Checklist template

Exam room readiness for veterinary hospitals

A ready-to-use checklist with 111 items in 6 sections, covering Cleanliness, Supplies, Equipment, Turnover, Odour control, Stocking. Use it as-is in InspectLoop, or adapt it to your own standards in minutes.

  • 6 Sections
  • 111 Items
  • 95 Yes / No checks
  • 6 Scored ratings
  • 125 Points

Use this template How audits work

1. Cleanliness 18 items

  1. Exam rooms inspected during the visit Number
  2. The exam table top is free of hair, nail clippings and dried fluids Yes / No 1 pt
  3. The edges, underside lip and base of the exam table are free of hair and splatter Yes / No 1 pt
  4. The floor is free of hair along the baseboards and under the client bench Yes / No 1 pt
  5. Walls and the door are free of splatter and nose prints up to 3 ft (1 m) from the floor Yes / No 1 pt
  6. The client bench or chairs are free of pet hair Yes / No 1 pt
  7. The countertop is clear of used syringes, swabs and sample tubes Yes / No 1 pt
  8. The sink basin and drain are free of hair Yes / No 1 pt
  9. The keyboard and mouse have a wipeable cover or are wiped daily per the cleaning checklist Yes / No 1 pt
  10. The sharps container is below its fill line Yes / No 1 pt
  11. The sharps container is wall-mounted or out of reach of children and pets Yes / No 1 pt
  12. The trash can has a lid and is less than three-quarters full Yes / No 1 pt
  13. No used otoscope cone is left on the counter Yes / No 1 pt
  14. The thermometer is wiped clean, with no residue on the probe Yes / No 1 pt
  15. The treat jar is closed and free of crumbs on the outside Yes / No 1 pt
  16. Ceiling vents and light fixtures are free of dust and hair Yes / No 1 pt
  17. The end-of-day deep-clean checklist for the exam rooms is initialed for yesterday Yes / No 1 pt
  18. Cleanliness of the exam rooms inspected Rating
    • Every room ready for a patient 5 pts
    • Minor hair or clutter in a room 3 pts
    • Soiled surfaces or used items left out 1 pt

2. Supplies 21 items

  1. Exam gloves are in each room in at least two sizes Yes / No 1 pt
  2. Each room has disinfectant in a bottle labeled with the product name and the date it was diluted Yes / No 1 pt
  3. The paper towel dispenser is filled Yes / No 1 pt
  4. Hand soap is at the sink of each room Yes / No 1 pt
  5. Syringes of 1 mL, 3 mL, 6 mL and 12 mL are in the drawer Yes / No 1 pt
  6. Needles of 22 and 25 gauge are in the drawer Yes / No 1 pt
  7. Blood collection tubes in the room are within their expiry date Yes / No 1 pt
  8. Alcohol, cotton and gauze are kept in closed containers Yes / No 1 pt
  9. Ear cleaner, cotton-tipped swabs and microscope slides for ear cytology are in each room Yes / No 1 pt
  10. Fluorescein strips and tear test strips are within their expiry date Yes / No 1 pt
  11. Lubricating jelly and thermometer probe covers are in each room Yes / No 1 pt
  12. Nail trimmers and styptic powder are in each room Yes / No 1 pt
  13. Gauze squares and a pressure bandage are in each room for a bleeding nail or vein Yes / No 1 pt
  14. Pill pockets or a pill gun are in each room for giving a first dose Yes / No 1 pt
  15. A non-slip mat or clean towel is available for the table top Yes / No 1 pt
  16. Treats include a hypoallergenic option for patients on a food trial Yes / No 1 pt
  17. Fecal loops and sample containers are in each room Yes / No 1 pt
  18. A box of tissues is available for clients Yes / No 1 pt
  19. No vaccine or drug is left drawn up in an unlabeled syringe Yes / No 1 pt
  20. A check of 10 dated items in the room found none past its expiry date Yes / No 1 pt
  21. Supplies at the point of use Rating
    • Complete in every room 5 pts
    • One or two items missing 3 pts
    • The technician must leave the room for basic items 1 pt

3. Equipment 19 items

  1. The otoscope light is bright on each handle tested Yes / No 1 pt
  2. The ophthalmoscope light works Yes / No 1 pt
  3. A spare charged handle or spare bulb is available for the otoscope Yes / No 1 pt
  4. The lift table raises and lowers through its full travel without jerking Yes / No 1 pt
  5. The built-in table scale reads zero when empty Yes / No 1 pt
  6. A check weight placed on the walk-on scale reads within the tolerance set by company policy Yes / No 1 pt
  7. Date of the last scale accuracy check Date
  8. A scale reading in ounces or grams is available for patients under 10 lb (4.5 kg) Yes / No 1 pt
  9. The exam light works and its arm stays where it is placed Yes / No 1 pt
  10. The workstation in each room opens the practice software without delay Yes / No 1 pt
  11. The microchip scanner reads a test chip Yes / No 1 pt
  12. Spare batteries for the thermometer and the microchip scanner are in the room or at the technician station Yes / No 1 pt
  13. The blood pressure unit has cuffs in at least three sizes Yes / No 1 pt
  14. The Wood's lamp works Yes / No 1 pt
  15. The exam room door latches so a loose patient cannot push it open Yes / No 1 pt
  16. Electrical cords are out of reach of a patient on the floor Yes / No 1 pt
  17. Drawers and cabinet doors close fully Yes / No 1 pt
  18. The wall-mounted otoscope set or handle charger is fixed firmly to the wall Yes / No 1 pt
  19. Condition of exam room equipment Rating
    • Everything works 5 pts
    • One item out of service with a backup available 3 pts
    • Equipment failures delay exams 1 pt

4. Turnover 17 items

  1. The exam table was disinfected between patients on each turnover observed Yes / No 1 pt
  2. The disinfectant stays wet on the table for the contact time on its label before it is wiped Yes / No 1 pt
  3. Contact time stated on the label of the disinfectant in use (minutes) Number
  4. Hair on the floor is swept or vacuumed between patients Yes / No 1 pt
  5. Used towels and mats go to the laundry hamper after each patient Yes / No 1 pt
  6. Used otoscope cones, nail trimmers and clipper blades are taken out for cleaning after each patient Yes / No 1 pt
  7. Needles and syringes are put in the sharps container by the person who used them Yes / No 1 pt
  8. Sample tubes are labeled and taken to the laboratory before the next patient is roomed Yes / No 1 pt
  9. A flag, light or software status shows whether each room is clean, occupied or waiting to be cleaned Yes / No 1 pt
  10. A room used for a suspected contagious patient (parvovirus, ringworm, kennel cough) is closed until cleaned by the isolation protocol Yes / No 1 pt
  11. The employee cleaning after a contagious patient wears a gown and gloves that are discarded in the room Yes / No 1 pt
  12. Employees observed washed or sanitized their hands between patients Yes / No 1 pt
  13. The client bench is wiped after a pet has been on it Yes / No 1 pt
  14. The previous patient's record is closed on the screen before the next client enters Yes / No 1 pt
  15. Minutes taken to turn over a room during the visit Number
  16. Turnover is completed within the time set by company policy Yes / No 1 pt
  17. Turnover between patients observed Rating
    • Full clean and reset every time 5 pts
    • Table cleaned, other steps skipped 3 pts
    • Next patient roomed without cleaning 1 pt

5. Odour control 17 items

  1. No odor of urine, feces or anal gland secretion is noticeable on entering each room Yes / No 1 pt
  2. Urine accidents are treated with an enzymatic cleaner, not only with disinfectant Yes / No 1 pt
  3. Trash holding feces or anal gland material is taken out of the room at once Yes / No 1 pt
  4. Air is drawn into the exhaust vent of each room (tissue held to the grille) Yes / No 1 pt
  5. No essential oil diffuser is used in exam rooms Yes / No 1 pt
  6. No scented spray is used while a patient is in the room Yes / No 1 pt
  7. An odor neutralizer approved by the company is used after each anal gland expression Yes / No 1 pt
  8. Date the exhaust fans of the exam rooms were last cleaned Date
  9. Mop heads in use have no sour smell Yes / No 1 pt
  10. The laundry hamper has a lid Yes / No 1 pt
  11. Floor seams and baseboards are sealed so urine cannot seep under them Yes / No 1 pt
  12. Exam rooms have no fabric chairs or rugs Yes / No 1 pt
  13. Water is run weekly in the sinks of seldom-used rooms to keep the drain traps filled Yes / No 1 pt
  14. Disinfectant is mixed at the label dilution with a measuring pump or dispenser Yes / No 1 pt
  15. The cat-only room is not used for dogs during its posted hours Yes / No 1 pt
  16. Date the ventilation filters were last changed Date
  17. Odor in the exam rooms inspected Rating
    • No odor 5 pts
    • Faint odor in one room 3 pts
    • Persistent odor of urine or anal glands 1 pt

6. Stocking 19 items

  1. A par list in each room shows the items and quantities for each drawer Yes / No 1 pt
  2. Drawers are laid out the same way in every exam room Yes / No 1 pt
  3. Drawers and cabinets are labeled with their contents Yes / No 1 pt
  4. The closing restock checklist is initialed for yesterday Yes / No 1 pt
  5. A midday restock check is assigned on today's schedule Yes / No 1 pt
  6. New stock is placed behind older stock in the drawers Yes / No 1 pt
  7. Vaccines are brought from the refrigerator for each appointment and not kept in the room Yes / No 1 pt
  8. One named employee per shift is responsible for exam room stocking Yes / No 1 pt
  9. The central supply room holds at least the minimum quantity of gloves, syringes, needles and blood tubes Yes / No 1 pt
  10. Items that reach their reorder point are written on the want list Yes / No 1 pt
  11. No overstock is piled on counters or on the floor Yes / No 1 pt
  12. Opened bottles of ear cleaner, saline and alcohol are marked with the date opened Yes / No 1 pt
  13. Date of the last expiry check of exam room drawers Date
  14. Clean otoscope cones are stocked in each size Yes / No 1 pt
  15. The clean towel stock in each room meets the par level Yes / No 1 pt
  16. Items missing against the par list in the rooms inspected Number
  17. Name of the technician responsible for exam rooms today Short text
  18. Overall readiness of exam rooms Rating
    • Every room clean, stocked and working 5 pts
    • Rooms usable with missing items or minor faults 3 pts
    • A room unfit to receive a patient 1 pt
  19. Corrective actions required in the exam rooms Comments

About this template

This checklist is part of the InspectLoop template library. Yes / No checks score 1 point when met; ratings score the points shown for each option. The overall score is the percentage of points earned, with N/A answers excluded. In InspectLoop you can add photos, assign corrective actions, require sign-off and compare results across sites.

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