Pathogen Preparedness Checklist Form
Use this form to plan and document essential operational readiness checks for pathogen preparedness at your facility or organization.
Facility/Organization Name
*
Date of Assessment
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Preparedness Coordinator Name
Operational Readiness Checks
Essential protocols and procedures for pathogen response are documented and accessible.
Completed
Staff have received up-to-date training on infection prevention and control.
Completed
Personal protective equipment (PPE) is available and stock levels are adequate.
Completed
Cleaning and disinfection protocols for high-touch surfaces are in place and being followed.
Completed
Communication plan for staff and stakeholders is established and ready to activate.
Completed
Additional Comments or Notes
Submit
Should be Empty: