Run C. difficile Enhanced Environmental Cleaning Verification — Free

Inspection Details

Resident or room identified for C. difficile precautions

Record the room number, unit, or resident identifier used by the facility.

Inspection type

Select the type of enhanced cleaning verification performed.

Date and time of verification critical (required)

Inspector name and role critical (required)

PPE and Worker Protection

Appropriate PPE worn during cleaning verification critical (required)

Verify gloves and gown were used as required by facility precautions and task exposure.

Yes No N/A

Hand hygiene performed before and after room entry critical (required)

Yes No N/A

Cleaning staff trained on C. difficile enhanced cleaning procedure

Confirm the assigned staff member is trained on bleach-based disinfection and verification process.

Yes No N/A

Bleach-Based Disinfectant Preparation and Contact Time

EPA-registered bleach-based disinfectant used for C. difficile surfaces critical (required)

Confirm the product used is approved by facility policy for C. difficile environmental disinfection.

Yes No N/A

Disinfectant prepared according to label or facility SOP critical (required)

Yes No N/A

Required wet contact time achieved on treated surfaces critical (required)

Verify surfaces remained visibly wet for the full required dwell time.

Yes No N/A

High-touch surfaces treated with bleach-based disinfectant critical (required)

Examples include bed rails, call bell, overbed table, bedside cabinet handles, light switches, door handles, and bathroom fixtures.

Yes No N/A

Room and Bathroom Cleaning Verification

Bed area cleaned and disinfected critical (required)

Yes No N/A

Bathroom surfaces cleaned and disinfected critical (required)

Verify toilet, sink, faucet handles, grab bars, flush handle, and nearby touch points were disinfected.

Yes No N/A

Frequently touched room surfaces free of visible soil after cleaning critical (required)

Yes No N/A

Waste and linen removed and handled per infection control procedure

Yes No N/A

Room ready for re-occupancy critical (required)

Yes No N/A

Shared Equipment and Transport Items

Shared equipment cleaned and disinfected before removal from room critical (required)

Includes blood pressure cuff, thermometer, pulse oximeter, walker, commode, or other reusable equipment.

Yes No N/A

Equipment surfaces free of visible soil and residue critical (required)

Yes No N/A

Dedicated or disposable items disposed of or returned per policy

Yes No N/A

Objective Verification and Documentation

ATP or fluorescent marker verification performed critical (required)

Select the objective verification method used to assess cleaning quality.

Note (optional)

Verification result meets facility acceptance criteria critical (required)

Document whether the ATP reading or fluorescent marker removal passed the facility threshold.

Yes No N/A

Deficiencies documented and corrected before sign-off critical (required)

Yes No N/A

Inspector signature critical (required)

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Run: C. difficile Enhanced Environmental Cleaning Verification

Inspection Details

PPE and Worker Protection

Bleach-Based Disinfectant Preparation and Contact Time

Room and Bathroom Cleaning Verification

Shared Equipment and Transport Items

Objective Verification and Documentation

Get your results