Vehicle Audit

Date *

Your name *

Vehicle *

Is the exterior of the vehicle clean *

Yes

No

NA

Does the interior of the vehicle appear cleaned *

Yes

No

NA

Is there any loose rubbish or dirt on the floor *

Yes

No

NA

Is the stretcher made up with clean linen *

Yes

No

NA

Is there 3 yellow clinical waste bags available in the press *

Yes

No

NA

Is the clinical waste bin emptied *

Yes

No

NA

Is there hand sanitizer available in the clinical area *

Yes

No

NA

Is the domestic waste bin emptied *

Yes

No

NA

Are there gloves available in 3 sizes for crew *

Yes

No

NA

Does the stretcher have washable strapping? *

Yes

No

NA

Is the mattress free from rips and tears *

Yes

No

NA

Is the strapping free from tears and frays *

Yes

No

NA

Is there a sticker to indicate when the vehicle was deep cleaned last *

Yes

No

NA

Is there a sharps box mounted to a wall and easily accessible *

Yes

No

NA

Is the sharps box dated and not open longer than 3 months *

Yes

No

NA

Is there a spills kit available *

Yes

No

NA

Is there cleaning materials (as per policy) within the vehicle *

Yes

No

NA

Is the cleaning materials in date *

Yes

No

NA

Is there 2 red alginate bags available in the press *

Yes

No

NA

Are there a cleaning instructions available for crew *

Yes

No

NA

Are there emesis bags available *

Yes

No

NA

Are the incontinence sheets available *

Yes

No

NA

Are there bed pans/bottles available *

Yes

No

NA

Is spare linen clean and wrapped *

Yes

No

NA

Is there Face masks available on the vehicle (Surgical and FFP3) *

Yes

No

NA

Are there aprons available *

Yes

No

NA

Does each large piece of patient carrying equipment have a cleaned label *

Yes

No

NA

Are protective eye goggles/glasses available *

Yes

No

NA

Comments *

Images *

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Signature *

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