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Formulir Pemantauan Instalasi Ventilasi, Listrik, Air, dan Gas

Puskesmas Cicalengka
Bulan/Tahun : Februari 2020
Ventilasi Kelistrikan Air Gas
No Ruang Unit Kontruksi Kebersihan
Stop Kontak Jaringan Socket
Kran Air Plumbing Debit K3
Keterangan
dan Lampu Kabel Outlet
1 Ruang Administrasi OK OK OK OK OK
Ruang KA
2 OK OK OK OK OK
Puskesmas
Ruang Pendaftaran
3 OK OK OK OK OK
dan Rekam Medik
Ruang Pelayanan
4 OK OK OK OK OK OK OK OK
Umum
Ruang Pelayanan
5 OK OK OK OK OK OK OK OK
Lansia
Ruang Pelayanan
6 OK OK OK OK OK OK OK OK
GiMut
7 Ruang Gizi OK OK OK OK OK
8 UGD OK OK OK OK OK OK OK OK
9 Ruang Rawat Inap OK OK OK OK OK OK OK OK
10 Ruang MTBS OK OK OK OK OK OK OK OK
11 Ruang KIA OK OK OK OK OK OK OK OK
12 PONED OK OK OK OK OK OK OK OK
13 Ruang TB OK OK OK OK OK
14 Laboratorium OK OK OK OK OK OK OK OK
15 Ruang Farmasi OK OK OK OK OK
16 Ruang Rapat/ Aula OK OK OK OK OK OK OK OK
17 Toilet Pasien OK OK OK OK OK OK OK OK
18 Toilet Karyawan OK OK OK OK OK OK OK OK
19 Ruang Tunggu Lt 1 OK OK OK OK OK
20 Ruang Tunggu Lt 2 OK OK OK OK OK
21 Koridor OK OK OK OK OK
22 Dapur OK OK OK OK OK OK OK OK
23 Ruang SP3 OK OK OK OK OK OK OK OK
24 Ruang Mutu OK OK OK OK OK
25 Ruang PI OK OK OK OK OK OK OK OK
26 Ruang PK OK OK OK OK OK OK OK OK
27 Ruang BOK OK OK OK OK OK
28 Ruang Vaksin OK OK OK OK OK OK OK OK
30 Ruang Akreditasi OK OK OK OK OK OK OK OK
31 Gudang Obat OK OK OK OK OK

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