counter tops
    Paper towel dispenser and handles
    Air hand-dryer and push buttons
    Trash receptacles
    Other

    Restrooms DAY 6 DAY 7 DAY 8 DAY 9 DAY 10


    1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift
    Door knobs/handles and/or any surface on
    door(s) that require touching
    Stall door handles
    Stall door locks
    Toilets
    Toilet handles
    Toilet paper dispenser
    Sinks and sink handles
    Counter tops
    Paper towel dispenser and handles
    Air hand-dryer and push buttons
    Trash receptacles
    Other

    Offices (Main and Plant) DAY 11 DAY 12 DAY 13 DAY 14 DAY 15


    1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift

    Door knobs/handles and/or any surface on


    door(s) that require touching
    Stall door handles
    Stall door locks
    Toilets
    Toilet handles
    Toilet paper dispenser
    Sinks and sink handles
    Counter tops
    Paper towel dispenser and handles
    Air hand-dryer and push buttons
    Trash receptacles
    Other
    Restroom Shift-End Disinfection Checklist HF-2
    Pandemic Preparedness

    Restrooms DAY 47 DAY 48 DAY 49 DAY 50 DAY 51


    1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift
    Door knobs/handles and/or any surface on
    door(s) that require touching
    Stall door handles
    Stall door locks
    Toilets
    Toilet handles
    Toilet paper dispenser
    Sinks and sink handles
    Counter tops
    Paper towel dispenser and handles
    Air hand-dryer and push buttons
    Trash receptacles
    Other

    Restrooms DAY 52 DAY 53 DAY 54 DAY 55 DAY 56


    1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift
    Door knobs/handles and/or any surface on
    door(s) that require touching
    Stall door handles
    Stall door locks
    Toilets
    Toilet handles
    Toilet paper dispenser
    Sinks and sink handles
    Counter tops
    Paper towel dispenser and handles
    Air hand-dryer and push buttons
    Trash receptacles
    Other

    Offices (Main and Plant) DAY 57 DAY 58 DAY 59 DAY 60 DAY 61


    1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift

    Door knobs/handles and/or any surface on


    door(s) that require touching
    Stall door handles
    Stall door locks
    Toilets
    Toilet handles
    Toilet paper dispenser
    Sinks and sink handles
    Counter tops
    Paper towel dispenser and handles
    Air hand-dryer and push buttons
    Trash receptacles
    Other
    Plant Shift-End Disinfection Checklist HF-2
    Pandemic Preparedness

    Plant DAY 1 DAY 2 DAY 3 DAY 4 DAY 5


    1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift
    All interior and exterior door knobs/handles
    Machine buttons and touch screens
    Shared goggles, glasses, and other PPE
    Shared inspection tools and gages
    Shared carts, handtrucks, forklifts, etc.
    Other common tools
    Water fountains and potable water supplies
    Trash receptacles
    Timeclocks
    Thermnal Scanning

    Plant DAY 6 DAY 7 DAY 8 DAY 9 DAY 10


    1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift
    All interior and exterior door knobs/handles
    Machine buttons and touch screens
    Shared goggles, glasses, and other PPE
    Shared inspection tools and gages
    Shared carts, handtrucks, forklifts, etc.
    Other common tools
    Water fountains and potable water supplies
    Trash receptacles
    Timeclocks
    Thermnal Scanning

    Plant DAY 11 DAY 12 DAY 13 DAY 14 DAY 15


    1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift
    All interior and exterior door knobs/handles
    Machine buttons and touch screens
    Shared goggles, glasses, and other PPE
    Shared inspection tools and gages
    Shared carts, handtrucks, forklifts, etc.
    Other common tools
    Water fountains and potable water supplies
    Trash receptacles
    Timeclocks
    Thermnal Scanning
    Plant Shift-End Disinfection Checklist HF-2
    Pandemic Preparedness

    Plant DAY 47 DAY 48 DAY 49 DAY 50 DAY 51


    1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift
    All interior and exterior door knobs/handles
    Machine buttons and touch screens
    Shared goggles, glasses, and other PPE
    Shared inspection tools and gages
    Shared carts, handtrucks, forklifts, etc.
    Other common tools
    Water fountains and potable water supplies
    Trash receptacles
    Timeclocks
    Thermnal Scanning

    Plant DAY 52 DAY 53 DAY 54 DAY 55 DAY 56


    1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift
    All interior and exterior door knobs/handles
    Machine buttons and touch screens
    Shared goggles, glasses, and other PPE
    Shared inspection tools and gages
    Shared carts, handtrucks, forklifts, etc.
    Other common tools
    Water fountains and potable water supplies
    Trash receptacles
    Timeclocks
    Thermnal Scanning

    Plant DAY 57 DAY 58 DAY 59 DAY 60 DAY 61


    1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift
    All interior and exterior door knobs/handles
    Machine buttons and touch screens
    Shared goggles, glasses, and other PPE
    Shared inspection tools and gages
    Shared carts, handtrucks, forklifts, etc.
    Other common tools
    Water fountains and potable water supplies
    Trash receptacles
    Timeclocks
    Thermnal Scanning
    Lunch and Break Room Shift-End Disinfection Checklist HF-2
    Pandemic Preparedness

    Lunch and Break Rooms DAY 1 DAY 2 DAY 3 DAY 4 DAY 5


    1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift
    Tables
    Chairs
    Counters
    Vending Machines
    Refrigerators
    Microwaves, toasters, etc.
    Water fountains and potable water supplies
    Common trash receptacles
    Other

    DAY 6 DAY 7 DAY 8 DAY 9 DAY 10


    1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift
    Lunch and Break Rooms

    Tables
    Chairs
    Counters
    Vending Machines
    Refrigerators
    Microwaves, toasters, etc.
    Water fountains and potable water supplies
    Common trash receptacles
    Other

    DAY 11 DAY 12 DAY 13 DAY 14 DAY 15


    1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift
    Lunch and Break Rooms

    Tables
    Chairs
    Counters
    Vending Machines
    Refrigerators
    Microwaves, toasters, etc.
    Water fountains and potable water supplies
    Common trash receptacles
    Other
    Locker Room Shift-End Disinfection Checklist HF-2
    Pandemic Preparedness

    Locker Rooms DAY 1 DAY 2 DAY 3 DAY 4 DAY 5


    1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift
    Shared lockers
    Door knobs/handles, and/or any surface on door(s) that require
    touching
    Stall door handles
    Stall door lockes
    Toilets
    Toilet handles
    Toilet paper dispenser
    Sinks and sink handles
    Counter tops
    Bench tops
    Paper towel dispenser and handles
    Air hand-dryer and push buttons
    Trash receptacles
    Shower handles, heads
    Other

    Locker Rooms DAY 6 DAY 7 DAY 8 DAY 9 DAY 10


    1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift
    Shared lockers
    Door knobs/handles, and/or any surface on door(s) that require
    touching
    Stall door handles
    Stall door lockes
    Toilets
    Toilet handles
    Toilet paper dispenser
    Sinks and sink handles
    Counter tops
    Bench tops
    Paper towel dispenser and handles
    Air hand-dryer and push buttons
    Trash receptacles
    Shower handles, heads
    Other

    Locker Rooms DAY 11 DAY 12 DAY 13 DAY 14 DAY 15


    1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift 1st Shift 2nd Shift 3rd Shift 4th Shift
    Shared lockers
    Door knobs/handles, and/or any surface on door(s) that require
    touching
    Stall door handles
    Stall door lockes
    Toilets
    Toilet handles
    Toilet paper dispenser
    Sinks and sink handles
    Counter tops
    Bench tops
    Paper towel dispenser and handles
    Air hand-dryer and push buttons
    Trash receptacles
    Shower handles, heads
    Other
    PANDEMIC EXPOSURE LOG HF-2
    Pandemic Preparedness

    Where Self-Reported Quarantine


    Employee Name Date Work Area Shift Called In? Exposed? Exposed? Symptomatic? or Observed? Quarantined? Date Notes/Follow Up

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