Run Patient Room Daily Cleaning — Free

Inspection Details

Patient room identifier recorded

Enter the room number or unit/bed identifier for the inspection record.

Inspection completed after routine daily cleaning critical (required)

Confirm the room was inspected after the assigned daily cleaning task was completed.

Yes No N/A

Inspector name and role recorded

Document the EVS supervisor or other authorized inspector conducting the review.

Date and time of inspection recorded

Capture when the inspection was performed.

Note (optional)

Applicable cleaning protocol identified

Select the protocol(s) used for this room inspection.

High-Touch Surfaces

Bed rails, bed controls, and call button disinfected critical (required)

Check that the bed rails, control panel, and patient call device were cleaned and disinfected.

Yes No N/A

Overbed table, bedside table, and chair arms disinfected critical (required)

Verify all patient-use furniture touch points are visibly clean and disinfected.

Yes No N/A

Door handles, light switches, and hand contact points disinfected critical (required)

Confirm entry/exit and room contact surfaces were included in the cleaning process.

Yes No N/A

IV pole, monitor controls, and other room equipment touch points disinfected critical (required)

Verify all facility-designated equipment touch points in the room were addressed.

Yes No N/A

Frequently touched horizontal surfaces free of visible soil critical (required)

Check for dust, residue, body fluid contamination, or other visible soil on high-touch surfaces.

Yes No N/A

Cleaning agent and contact time followed per SOP critical (required)

Confirm the approved disinfectant and required wet contact time were followed according to facility procedure.

Yes No N/A

Bathroom and Sink Area

Toilet, flush handle, and surrounding surfaces disinfected critical (required)

Verify the toilet bowl exterior, seat, flush handle, and nearby surfaces are clean and disinfected.

Yes No N/A

Sink, faucet handles, and soap/dispenser area cleaned critical (required)

Confirm the sink basin, faucet controls, and dispenser surfaces are free of residue and visibly clean.

Yes No N/A

Shower/tub area cleaned and free of visible buildup

Inspect the shower or tub area for soap scum, hair, standing water, or other visible soil.

Yes No N/A

Bathroom floor clean, dry, and free of slip hazards critical (required)

Check for moisture, debris, or residue that could create a slip or infection-control concern.

Yes No N/A

Floors and General Room Condition

Patient room floor vacuumed or mopped with no visible soil critical (required)

Confirm the floor was cleaned throughout accessible areas, including under and around furniture as applicable.

Yes No N/A

Corners, edges, and under-bed area addressed

Inspect hard-to-reach floor areas for dust, debris, or missed cleaning.

Yes No N/A

Trash removed and waste containers clean critical (required)

Verify waste was removed per procedure and container exteriors are clean and not overfilled.

Yes No N/A

Room free of clutter and unnecessary items

Check that supplies, personal items, and equipment do not obstruct cleaning or create contamination risk.

Yes No N/A

No visible dust, spills, or body fluid residue present critical (required)

Confirm the room is free of visible contamination on surfaces, furnishings, and floor areas.

Yes No N/A

Documentation and Completion

Cleaning task documented in facility system or log critical (required)

Verify the daily cleaning was recorded according to facility documentation requirements.

Yes No N/A

Deficiencies or non-conformances documented with corrective action critical (required)

If any item failed, confirm the issue was recorded and escalated for correction per SOP.

Yes No N/A

Inspector signature captured critical (required)

Supervisor sign-off confirming the inspection findings.

Follow-up required before room release

Indicate whether the room requires re-cleaning or additional review before being considered compliant.

Yes No N/A

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Run: Patient Room Daily Cleaning

Inspection Details

High-Touch Surfaces

Bathroom and Sink Area

Floors and General Room Condition

Documentation and Completion

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