Isolation Cart Checklist Form
Complete this checklist to confirm isolation cart setup and daily readiness. Ensure all items are checked for proper cart functionality and accessibility.
Personal protective equipment (PPE) stocked: gowns, gloves, masks
*
Gowns available
Gloves available
Masks available
Hand sanitizer present and accessible
*
Hand sanitizer bottle full
Dispenser functioning
Disinfectant wipes or surface cleaner available
*
Wipes stocked
Cleaner bottle full
Biohazard waste bags stocked and accessible
*
Biohazard bags present
Bag dispenser working
Isolation signage available and visible
*
Signage present
Signage readable
Eye protection (face shields or goggles) available
*
Face shields stocked
Goggles stocked
Sharps container present and within capacity
*
Sharps container present
Not overfilled
Isolation cart is clean and free of debris
*
Exterior wiped down
No visible debris
All drawers and compartments organized and accessible
*
Drawers organized
All items easy to reach
Cart location is easily accessible and not blocked
*
Cart not obstructed
Path to cart clear
Submit Checklist
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