Checklist template

Instrument disinfection and lab safety for optical stores

A ready-to-use checklist with 114 items in 6 sections, covering Instrument disinfection, Trial lenses, Hand hygiene, Lab equipment guards, Chemicals, Eye protection. Use it as-is in InspectLoop, or adapt it to your own standards in minutes.

  • 6 Sections
  • 114 Items
  • 104 Yes / No checks
  • 6 Scored ratings
  • 134 Points

Use this template How audits work

1. Instrument disinfection 18 items

  1. A written disinfection procedure for each type of instrument is kept in the clinic area Yes / No 1 pt
  2. The disinfectants in use on instruments are those named in the written procedure Yes / No 1 pt
  3. An employee asked could state the wet contact time printed on the label of the disinfectant in use Yes / No 1 pt
  4. Applanation tonometer prisms are disinfected after each patient by the method in the procedure, or disposable prisms are used Yes / No 1 pt
  5. Disinfected tonometer prisms are rinsed and dried before they touch the next eye Yes / No 1 pt
  6. The prism soaking solution is changed on the schedule in the procedure Yes / No 1 pt
  7. The soaking container is labeled with the product and the date the solution was changed Yes / No 1 pt
  8. Tonometer prisms are free of cracks and chips Yes / No 1 pt
  9. Disposable tonometer tips or covers are discarded after one patient Yes / No 1 pt
  10. Gonioscopy and other diagnostic lenses that touch the eye are disinfected after each use Yes / No 1 pt
  11. Disinfected diagnostic lenses are stored dry in their cases Yes / No 1 pt
  12. Used and clean instruments are kept in separate, labeled trays Yes / No 1 pt
  13. Reusable metal instruments (forceps, lid retractors) are sterilized or replaced by single-use items, as the procedure states Yes / No 1 pt
  14. The end-of-day disinfection of pre-test instruments is recorded in a log Yes / No 1 pt
  15. Pupillometer nose pads and forehead rests are wiped after each customer Yes / No 1 pt
  16. Frames tried on by customers are disinfected by a method safe for frame finishes before they return to the boards Yes / No 1 pt
  17. Disinfectant products are within their expiry date Yes / No 1 pt
  18. Disinfection of eye-contact instruments Rating
    • Done after each patient and recorded 5 pts
    • Done but not recorded 3 pts
    • Not done consistently 1 pt

2. Trial lenses 17 items

  1. Reusable rigid and scleral diagnostic lenses are disinfected after each patient by the written procedure Yes / No 1 pt
  2. Each disinfection of a reusable diagnostic lens is logged with the date and initials Yes / No 1 pt
  3. Reusable diagnostic lenses are stored as their manufacturer instructs (dry or in fresh solution) Yes / No 1 pt
  4. Storage cases of reusable diagnostic lenses are replaced or disinfected on the schedule in the procedure Yes / No 1 pt
  5. Scratched or chipped reusable diagnostic lenses have been removed from the set Yes / No 1 pt
  6. Soft trial lenses are discarded after one patient has tried them Yes / No 1 pt
  7. No opened soft lens blister is kept in the fitting area Yes / No 1 pt
  8. Lenses are handled only after hand washing Yes / No 1 pt
  9. Lens removal plungers are disinfected after each patient or issued to one patient only Yes / No 1 pt
  10. Fluorescein is applied from single-use strips or single-dose units Yes / No 1 pt
  11. Saline used in fittings comes from single-dose units or from a bottle dated when opened Yes / No 1 pt
  12. The nozzle of a solution bottle does not touch lenses, fingers or the eye Yes / No 1 pt
  13. No tap water is used on contact lenses or lens cases in the fitting area Yes / No 1 pt
  14. The trial frame's nose rest and temples are wiped after each patient Yes / No 1 pt
  15. Refraction trial lenses that touched lashes or skin are wiped before they return to the case Yes / No 1 pt
  16. The trial lens case is closed when not in use Yes / No 1 pt
  17. Handling of diagnostic contact lenses Rating
    • Disinfected, logged, stored correctly 5 pts
    • Disinfected but log incomplete 3 pts
    • Reuse without disinfection 1 pt

3. Hand hygiene 18 items

  1. A hand washing sink with running warm water is in or next to the exam lanes Yes / No 1 pt
  2. A hand washing sink is in or next to the contact lens fitting area Yes / No 1 pt
  3. Soap dispensers at the sinks are filled Yes / No 1 pt
  4. Single-use paper towels are stocked at every hand washing sink Yes / No 1 pt
  5. Hand rub is available at each dispensing table Yes / No 1 pt
  6. Hand rub is available at reception Yes / No 1 pt
  7. Hand rub dispensers are within their expiry date Yes / No 1 pt
  8. The clinician cleaned hands before touching a patient, as observed Yes / No 1 pt
  9. The clinician cleaned hands after the patient left, as observed Yes / No 1 pt
  10. The optician cleaned hands before fitting glasses on a customer's face, as observed Yes / No 1 pt
  11. Hand washing instructions are posted at the sinks Yes / No 1 pt
  12. Disposable gloves are available in at least two sizes in the clinic area Yes / No 1 pt
  13. Gloves are changed after each patient when worn Yes / No 1 pt
  14. Employees with cuts on their hands cover them with a waterproof dressing Yes / No 1 pt
  15. Employees with signs of an eye infection are kept away from patient contact as company policy states Yes / No 1 pt
  16. An employee asked could describe the room clean-down after a patient with a suspected contagious eye infection Yes / No 1 pt
  17. Hand washing sinks are clear of cups, tools and chemicals Yes / No 1 pt
  18. Hand hygiene observed during the visit Rating
    • Consistent before and after contact 5 pts
    • Occasional lapses 3 pts
    • Rarely practiced 1 pt

4. Lab equipment guards 24 items

  1. The edger's door interlock stops the cycle when the door is opened, as tested Yes / No 1 pt
  2. The edger's door and viewing window are intact, with no cracks or gaps Yes / No 1 pt
  3. The hand edger has its wheel guard in place Yes / No 1 pt
  4. The hand edger has its splash guard in place Yes / No 1 pt
  5. The hand edger wheel runs wet during use Yes / No 1 pt
  6. The guard of the lens groover is in place Yes / No 1 pt
  7. The guard of the lens drill is in place Yes / No 1 pt
  8. The polishing wheel has its hood in place Yes / No 1 pt
  9. The power switch of each machine can be reached from the operating position Yes / No 1 pt
  10. Machine cords are free of cuts, splices and tape repairs Yes / No 1 pt
  11. Outlets near the edger and sinks are protected against ground faults as required by local regulation Yes / No 1 pt
  12. Machines are stable on the bench and do not shift when running Yes / No 1 pt
  13. The frame warmer carries a hot surface warning Yes / No 1 pt
  14. The frame warmer is switched off at closing Yes / No 1 pt
  15. The lids of the tint unit are in place when it is heated Yes / No 1 pt
  16. The tint unit is not left heated in an unattended lab Yes / No 1 pt
  17. Polycarbonate swarf is emptied from the edger and its filter daily Yes / No 1 pt
  18. The edger's dust or odor extraction is running during cutting Yes / No 1 pt
  19. Machines are unplugged before a wheel change or cleaning Yes / No 1 pt
  20. Operators at rotating equipment wear no loose sleeves or dangling jewelry Yes / No 1 pt
  21. Operators at rotating equipment have long hair tied back Yes / No 1 pt
  22. A training record exists for each employee who operates the edger, drill or groover Yes / No 1 pt
  23. The lab floor is dry and free of lens swarf Yes / No 1 pt
  24. Guarding of lab machines Rating
    • All guards and interlocks in place and working 5 pts
    • One guard missing or damaged, machine tagged out 3 pts
    • Machine in use without a guard 1 pt

5. Chemicals 20 items

  1. A safety data sheet is available for each chemical in the lab and clinic (acetone, alcohol, lens dyes, neutralizer, coolant, disinfectants) Yes / No 1 pt
  2. The chemical inventory list matches the products found Yes / No 1 pt
  3. Every container carries the product name and hazard information, including spray bottles filled in store Yes / No 1 pt
  4. Acetone and alcohol are kept in closed containers Yes / No 1 pt
  5. Flammable liquids are stored away from the frame warmer and the tint unit Yes / No 1 pt
  6. The quantity of flammable liquids in the lab stays within the limit set by company policy Yes / No 1 pt
  7. Acetone is dispensed from a small pump dispenser rather than an open dish Yes / No 1 pt
  8. Chemical-resistant gloves are available for handling dyes, neutralizer and acetone Yes / No 1 pt
  9. An eyewash station or sealed eyewash bottles are within reach of the lab bench Yes / No 1 pt
  10. Access to the eyewash is unobstructed Yes / No 1 pt
  11. The eyewash is within its expiry date or has been flushed on schedule Yes / No 1 pt
  12. Date of the last eyewash check Date
  13. Absorbent material for chemical spills is available in the lab Yes / No 1 pt
  14. Used dyes, solvents and coolant are disposed of as required by local regulation Yes / No 1 pt
  15. No food or drink is kept or consumed in the lab Yes / No 1 pt
  16. Disinfectant concentrates are stored out of reach of patients and children Yes / No 1 pt
  17. Employees who handle chemicals have a hazard communication training record Yes / No 1 pt
  18. A fire extinguisher rated for flammable liquids is mounted in or next to the lab Yes / No 1 pt
  19. The fire extinguisher's inspection tag is current Yes / No 1 pt
  20. Chemical storage and labeling Rating
    • All labeled, stored and documented 5 pts
    • Minor labeling or storage gaps 3 pts
    • Unlabeled containers or flammables near heat 1 pt

6. Eye protection 17 items

  1. Safety glasses with side shields are worn at the hand edger, drill and groover, as observed Yes / No 1 pt
  2. Each lab employee has been issued safety eyewear Yes / No 1 pt
  3. Spare safety glasses are available for visitors and service technicians Yes / No 1 pt
  4. Safety eyewear in use carries the impact rating marking required by local regulation Yes / No 1 pt
  5. Safety eyewear lenses are free of scratches that impair vision Yes / No 1 pt
  6. Splash goggles are available for pouring dyes and chemicals Yes / No 1 pt
  7. A sign at the lab entrance requires eye protection Yes / No 1 pt
  8. Customers are not admitted to the lab while machines are running Yes / No 1 pt
  9. The shield of the UV curing unit is closed during operation Yes / No 1 pt
  10. Broken lens fragments are swept up with a brush and pan, not picked up by hand Yes / No 1 pt
  11. Broken glass lenses are discarded in a rigid container Yes / No 1 pt
  12. The first aid procedure for a chemical splash or a particle in the eye is posted in the lab Yes / No 1 pt
  13. Eye injuries and near misses are recorded in the incident log Yes / No 1 pt
  14. Eye injuries recorded in the last 12 months Number
  15. Name of the store manager Short text
  16. Overall hygiene and lab safety Rating
    • Strong 5 pts
    • Acceptable 3 pts
    • Weak 1 pt
  17. Corrective actions required 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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