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Run: Patient Room Terminal Cleaning Verification

Verify terminal cleaning after discharge with a clear, room-by-room checklist. Catch missed high-touch surfaces, mattress issues, and UV-C gaps before the ne...

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Inspection Details

Room number or identifier

Enter the patient room number, unit, or other unique identifier.

Discharge or transfer date and time

Document when the room became available for terminal cleaning.

Cleaning completed by environmental services critical (required)

Confirm that terminal cleaning was completed by assigned staff.

Yes No N/A

Bed and Mattress Verification

Mattress surface cleaned and free of visible soil critical (required)

Yes No N/A

Photo evidence (optional)

Mattress cover or encasement intact critical (required)

Yes No N/A

Bed frame, mattress seams, and crevices cleaned

Yes No N/A

Curtains and Soft Surfaces

Privacy curtain changed or laundered per protocol critical (required)

Yes No N/A

Photo evidence (optional)

Curtain track and surrounding area cleaned

Yes No N/A

Fabric furniture or soft surfaces addressed if present

Yes No N/A

UV-C Disinfection

UV-C cycle completed critical (required)

Yes No N/A

Photo evidence (optional)

UV-C device placement and room setup were appropriate

Yes No N/A

UV-C cycle log or indicator reviewed

Yes No N/A

Final Room Readiness

No visible soil or odor remains critical (required)

Yes No N/A

Photo evidence (optional)

Supplies restocked and room reset

Yes No N/A

Corrective actions documented for any failed item critical (required)

Yes No N/A

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Run: Patient Room Terminal Cleaning Verification

Inspection Details

High-Touch Surface Cleaning

Bed and Mattress Verification

Curtains and Soft Surfaces

UV-C Disinfection

Final Room Readiness

Get your results