Evsaudit

Introduction
This Environmental Services Audit Tracking Tool Workbook has been designed and developed by the Minnesota Department o
Infection Control and Response (ICAR) Team to assist long-term care facilities to conduct environmental service audits, record
data, and use the information to identify and guide improvement activities.
The workbook is to be used in conjunction with the Environmental Checklist for Monitoring Terminal Cleaning Observation PD
auditor records the occasion in which they observe if a staff member completes the relevant elements during a terminal clean
‘opportunities.’ The environmental services opportunities are defined on the “Element Standards” tab.
This workbook is one part of the MDH ICAR Infection Prevention Audit Tools, a suite of materials that were developed to meet
term care facilities. Additional audit tools are available for hand hygiene, personal protective equipment, and wound care.
MDH ICAR Infection Prevention Audit Tools (www.health.state.mn.us/facilities/patientsafety/infectioncontrol/icar/res/audit.h

To begin using the workbook, please navigate to the Instructions tab.
Environmental Services Audit Tracking Tool Instructions
Step 1: Before entering your monthly observational audit data, select an option from each of the drop-down menus (click on t
Complete the following fields: Facility Name, Tracking Year, Tracking Start Date, and Goal Compliance Rate.
FACILITY NAME:
TRACKING YEAR:
TRACKING START DATE: (mm-yyyy)
GOAL COMPLIANCE RATE:

(e.g. 90%, 95%, etc.)
Step 2: Navigate to the Month_1 tab to begin the first month of tracking.
Step 3: Insert "Y" for yes , "N" for no and "N/A" for not assessed, for each opportunity during the EVS audit.
The box will automatically go blue for "Y", red for "N" and yellow for "N/A". The pop-up box for 'Allowed Values' can be tempo
Step 4: Achievable Score, Total Score, Acual Score, Missed Opportunities, and Overall Percentage Score will be automatically c
ervices Audit Tracking Tool Instructions
observational audit data, select an option from each of the drop-down menus (click on the down arrow at the right of the field).
Name, Tracking Year, Tracking Start Date, and Goal Compliance Rate.
to begin the first month of tracking.
and "N/A" for not assessed, for each opportunity during the EVS audit.
"Y", red for "N" and yellow for "N/A". The pop-up box for 'Allowed Values' can be temporarily moved out of the way using the mouse, if d
Acual Score, Missed Opportunities, and Overall Percentage Score will be automatically calculated.
at the right of the field).
ut of the way using the mouse, if desired.

Environmental Cleaning Element Standards
Bed rails/controls
High Touch I Tray table
IV Pole (grab area)
Call box/ button

High Touch II Telephone
Bedside table handle
Chair
Room sink
High Touch III
Room light switch
Room inner doorknob
Bathroom inner doorknob/plate

Bathroom light switch
Bathroom handrails by toilet
Bathroom Surfaces Bathroom sink
Toilet seat
Toilet flush handle
Toilet bedpan cleaner
IV pump control
Monitor controls
Equipment Surfaces Monitor touch screen
Monitor cables
Ventilator control panel
nt Standards
All parts of the items should be visibly clean and free from blood or body
substances, dust, dirt, debris, and spillages. Equipment is free from tapes/plastic
etc., that may compromise cleaning. Equipment lets, wheels and castors are free
from mop strings, film, dust and cobwebs.
Hard surface items are free from dust, spots, film, fingerprints, and spillages.
Equipment is free from tapes/plastics, etc., which may compromise cleaning.
Hard surface items are free from dust, spots, film, fingerprints, and spillage. Soft
surface items are free from stains, lint, rips and worn areas. Sink porcelain and
tap fittings are free from smudges, smears, body fluids, soap build-up and
mineral deposits.
Hard surface items are free from dust, spots, film, fingerprints, and spillages.
Toilet porcelain and plastic surfaces are free from smudges, smears, body fluids,
soap build-up and mineral deposits. Sink porcelain and tap fittings are free from
smudges, smears, body fluids, soap build-up and mineral deposits. Equipment is
free from tapes/plastics, etc., which may compromise cleaning.
Equipment is free from dust, dirt, smudges, fingerprints, blood and body
substances. Equipment is free from tapes/plastic etc., that may compromise
cleaning. Equipment legs, wheels and castors are free from mop strings, film,
dust and cobwebs.
Month_1 Month_2 Month_3 Month_4 Month_5 Month_6 Month_7 Month_8 Month_9 Month_10 Month_11 Month_12
Reporting Month
Month_1 Month_2 Month_3 Month_4 Month_5 Month_6 Month_7 Month_8 Month_9 Month_10 Month_11 Month_12
0 0 0 0 0 0 0 0 0 0 0 0
# of Audits Conducted
Environmental Services Environmental Services #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A
COMPLIANCE Compliance Rate
Average # Missed Opportunities #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A
per Audit
High Touch I #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!
High Touch II #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!
Category TDC Score % High Touch III #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!
Bathroom Surfaces #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!
Equipment Surfaces #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!
GOAL RATE: #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A
Enviromental Services Compliance Rate by Month Average # Missed Environmental Services Opportunities per Audit by Month
1.00
Environmental Services Compliance Rate Goal Rate
100.0% 0.90
90.0% 0.80
80.0% 0.70
70.0%
60.0% 0.60
50.0% 0.50
40.0% 0.40
30.0%
20.0% 0.30
10.0% 0.20
0.0% 0.10
M M M M M M M M M M M M
on on on on on on on on on on on on
th th th th th th th th th th th th 0.00
_1 _2 _3 _4 _5 _6 _7 _8 _9 _1 _1 _1 M M M M M M M M M M M M
0 1 2 on on on on on on on on on on on on
th th th th th th th th th th th th
_1 _2 _3 _4 _5 _6 _7 _8 _9 _1 _1 _1
0 1 2
#N/A #N/A #N/A
SELECT MONTHS FOR COMPARISON →

Start of Week
WEEKLY (Su - Sa) RATES
End of Week
# of Audits Conducted #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A
Environmental Services #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A
# of Surfaces Missed
COMPLIANCE
Average # Missed Surfaces per #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A
Audit
#N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A
Bed rails/controls
Tray table
IV Pole (grab area)
Call box/ button
Telephone
Bedside table handle
Chair
Room sink
Room light switch
Room inner door knob
NUMBER OF MISSED #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A #N/A
OPPORTUNITIES BY DATA Bathroom inner door knob/plate
ELEMENTS
Bathroom light switch
Bathroom handrails by toilet
Bathroom sink
Toilet seat
Toilet flush handle
Toilet bedpan cleaner
IV pump control
Monitor controls
Monitor touch screen
Monitor cables
Ventilator control panel
- - - - - - - - - - - - - - -
Average # Missed Surfaces per Audit by Week

1.00
0.90
0.80
0.70
0.60
0.50
0.40
0.30
0.20
0.10
0.00
- - - - - - - - - - - - - - -
EVS Audit Action Plan
Department Issue Action
Assigned Staff Due Date Comments / Outcome
Month_1
Audit Information
Initials of ES staff Audit Date Room

(optional) (mm/dd/yyyy) Unit: Number:
Month_1
dit Information
High Touch I
IV Pole (grab
Mark the monitoring method used Bed rails/controls Tray table area)
Total Score (# of Surfaces Cleaned) 0 0 0
Missed Opportunities (# of Surfaces Missed) 0 0 0
Achievable Score (# of Surfaces Evaluated) 0 0 0
% of Surfaces Cleaned #DIV/0! #DIV/0! #DIV/0!

Category: Total # of Surfaces Cleaned 0
Category: Total # of Surfaces Evaluated 0
Category TDC Score: % of Surfaces Cleaned #DIV/0!
Comments (insert comments here):

E
Evaluate th
High Touch II High Touch III
Call box/ Bedside table Room light Room inner

button Telephone handle Chair Room sink switch door knob
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
#DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!

0 0
0 0
#DIV/0! #DIV/0!
Environmental Services Data Elements
Evaluate the following priority sites for each patient room
Bathroom Surfaces
Bathroom inner Bathroom

door Bathroom light handrails by Toilet flush Toilet bedpan
knob/plate switch toilet Bathroom sink Toilet seat handle cleaner
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0

0
0
#DIV/0!
Equipment Surfaces
Missed Opportunities
Actual Score
IV pump Monitor Monitor touch Monitor
control controls screen cables Ventilator control panel
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
#DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!

0
0
#DIV/0!
Monthly Compliance: #DIV/0!
Percentage Attained
Month_2
Audit Information

Month_2
dit Information
High Touch I
IV Pole (grab


Environ
Evaluate the foll

0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0

0 0
0 0
#DIV/0! #DIV/0!
Bathroom Surfaces
Bathroom Bathroom Toilet

inner door Bathroom handrails by Bathroom Toilet flush bedpan
knob/plate light switch toilet sink Toilet seat handle cleaner IV pump control
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
#DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!

0
0
#DIV/0!
Equipment Surfaces
Percentage Attained
Actual Score
Monitor Monitor touch
controls screen Monitor cables Ventilator control panel
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
#DIV/0! #DIV/0! #DIV/0! #DIV/0!

0
0
#DIV/0!
Month_3
Audit Information

Month_3
dit Information
High Touch I
IV Pole (grab


Environ
Evaluate the follo

0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0

0 0
0 0
#DIV/0! #DIV/0!
Bathroom Surfaces

0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0

0
0
#DIV/0!
Equipment Surfaces
Percentage Attained
Actual Score
Monitor Monitor touch Monitor
controls screen cables Ventilator control panel
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
#DIV/0! #DIV/0! #DIV/0! #DIV/0!

0
0
#DIV/0!
Month_4
Audit Information

Month_4
dit Information
High Touch I
IV Pole (grab


Environ
Evaluate the follo

0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0

0 0
0 0
#DIV/0! #DIV/0!
Bathroom Surfaces

0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0

0
0
#DIV/0!
Equipment Surfaces
Percentage Attained
Actual Score
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
#DIV/0! #DIV/0! #DIV/0! #DIV/0!

0
0
#DIV/0!
Month_5
Audit Information

Month_5
dit Information
High Touch I
IV Pole (grab


Environ
Evaluate the follo

0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0

0 0
0 0
#DIV/0! #DIV/0!
Bathroom Surfaces

0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0

0
0
#DIV/0!
Equipment Surfaces
Percentage Attained
Actual Score
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
#DIV/0! #DIV/0! #DIV/0! #DIV/0!

0
0
#DIV/0!
Month_6
Audit Information

Month_6
dit Information
High Touch I
IV Pole (grab


Environ
Evaluate the follo

0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0

0 0
0 0
#DIV/0! #DIV/0!
Bathroom Surfaces

0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0

0
0
#DIV/0!
Equipment Surfaces
Percentage Attained
Actual Score
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
#DIV/0! #DIV/0! #DIV/0! #DIV/0!

0
0
#DIV/0!
Month_7
Audit Information

Month_7
dit Information
High Touch I
IV Pole (grab


Environ
Evaluate the follo

0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0

0 0
0 0
#DIV/0! #DIV/0!
Bathroom Surfaces

0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0

0
0
#DIV/0!
Equipment Surfaces
Percentage Attained
Actual Score
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
#DIV/0! #DIV/0! #DIV/0! #DIV/0!

0
0
#DIV/0!
Month_8
Audit Information

Month_8
dit Information
High Touch I
IV Pole (grab


Environ
Evaluate the follo

0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0

0 0
0 0
#DIV/0! #DIV/0!
Bathroom Surfaces

0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0

0
0
#DIV/0!
Equipment Surfaces
Percentage Attained
Actual Score
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
#DIV/0! #DIV/0! #DIV/0! #DIV/0!

0
0
#DIV/0!
Month_9
Audit Information

Month_9
dit Information
High Touch I
IV Pole (grab


Environ
Evaluate the follo

0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0

0 0
0 0
#DIV/0! #DIV/0!
Bathroom Surfaces

0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0

0
0
#DIV/0!
Equipment Surfaces
Percentage Attained
Actual Score
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
#DIV/0! #DIV/0! #DIV/0! #DIV/0!

0
0
#DIV/0!
Month_10
Audit Information

Month_10
dit Information
High Touch I
IV Pole (grab

Comments:
(insert comments here)
Comments:
(insert comments here)
Environ
Evaluate the follo

0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0

0 0
0 0
#DIV/0! #DIV/0!
Bathroom Surfaces

0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0

0
0
#DIV/0!
Equipment Surfaces
Percentage Attained
Actual Score
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
#DIV/0! #DIV/0! #DIV/0! #DIV/0!

0
0
#DIV/0!
Month_11
Audit Information

Month_11
dit Information
High Touch I
IV Pole (grab


Environ
Evaluate the follo

0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0

0 0
0 0
#DIV/0! #DIV/0!
Bathroom Surfaces

0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0

0
0
#DIV/0!
Equipment Surfaces
Percentage Attained
Actual Score
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
#DIV/0! #DIV/0! #DIV/0! #DIV/0!

0
0
#DIV/0!
Month_12
Audit Information

Month_12
dit Information
High Touch I
IV Pole (grab


Environ
Evaluate the follo

0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0

0 0
0 0
#DIV/0! #DIV/0!
Bathroom Surfaces

0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0

0
0
#DIV/0!
Equipment Surfaces
Percentage Attained
Actual Score
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
#DIV/0! #DIV/0! #DIV/0! #DIV/0!

0
0
#DIV/0!

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Introduction

MDH ICAR Infection Prevention Audit Tools (www.health.state.mn.us/facilities/patientsafety/infectioncontrol/icar/res/audit.h

TRACKING START DATE: (mm-yyyy)

GOAL COMPLIANCE RATE:

to begin the first month of tracking.

ut of the way using the mouse, if desired.

Call box/ button

Bathroom inner doorknob/plate

#N/A #N/A #N/A

SELECT MONTHS FOR COMPARISON →

Average # Missed Surfaces per Audit by Week

Initials of ES staff Audit Date Room

Achievable Score (# of Surfaces Evaluated) 0 0 0

% of Surfaces Cleaned #DIV/0! #DIV/0! #DIV/0!

Comments (insert comments here):

High Touch II High Touch III

Call box/ Bedside table Room light Room inner

#DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!

Bathroom inner Bathroom

#DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!

#DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!

Initials of ES staff Audit Date Room

Achievable Score (# of Surfaces Evaluated) 0 0 0

% of Surfaces Cleaned #DIV/0! #DIV/0! #DIV/0!

Comments (insert comments here):

High Touch II High Touch III

Call box/ Bedside table Room light Room inner

#DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!

Bathroom Bathroom Toilet

#DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!

#DIV/0! #DIV/0! #DIV/0! #DIV/0!

Initials of ES staff Audit Date Room

Achievable Score (# of Surfaces Evaluated) 0 0 0

% of Surfaces Cleaned #DIV/0! #DIV/0! #DIV/0!

Comments (insert comments here):

High Touch II High Touch III

Call box/ Bedside table Room light Room inner

#DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!

Bathroom Bathroom Toilet

#DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!

#DIV/0! #DIV/0! #DIV/0! #DIV/0!

Initials of ES staff Audit Date Room

Achievable Score (# of Surfaces Evaluated) 0 0 0

% of Surfaces Cleaned #DIV/0! #DIV/0! #DIV/0!

Comments (insert comments here):

High Touch II High Touch III

Call box/ Bedside table Room light Room inner

#DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!

Bathroom Bathroom Toilet

#DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!

#DIV/0! #DIV/0! #DIV/0! #DIV/0!

Initials of ES staff Audit Date Room

Achievable Score (# of Surfaces Evaluated) 0 0 0

% of Surfaces Cleaned #DIV/0! #DIV/0! #DIV/0!

Comments (insert comments here):

High Touch II High Touch III

Call box/ Bedside table Room light Room inner

#DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!

Bathroom Bathroom Toilet

#DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!

#DIV/0! #DIV/0! #DIV/0! #DIV/0!

Initials of ES staff Audit Date Room