Bloodborne Pathogens Compliance Checklist
Complete this checklist to assess and document compliance with bloodborne pathogens safety standards in your workplace.
Employee Full Name
*
First Name
Last Name
Department/Unit
*
Date of Assessment
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Has the employee received bloodborne pathogens training within the last 12 months?
*
Yes
No
Is a written Exposure Control Plan available and accessible to employees?
*
Yes
No
Not Sure
Personal Protective Equipment (PPE) is provided and used appropriately.
*
Always
Sometimes
Never
Sharps disposal containers are available, properly labeled, and not overfilled.
*
Yes
No
Not Applicable
Engineering controls (e.g., needleless systems, self-sheathing needles) are in place and used correctly.
*
Yes
No
Not Applicable
Please rate the overall compliance with bloodborne pathogens safety procedures in your area.
*
1
2
3
4
5
List any concerns or corrective actions needed regarding bloodborne pathogens compliance.
I acknowledge that the information provided in this checklist is accurate and complete to the best of my knowledge.
*
Submit Checklist
Submit Checklist
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