Sterile Environment Maintenance Checklist
Complete this checklist to ensure all required sterile environment maintenance tasks have been performed accurately.
Date of Maintenance
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Responsible Person
*
First Name
Last Name
Work Area/Location
*
Checklist of Maintenance Tasks
*
All surfaces cleaned and disinfected
Floors mopped with approved disinfectant
Waste bins emptied and replaced with new liners
High-touch points (e.g., door handles, switches) sanitized
Supplies restocked (gloves, gowns, masks, etc.)
Equipment wiped down and stored properly
Were any issues identified during maintenance?
*
No issues identified
Issues identified (see notes below)
Additional Notes or Observations
Signature
*
Submit Checklist
Submit Checklist
Should be Empty: