HomeMy WebLinkAboutOIH Small House Operating Plan - 1-5-17 (1)Rabig Consulting
OPERATING PLAN
Page1 Table of Contents
Overview ..................................................................................................................................................... 3
Philosophy .................................................................................................................................................. 4
Guiding Principles ..................................................................................................................................... 5
Architecture – Floor Plan .......................................................................................................................... 6
Administration – Time and Attendance ................................................................................................. 7
Administration – Security/Visiting......................................................................................................... 8
Administration – Mail ............................................................................................................................... 8
Administration – Resident Accounts ...................................................................................................... 8
Administration – Communication ........................................................................................................... 9
Administration – Committees and Work Groups ................................................................................. 9
Administration – Offices ........................................................................................................................... 9
Human Resources Hiring ....................................................................................................................... 11
Job Description – Medical Director ....................................................................................................... 11
Job Description – Licensed Nursing Home Administrator (Guide) ................................................. 16
Job Description – Director of Nursing .................................................................................................. 19
Job Description – Nurse .......................................................................................................................... 22
Job Description – Care Partner (CNA) .................................................................................................. 24
Job Description – Dining Leader ............................................................................................................ 26
Job Description – Administrative Nurse .............................................................................................. 27
Job Description – Social Worker ............................................................................................................ 29
Job Description – Dietitian ...................................................................................................................... 30
Job Description – Life Enrichment Worker .......................................................................................... 31
The Care Partner Empowered Work Team .......................................................................................... 32
Beauty Salon/Barber ............................................................................................................................... 37
Information Technology.......................................................................................................................... 37
Communication Plan ............................................................................................................................... 38
Dietary – Philosophy ............................................................................................................................... 41
Dietary – Dining Plan .............................................................................................................................. 42
Dietary – House Kitchens ....................................................................................................................... 43
Dietary – Utensil and Dishware Management ..................................................................................... 43
Page2 Dietary – Infection Control ..................................................................................................................... 43
Dietary – Resident Safety in the Kitchen .............................................................................................. 45
Dietary – Food Delivery and Storage .................................................................................................... 45
Dietary – Food Preparation .................................................................................................................... 49
Dietary – Kitchen Workflow Maps ........................................................................................................ 58
Housekeeping ........................................................................................................................................... 63
Laundry ..................................................................................................................................................... 64
Clinical – Reporting and Communication ............................................................................................ 66
Clinical – Care planning .......................................................................................................................... 67
Clinical – Medication Administration ................................................................................................... 68
Clinical – Treatments ............................................................................................................................... 69
Clinical – Emergency ............................................................................................................................... 69
Clinical – Nursing Rounds...................................................................................................................... 69
Clinical – MDS .......................................................................................................................................... 70
Clinical – Personal Care .......................................................................................................................... 71
Clinical – Nursing Care ........................................................................................................................... 71
Clinical – Responsibilities by Shift......................................................................................................... 72
Therapy – OT/PT/Speech ...................................................................................................................... 73
Engagement/Enrichment ....................................................................................................................... 73
Medical Records ....................................................................................................................................... 73
Family/Visitors ........................................................................................................................................ 73
Equipment ................................................................................................................................................. 74
Training Plan ............................................................................................................................................ 75
Waivers ...................................................................................................................................................... 77
Appendix A – Housekeeping Schedules & Proceedures ................................................................... 78
Page3 Overview
The purpose of the operating plan is to outline the interface between the operational processes
and the architecture, and to assist all staff to understand the way a small house is intended to
run. This plan is meant to act as a resource and it is used during orientation to assist staff in
understanding the operation. A copy of the operating plan is kept online so that staff may easily
access needed information. The plan is updated by the administrator whenever an element of
the operation changes. This guide should allow individuals who have never worked in a small
house environment to understand the intended operation of the Our Island Home Small
Houses.
The Our Island Home operating plan as submitted is subject to review and revision by the Our
Island Home implementation team. The architectural team that is assigned to create
construction drawings should fully review the operating plan to assure the incorporation of
necessary architectural elements. This document is provided for internal use only and any
circulation external to the town of Nantucket in written or electronic form is limited to the
architectural team.
Page4 Philosophy
The small house is a home for 10 residents that provides support with activities of daily living,
and good chronic disease management. The approach is meant to give equal weight to all
aspects of the holistic person, not to uphold physical/medical needs as the major need of the
individual. The resident’s choices are important and honored.
Page5 Guiding Principles
Small house person-centered care is a holistic approach which honors:
Care Partnership
Together with residents we agree on the care that is provided to ensure a high quality of life.
Individuality
Individuals are honored for their culture, history, beliefs, values, and unique preferences.
This may mean serving each person in a different way.
Choice
People should direct their own lives and have control of their personal space. Decisions are
not directive, but rather discussed in partnership.
Privacy & Dignity
Private information is protected, private space honored, and everyone in the house is
treated with respect at all times.
Security
Residents, staff, and families will feel safe and secure.
Community
We build community with residents, staff, family, and neighbors. We engage through
traditions, spontaneity, friendship, spirituality, celebration, recreation, creativity, and
humor.
Enjoyment
Life should be fun. Together we strive to make every day meaningful and enjoyable.
Page6 Architecture – Floor Plan
Page7 Administration – Time and Attendance
The administration will create a master schedule for each house. Every two weeks, the house
team will review the upcoming master schedule and will adjust the schedule based on the
known needs of individual staff. The scheduling coordinator in the house will enter the
adjustments into the schedule. Special house scheduling meetings will be held in September to
discuss holiday schedules and in March to discuss vacation schedules.
Timekeeping
Staff members will report to their house sign into the house computer and access the
time and attendance program using their password and record their arrival time. When
leaving, staff will again sign into the house computer access the time and attendance
program and record their departure time.
Callouts
As soon as an individual is aware of the need to miss work, they will utilize the
scheduling software to alert their colleagues to their intended absence and arrange for
coverage, and they will also call their assigned house to advise them of their absence. If
this staff member is dealing with a true emergency they will call their assigned house
and the house will notify the Director of Nursing. If the absence is less than four hours
before the beginning of the shift, they will also call their assigned house to notify them
of their potential absence. The scheduling software alert will be managed by the Director
of Nursing, or designee.
Breaks
If a team member works six or more hours in a shift, they are entitled to an
uninterrupted 30-minute break and one 15-minute break. Break times are determined by
the needs of the residents and current workflow in the house. One team member must
always be present in the house. Care partners on the day and evening shift will notify
their house coworker before leaving for break. Nurses will notify house teams that they
are on break or place their phones on call forward to another nurse. On the 11 to 7 shift
the nurse will cover break times in each house. All breaks must be taken outside of the
house and staff will log into the time and attendance system at the beginning and end of
their breaks.
PTO
Paid time off must be requested as far as possible in advance of desired date. The
duration and timing of scheduled time off is based on the needs of the house and how
many other staff members have requested time off during the same time period. PTO is
approved based on established criteria and should be submitted through the electronic
scheduling program.
Page8 Administration – Security/Visiting
The lobby door of Our Island Home will be secured from 6 PM to 6 AM. A remote monitoring
video system will allow staff to be alerted by the doorbell to identify the visitor and remotely
unlock the door. The front door of each house will be locked with key card access. All visitors
must knock or ring the doorbell and a staff member a resident will answer the door and
determine if it’s a known person. Visitors for business purposes should contact the Guide who
will arrange visits to the houses.
Administration – Mail
Change of address cards will be completed for each resident listing the building street address
and the house number where the resident lives. The building central reception area will house
one mailbox for each small house and an outgoing mail slot. A mail key (e.g. Mail House 1)
with a labeled bulky keychain will be in the pantry of the kitchen. After the lunch meal on
Monday through Saturday, one care partner from each house locates the key and picks up the
mail and distributes it to each resident in their room. The administrator will retain copies of the
mailbox key.
Administration – Resident Accounts
Resident accounts are managed by the administrator or their designee in accordance with the
facility policy.
Page9 Administration – Communication
Staff
The administration will communicate with staff via email and electronic messaging
board. No memos will be posted.
Families
The administration will communicate with families in the most effective method as
designated by the family. Before transition to the houses, family members will indicate
their preference of either email or letter. An electronic messaging board for families may
also be implemented if the families would like to participate.
Administration – Committees/Work Groups
The administration will include care partners and staff nurses in all committees as appointed
members for the usual terms and to all work groups.
Administration – Offices
The small house leadership model is embedded leadership, that is the leaders are committed to
80% of their time spent in the work arena with residents and staff than 20% of their time or less
on paperwork and office responsibilities. This is accompanied by primarily electronic workflow
which allows leaders to house their work on their laptops. A hoteling office is provided along
with the conference room. The hoteling office contains a shredder, printer, fax, copier, and
charging stations as well as individual lockers for all the leadership team members. Leaders are
free to use office space at their convenience. And electronic calendar will be maintained for the
use of the conference room. Leadership staff are also free to use any space within the houses to
complete work. The dance in the houses are available for small group meetings as well as
meetings with families.
Page10 Human Resources Hiring
The Human Resource Director will follow all the organizational policies and procedures and
other pertinent agreements including the union contract.
A collaborative process is followed for interviewing. Candidates who have met the
requirements for hire visit the house where the vacancy exists and spend time with residents
and staff of the house usually over coffee and snacks. The meeting is established for time that
the household can accommodate. All staff who participate must have received interview skills
training and guidelines for legal interview before meeting with candidates. It is made clear to
the candidates that the purpose of the visit is to meet the residents and staff in the house where
they may be working, and that the human resource leader/hiring manager will be seeking
feedback from the house and residents.
After the visit a brief discussion is held with the staff and the hiring manager. The decision to
hire is made by considering all information presented about all potential candidates and
includes but is not limited to the information provided by the house team. The final decision is
made by the hiring manager.
Page11 Job Description – Medical Director1
The Medical Director is responsible for serving as the physician leader who works in
collaboration with the administrator, DON and other professionals to assure the provision of
excellent medical care in the small houses.
The Medical Director:
Serves as the physician responsible for the overall care and clinical practice carried out
at the facility.
Applies clinical and administrative skills to guide the facility in providing care.
Helps the facility develop and manage both quality and safety initiatives, including risk
management.
Provides information that helps others (including facility staff, practitioners, and those
in the community) understand and provide care.
Participates in administrative decision-making and recommends and approves relevant
policies and procedures.
Organizes and coordinates physician services and the services provided by other
professionals as they relate to patient care.
Participates in the process to ensure the quality of medical care and medically related
care, including whether it is effective, efficient, safe, timely, patient-centered, and
equitable.
Participates in developing and disseminating key information and education.
Participates in the surveillance and promotion of employee health, safety, and welfare.
Helps articulate the long-term care facility’s mission to the community.
Participates in establishing policies and procedures for assuring that the rights of
individuals (patients, staff, practitioners, and community) are respected.
Acquires and applies knowledge of social, regulatory, political, and economic factors
that relate to patient care and related services.
Supports and promotes person-directed care.
Communicates regularly with the administrator, the director of nursing, and other key
decision makers in the nursing home and provides leadership needed to achieve
medical care goals.
Participates in the development and periodic evaluation of care-related policies and
procedures.
Guides and advises the facility’s committees related to quality assurance/performance
improvement, pharmacy, infection control, safety, and medical care.
1 The Nursing Home Medical Director: Leader & Manager, White Paper, AMDA March 1, 2011
Page12 Participates in licensure and compliance surveys and interacts with outside regulatory
agencies.
Informs medical staff about relevant policies and procedures, including updates.
Collaborates with the administrator to identify a job description that clearly defines roles
and functions in the facility.
Stays informed about factors that affect long-term care and incorporates relevant
information about social, medical, and fiscal issues into policies and procedures.
Helps the facility develop or incorporate policies and procedures and utilize pertinent
strategies to effect and manage change.
Organizes, coordinates, and monitors the activities of the medical staff and helps ensure
that the quality and appropriateness of services meets community standards.
Helps the facility arrange for the availability of qualified medical consultative staff and
oversees their performance.
Assures coverage for medical emergencies and participates in decisions about the
facility’s emergency equipment, medications, and supplies.
Collaborates with the DON and other clinical managers to help ensure that practitioners
in the facility have adequate support from staff to assess and manage the patients (e.g.
when they are making patient rounds or responding to calls about changes in
condition).
Develops and periodically reviews and revises, as indicated, policies that govern
practitioners in the facility other than physicians, including physician assistants and
nurse practitioners; and guides the facility regarding the professional qualifications of
other staff related to clinical decision making and the provision of direct care.
Guides the administrator in documenting the credentials of the facility’s practitioners.
Collaborates with the facility to hold practitioners accountable for their performance and
practice, including corrective actions as needed.
Develops and periodically reviews and updates, as needed, key documents governing
physician services, such as by-laws or rules and regulations.
Helps the facility establish affiliation agreements with other health care organizations
and helps the facility establish effective outside relationships; for example, with
regulatory agencies, various professional groups, insurers, ambulance companies, and
emergency medical systems.
Helps support the care-related activities of the interdisciplinary team.
Helps the facility ensure that its medical records systems meet the needs of patients and
practitioners.
Helps the facility ensure adequate documentation of patient care and related
information.
Advises the facility on interacting with utilization review organizations.
Develops policies and procedures related to activities of health care trainees within the
facility (e.g. physicians in residency programs, medical students).
Advises the facility about the appropriateness of admissions and transfers, including
related orders and the facility’s case mix.
Advises and supports the practitioners and the facility regarding family issues; for
example, concerns about the appropriateness and timeliness of the care.
Page13 Participates in monitoring and improving the facility’s care through a quality assurance
and performance improvement program that encourages self-evaluation, anticipates and
plans for change, and meets regulatory requirements.
Applies knowledge of state and national standards for nursing home care to help the
facility meet applicable standards of care.
Monitors physician performance and practice.
Helps ensure that the facility’s quality assurance and performance improvement
program and addresses issues that are applicable to the quality of patient care and
facility services.
Helps the facility use the results of its quality assurance and performance improvement
program findings, as appropriate, to update and improve its policies, procedures, and
practices.
Participates in quality review of care, including (but not limited to) areas covered by
regulation (e.g. monitoring medications, laboratory monitoring).
Helps the facility interpret and disseminate information gained from the quality
assurance and performance improvement program in a form that is useful to patients,
family members, staff members, attending physicians, and others as appropriate.
Helps the facility consider the feasibility and appropriateness of any proposed research
projects and helps ensure that they meet pertinent standards and contain appropriate
safeguards.
Periodically reviews admission, transfers, and discharges of patients.
Helps the facility identify private and public funding for research activities.
Provides medical leadership for research and development activities in long-term care.
Includes physician input in identifying and applying quality assurance standards.
Sustains his or her professional development through self-directed and continuing
education.
Helps the facility educate and train its staff in areas that are relevant to providing high
quality patient care.
Serves as a resource regarding geriatric medicine and other care-related topics, and
helps the staff and practitioner identify and access relevant educational resources (e.g.
books, periodicals, articles).
Informs attending physicians about policies and procedures and state and federal
regulations, including updates.
Participates in the development, organization, and delivery of education programs for
patients and patients’ families, board members, and the community at-large.
Encourages the facility to support staff membership in professional organizations.
Contributes to facility publications, as appropriate.
Supports educational opportunities within the nursing home for trainees in the health
care professions.
Helps the facility foster a sense of self-worth and professionalism among employees.
Advises the facility about infectious disease issues related to employees.
Helps the facility identify, evaluate, and address situations that increase the risk of
employee injury and illness.
Helps the facility implement a program to identify job requirements and assess
employee capabilities relative to those requirements.
Advises the facility's safety committee, in areas where medical expertise is helpful.
Page14 Advises the facility on establishing and implementing employee wellness programs (e.g.
weight reduction, stress reduction, cholesterol reduction, blood pressure reduction,
nutrition, exercise).
Guides the facility in developing and implementing programs for employees
experiencing physical, social, or psychological problems.
Advises the facility on policies related to the health and safety of staff, visitors, and
volunteers.
Advises the facility on preventing and managing employee injuries.
Helps the facility identify and utilize collaborative approaches to health care, including
integration with community resources and services.
Acts as an advocate for the facility, encourages and facilitates community involvement
in the activities of the facility, and helps the facility educate the community about its
capabilities and services.
Participates in the activities of geriatrics and long-term care committees of medical
organizations and identifies issues and seeks solutions to problems that involve other
institutions and programs.
Participates in health care planning in the community, including innovative cost-
effective alternative health care programs for long-term care.
Serves as a mentor to physicians-in-training within the facility.
Helps the facility address and communicate regarding situations that have brought the
facility to the attention of the public and/or the media.
Meets with other long-term care professionals in the community as appropriate.
Helps the facility ensure that its policies and practices reflect and respect resident rights,
including the opportunity for self-determination; e.g. via tools such as living wills and
durable powers of attorney.
Helps the facility ensure that the ethical and legal rights of residents (including those
who lack decision-making capacity, regardless of whether they have been deemed
legally incompetent) are respected. This includes the right of residents to request
practitioners to limit, withhold, or withdraw treatment(s).
Helps the facility accommodate patients’ choice of an attending physician.
Participates in the activities of the institutional biomedical ethics committee and
identifies community resources that can assist in resolving ethical and legal issues.
Helps the facility establish a system for identifying and reporting abuse, as well as
criteria for identifying potential abuse among both residents and staff.
Helps the facility identify and use available community resources to help address ethical
issues (e.g. ombudsman, health department, ministerial association).
Participates, when necessary, in family meetings and similar activities to help the facility
and attending physicians promote and protect resident rights.
Helps the facility identify and provide care that is consistent with applicable social,
regulatory, political, and economic policies and expectations.
Helps the facility identify, interpret, and comply with relevant State and Federal laws
and regulations.
Seeks and disseminates information about aging, long-term care, and geriatric medicine
to the facility's practitioners, staff and residents.
Page15 Helps the facility make decisions about resource allocation including financial
considerations that affect medical care (e.g. use of formularies, contracts, appropriate
use of lab tests).
Participates in the facility budget process to help the facility allocate sufficient resources
for essential medical functions and patient care activities.
Provides feedback, as appropriate, to legislators and public policy makers about existing
and proposed laws and regulations.
Oversees clinical and administrative staff, to help maintain and improve the quality of
care including the success of person-directed care and patient and family satisfaction
with all aspects of the care.
Guides the physicians and other health care professionals and staff to provide person-
directed care that meets relevant clinical standards.
Collaborates with facility leadership to create a person-directed care environment while
maintaining standards of care.
Helps the facility encourage active resident participation in, and promotes the
incorporation of resident preferences and goals into development of, a person-directed
plan of care.
Helps the facility develop, implement, and review policies and procedures that ensure
residents are offered choices that promote comfort and dignity (e.g. choices regarding
awakening, sleep, and medication administration times, discussions of risks/benefits
regarding therapeutic diets, medications and treatments).
Collaborates with the interdisciplinary team (IDT), families, and allied services within
and outside of the organization to encourage planning, implementing, and evaluating
clinical services to maximize resident choice, quality of life, and quality of care.
Page16 Job Description – Licensed Nursing Home Administrator (Guide)
The Guide is responsible for oversight on all aspects of the creation of a home for people who
live in the small houses.
The Guide will ensure excellence in care and services by:
Leading all staff to consistently incorporate resident autonomy, dignity and choice as
core values in their service delivery.
Holding staff accountable to providing and promoting services that support
independence and holistic wellness.
Ensuring that residents are involved in decision making at all levels of care; “nothing
about me without me” approach.
Ensuring that decisions are made using the “at-home” principles.
Establishing and leading a collaborative quality assurance and compliance monitoring
program.
Establishing and maintaining positive productive relationships with families and
community members.
Conducting regular resident satisfaction rounds and listening sessions to evaluate
effectiveness.
Promoting, expecting and role modeling an “all hands on deck” approach to meeting
resident needs.
The Guide will ensure organizational excellence by;
Maintaining high standards of business and ethical conduct in accordance with
applicable federal, state and local laws and regulations including fraud, waste and
abuse.
Collaborating with his/her team to develop, administer and monitor facility budget.
Meeting or exceeding established financial targets, including census levels, without
compromising resident care.
Collaborating with his/her team to develop, implement and monitor evidence-based
facility policies, procedures and programs to provide quality service to all stakeholders.
Complying with D.P.H., JCAHO, OSHA and other local, state and federal regulations
and monitors that other personnel do the same.
Gathers robust data to measure outcome effectiveness.
Page17
The Guide will ensure excellence in staffing by:
Creating a participatory democratic organization by ensuring that staff, residents and
families are members of all committees and work groups.
Effectively articulating and demonstrating the organizational vision, mission, and
values.
Collaboratively with others hiring and developing staff who are qualified, aligned with
the person-centered vision of the organization and willing to accept empowerment and
opportunities for growth.
Interacting with all staff members in a manner that is respectful and collaborative.
Mentoring nurturing and fostering growth in all staff.
Inspiring high performance through words and actions.
Providing tools and resources to empower staff members to deliver excellent holistic
care.
Collaborates with the staff development team and other staff members to assure that the
program meets organizational and personal development needs.
Maintain conditions that foster high levels of staff satisfaction and low turnover
Collaboratively problem solving issues which obstruct any of the desired outcomes.
Conducting regular listening sessions with staff to hear their opinions about the
effectiveness of programs and his/her leadership.
Holding all staff to high performance standards, maintaining strong processes to
identify sub-performers and following the coach them up or coach them out
performance coaching model.
The Guide will ensure that the environment is safe for all stakeholders by:
Keeping staff informed on OSHA, CDC and other environmental agency guidelines and
updates.
Ensuring that policies and practices are updated to reflect new regulations.
Monitoring staff to validate that all safety, security, infection control and hazardous
materials policies and procedures and being followed.
Verifying that all required emergency management plans are current and that staff have
the knowledge and understanding of these plans.
Actively participates in drills, reviews, safety initiatives, and provides education as
needed.
Conducting routine interdisciplinary safety rounds.
Monitoring compliance with all food safety requirements.
Ensuring that all staff have access to an adequate supply of safety equipment and is
using it as required including lifts, gait belts, and PPE.
Page18
Skills & Knowledge:
Administrative experience and expertise.
Robust fiscal planning and management skills.
An advanced understanding of organizational development.
A collaborative work style which rejects bureaucracy.
A focus on embedded and participatory leadership—working alongside the team.
An understanding of how the ‘change process’ affects people.
Excellent observational skills.
Excellent time management skills.
Advanced computer skills.
A passionate commitment to achieving excellence.
Tact and humor.
A passion for continuous improvement.
Page19 Job Description – Director of Nursing
The Director of Nursing (DON) is responsible for all aspects of the clinical care of residents who
live in the houses.
The DON will ensure excellence in care and services by:
Leading all clinical staff to consistently incorporate resident autonomy, dignity, and
choice as core values in their service delivery.
Holding clinical staff accountable to providing and promoting services that support
independence and holistic wellness.
Ensuring that residents are involved in clinical decision; “nothing about me without
me” approach.
Ensuring that clinical decisions are made using the “at-home” principles.
Participating in a collaborative quality assurance and compliance monitoring program.
Establishing and maintaining positive productive relationships with families and
community members.
Conducting regular clinical rounds to evaluate compliance with care plan, resident
preferences and effectiveness of outcomes.
Promoting, expecting and role modeling an “all hands on deck” approach to meeting
resident needs.
The DON will ensure organizational excellence by:
Maintaining high standards of business and ethical conduct in accordance with
applicable federal, state and local laws and regulations including fraud, waste and abuse
Collaboratively with his/her team developing, administering and monitoring the
clinical budget.
Meeting or exceeding established financial targets, including census levels without
compromising resident care.
Collaboratively with his/her team develops, implements and monitors evidence based
clinical policies, procedures and programs to provide quality service residents
Complying with D.P.H., JCAHO, OSHA and other local, state and federal regulations.
Gathers robust data to measure outcome effectiveness.
Page20 The DON will ensure excellence in staffing by:
Effectively articulating and demonstrating the organizational vision, mission, and
values.
Collaboratively, with others, hiring and developing clinical staff who are qualified,
aligned with the person-centered vision of the organization and willing to accept
empowerment and opportunities for growth.
Interacting with all staff members in a manner that is respectful and collaborative.
Mentoring nurturing and fostering growth in all clinical staff.
Inspiring high performance through words and actions.
Providing tools and resources to empower staff members to deliver excellent holistic
clinical care.
Collaborates with the staff development team and other staff members to assure that the
program meets organizational and personal development needs.
Directly providing staff development to clinical staff.
Maintain conditions that foster high levels of staff satisfaction and low turnover
Collaboratively problem solving issues which obstruct any of the desired outcomes.
Conducting regular listening sessions with clinical staff to hear their opinions about the
effectiveness of programs and his/her leadership.
Holding all clinical staff to high performance standards, maintaining strong processes to
identify sub-performers and following the coach them up or coach them out
performance coaching model.
The DON will ensure excellence in clinical care by:
Promoting a clinical philosophy that focuses on the residents (not the regulatory
agencies) as the customer.
Maintaining current clinical knowledge and skills.
Ensuring that all practices are evidence based.
Ensuring that clinical services comply with all OSHA, CDC and other CMS and
Department of Health guidelines.
Ensuring that policies and practices are updated to reflect new regulations.
Monitoring staff to validate that all safety, security, infection control and hazardous
materials policies and procedures and being followed.
Ensuring that there are adequate numbers of well-trained, consistently assigned clinical
staff.
Ensuring that staff have an adequate supply of the materials and equipment required to
meet the need of the residents.
Monitoring admissions to ensure that residents are placed in the level of care which
meets their clinical needs.
Oversees the effectiveness of the care planning process including the MDS, and care
planning meetings which include the resident and care partner.
Validating that the care plan is
Page21 Skills & Knowledge:
Current Commonwealth of Massachusetts license as a registered nurse.
Gerontological nursing skills.
Understanding of current nursing theory and research including evidence-based
practice.
Advanced computer skills.
A collaborative work style which rejects bureaucracy.
A focus on embedded and participatory leadership—working alongside the team.
An understanding of how the change process affects people.
Excellent observational skills.
Excellent time management skills.
Advanced computer skills.
A passionate commitment to achieving excellence.
Tact and humor.
A passion for continuous improvement.
Page22 Job Description – Nurse
The small house nurse provides person-centered, rehabilitative, holistic care and chronic
disease management to residents in small houses. Each nurse serves all residents needs in the
assigned houses with an in depth focused responsibility on a small group of assigned residents.
The nurse provides clinical leadership in their assigned houses and assures that staff are
providing care per the care plan.
The Nurse will assure excellence in staffing by:
Interacting with all staff members in a manner that is respectful and collaborative.
Mentoring nurturing and fostering growth in all clinical staff.
Inspiring high performance through words and actions.
Providing tools and resources to empower staff members to deliver excellent holistic
clinical care.
The Nurse will ensure excellence in care and services by:
Leading all clinical staff to consistently incorporate resident autonomy, dignity, and
choice as core values in their service delivery.
Holding clinical staff accountable to providing and promoting services that support
independence and holistic wellness.
Ensuring that residents are involved in clinical decision making
Ensuring that clinical decisions are made using the “at-home” principles.
Participating in a collaborative quality assurance and compliance monitoring program.
Establishing and maintaining positive productive relationships with families and
community members.
Conducting regular clinical rounds to evaluate compliance with care plan, resident
preferences and effectiveness of outcomes.
Promoting, expecting and role modeling an “all hands on deck” approach to meeting
resident needs.
Page23 Duties:
Willing to promote standards
Collaborates with the care partners in planning resident care.
Conducts clinical rounds on every assigned resident every day.
Based on outcome of rounds adjusts care
Plans and provides feedback and guidance to care partners.
Leads quality assurance and infection control in the houses as assigned.
Provide care to meet resident needs including direct care, medication administration,
and treatments.
Participates in house work, including cooking cleaning and laundry as needed to meet
resident needs.
Participates in the Clinical Team meetings.
Collaborates with all members of the interdisciplinary team to assure holistic wellness.
Collaborates with the physician and pharmacist to manage resident medications.
Contributes to the community’s education and growth by providing teaching as needed.
Acts as a care manager - conducts assessments, leads care planning and manages family
expectations for the residents who are assigned to them as their residents.
Contacts the primary family member as needed and change
Participates as needed in house resident listening sessions.
Skills and Knowledge:
Current Commonwealth of Massachusetts license as a registered nurse or licensed
practical nurse.
Experience in geriatric nursing.
Willing to promote standards of person-centered care
Strong computer skills.
Good organizational and multitasking ability.
Critical thinking.
Page24 Job Description – Care Partner (CNA)
Care Partners are responsible for the delivery of holistic resident centered, resident-directed
care that promotes maximization of function, resident autonomy, and choice. The
responsibilities of the Care Partner also include care of the elder and the residents’
environment, including cooking, laundry, and housekeeping.
The Care Partner will ensure excellence in care and services by:
Recognizing the autonomy and dignity of all residents.
Communicating a sense of caring, concern, and dignity for residents.
Placing decision-making in the hands of the residents whenever possible and appropriate.
Making prompt and accurate judgments about elder care and emergencies.
Following the care plan and the direction of the clinical support team in all matters related
to nursing care and services.
The Care Partner will ensure organizational excellence by:
Complying with all policies and procedures of the organization.
Participating in the quality assurance program.
Serving on committees and workgroups.
The Care Partner will ensure excellence in staffing by:
Excellent attendance.
Reporting to work on time.
Attending weekly team meetings.
Following the organizational Code of Ethics.
Working collaboratively with all staff members in the house.
Communicating with all in a respectful manner.
The Care Partner will ensure that the environment is safe for all stakeholders by:
Knowing and following all emergency procedures.
Maintaining a lift free care environment.
Following safe chemical handling practices.
Following all infection control guidelines.
Using Personal Protective Equipment as required.
Reporting any safety concerns immediately.
Page25
Duties:
1. Listening to and giving reports.
2. Providing care to residents accordingly by assisting with ADLs as needed.
3. And outlined in the resident’s care plan. Personal care may include shower/bath,
shampoo, perineal care, oral hygiene, positioning, nails short and clean, dressing, range
of motion, ambulation and insure adaptive devices are worn (i.e. dentures, hearing aids,
glasses, etc.).
4. Observing residents and reporting any reactions or changes in condition to the nurse.
5. Conduct menu planning meetings with residents using menu planning software.
6. Preparing and serving meals, and snacks between meals, bedtime and other nutritional
snacks per the stated preferences of the elder.
7. Cleaning up after meals and snacks.
8. Laundering resident’s personal clothing.
9. Cleaning and maintaining the environment of the home following housekeeping
schedules.
10. Documenting care as required in the electronic medical record.
11. Performing other related duties as required by the elder.
12. Participates in the collaborative care planning meeting with the clinical support team
and the elder.
13. Identifies and honors resident choices in activities of daily living while maintaining
resident safety.
14. Attends and participates in team meetings.
15. Provides engagement and activities for residents.
16. Reporting accidents and incidents when they occur.
17. Maintaining a lift free environment.
18. Annually attends all required educational programs per administrative policies and
procedures.
19. Maintains required certification.
Skills and Knowledge:
1. Maintain Certified Nurse Assistant (C.N.A.) certification as required by the State of
Massachusetts.
2. ServSafe® certification as required by the State of Massachusetts.
3. C.P.R.
4. First aid training.
5. Participates in Dementia care training.
6. Computer skills–MS word, Internet, e-mail, electronic medical records.
7. Culinary skills.
Page26 Job Description – Dining Leader
The dining leader is responsible for the management of all aspects of food service in the houses,
including elder satisfaction with meals and food, compliance with all practices that promote
food safety and prevent food-borne illnesses and they ensure that all dining policies and
procedures, D.PH. regulations and ServSafe® standards are met in the house kitchen including
house kitchen sanitation; food and equipment temperature logs.
1. Conducting and recording outcomes of rounds in each kitchen 3-5x per week to ensure
that:
a. All food is stored, dated and maintained properly
b. All equipment is clean, and operating correctly
c. All temperature logs are being accurately maintained
d. Par-cooked food levels are on hand
e. Menus are being followed
f. Substitution records are being maintained
2. Providing education and remediation to staff in the houses.
3. Engage residents in discussions regarding food satisfaction at least weekly.
4. Monitor the kitchen during food preparation for compliance with standards of safe
practice.
5. Complete the Food Service observation checklist weekly and discuss outcomes with the
guide.
6. Review temperature logs daily.
7. Review substitution logs daily.
8. Present food service observation/compliance report at the team meeting.
9. Review resident satisfaction with food weekly.
10. Conduct the weekly menu planning meeting with the residents and forward the
proposed menu to the dietician for review, discussion and approval.
11. Order food supplies based on the menu.
12. Monitor compliance with food storage including dating, and disposal of expired
product.
13. Report any staff performance issues to the administrator for intervention.
Skills and Knowledge:
Experience successfully managing a food service program.
Certification as a dining manager.
Knowledge of all local state and federal regulations regarding dining and food safety.
Page27 Job Description – Administrative Nurse
The small house Administrative Nurse provides person-centered, rehabilitative, holistic care
and chronic disease management to residents in small houses. The nurse provides clinical
leadership the houses and ensures that staff are providing care per the care plan.
The Administrative Nurse will ensure excellence in staffing by:
Interacting with all staff members in a manner that is respectful and collaborative.
Mentoring nurturing and fostering growth in all clinical staff.
Inspiring high performance through words and actions.
Providing tools and resources to empower staff members to deliver excellent holistic
clinical care.
The Administrative Nurse will ensure excellence in care and services by:
Leading all clinical staff to consistently incorporate resident autonomy, dignity and
choice as core values in their service delivery.
Holding clinical staff accountable to providing and promoting services that support
independence and holistic wellness.
Ensuring that residents are involved in clinical decision making; “nothing about me
without me” approach.
Ensuring that clinical decisions are made using the “at-home” principles.
Participating in a collaborative quality assurance and compliance monitoring program.
Establishing and maintaining positive productive relationships with families and
community members.
Conducting regular clinical rounds to evaluate compliance with care plan, resident
preferences and specific clinical outcomes including skin management, infection
control compliance, and falls management.
Completes resident assessment using the MDS.
Coordinates the care planning meetings and assures that care plans meet resident
needs.
Promoting, expecting and role modeling an “all hands on deck” approach to meeting
resident needs.
Page28
Collaborates with the clinical team in planning resident care.
Conducts clinical rounds daily.
Based on outcome of rounds collaborates with team to adjusts care plans and provides
feedback and guidance to care partners.
Leads quality assurance process and committee
Participates in house work, including cooking cleaning and laundry as needed to meet
resident needs.
Collaborates with all members of the interdisciplinary team to assure holistic wellness.
Evaluates the educational needs of staff.
Coordinates the community’s education and growth by providing teaching to groups
and individual coaching as needed.
Assures staff compliance with mandatory educational requirements
Participates as needed in house resident listening sessions.
Skills and Knowledge:
Current Commonwealth of Massachusetts license as a registered nurse or licensed
practical nurse.
Experience in geriatric nursing.
Willing to promote standards of person-centered care.
Strong computer skills.
An understanding of the adult learning process.
Excellent organizational and multitasking ability.
Critical thinking.
Page29 Job Description – Social Worker
The social worker is responsible for assessment and planning to meet the psychosocial needs of
the small house residents.
The Social Worker will ensure excellence in care and services by:
Leading all staff to consistently incorporate resident autonomy, dignity and choice as
core values in their service delivery.
Coaching staff to assist them in providing and promoting services that support
independence and holistic wellness.
Facilitating resident involvement in decision making at all levels of care; “nothing
about me without me” approach.
Ensuring that decisions regarding psychosocial needs are made using the “at-home”
principles.
Establishing and maintaining positive productive relationships with families and
community members.
Promoting, expecting and role modeling an “all hands on deck” approach to meeting
resident needs.
Duties:
Serve as a champion for the resident voice in all matters; “nothing about me without
me” approach.
Understand and support implementation of policies and procedures regarding resident
choice.
Manage admission and discharge coordination.
Complete psychosocial assessments on new residents and has needed on existing
residents.
Provide at transition support program for new residents.
Gather resident life history’s and discuss and role model for staff they use in resident
interactions.
Provide individualized psychosocial support for residents with psychosocial needs
including depression, and mental health diagnoses.
Provide family support individually or in support groups.
Skills and Knowledge:
An educational degree in social work.
Experience in geriatric social work.
Understanding of and support for person-centered holistic care.
Strong computer skills.
Page30 Job Description – Dietitian
The Dietitian will insure excellence and safety in food services by:
Assisting in planning organizing implementing and evaluating food service.
Completes routine and problems centered nutritional assessments.
Reviews menus that residents in the houses have created and suggests changes that
might improve the choices as they relate to a balanced diet.
Provides nutritional education to residents as needed.
Respects the decisions of residents regarding all aspects of their dietary choices.
Skills and Knowledge:
Bachelor’s degree in food and nutrition from an accredited institution.
Registration with the American dietetic Association and licensure in the Commonwealth
of Massachusetts.
Experience in a skilled nursing facility.
Understanding and support for person-centered holistic care.
Strong computer skills.
Page31 Job Description – Life Enrichment Worker
The Life Enrichment Worker will ensure excellence in engagement and socialization
opportunities by:
Consistently incorporating resident autonomy, dignity and choice as core values in
their programs and services.
Coaching staff to assist them in providing and promoting engagement and socialization
opportunities that support independence and holistic wellness.
Facilitating resident involvement in decision making regarding calendars and
programming; “nothing about me without me” approach.
Duties:
Conduct individualized assessments on each resident to understand known recreational
preferences and life patterns of engagement and socialization.
Enrich the house environment with specific opportunities for engagement.
Create socialization programs and opportunities for the individual houses which can be
regularly delivered by care partners.
Create large group programs for entertainments, education or socialization which are
open to all houses.
Create individual engagement plans based on resident assessment.
Obtain the necessary materials and supplies for the individual resident.
Skills and Knowledge:
Understanding and support of person-centered care and resident choice.
Education and experience per Commonwealth of Massachusetts requirements.
Strong computer skills.
Page32 The Care Partner Empowered Work Team
Life in the house is organized around the needs and lives of the residents who live there. The
constant companion of the elder is the care partner. It is the duty of the care partner to protect,
to nurture and to sustain the elder. Care partner are responsible for maintaining the safety and
cleanliness of the environment and for providing high quality of care.
Each care partner in the house is an equal member of the empowered team. The team meets
weekly to plan and discuss their work. The meeting is held in the house. Each house will have a
bulletin board where both an agenda and a reminder about the date and time of the meeting
will be posted.
Members of the Clinical Support Team and the Guide may attend the team meeting at the
invitation of the care partners only, but they may post agenda item, which they would like to
have the Care partner discuss. Agenda items added by individuals must be signed so that the
team can provide appropriate feedback after the meeting.
elder
food
coordinator
houskeeping
coordinator
team
coordinator
scheduling
coordinator
Page33
At the first meeting each month, the following positions are filled by mutual agreements of the
care partners. These positions must rotate among house members and no one can serve in a role
for more than two consecutive months.
Team Coordinator
The role of the Team Coordinator is to monitor the team's compliance with care plans,
and their effectiveness at meeting the care needs of the residents.
The Care Coordinator will be responsible for checking that care and documentation has
been completed as outlined in the care plans of the residents. They act as liaison between
the team, all other members of the staff, including the clinical support team and the
guide. They conduct all the team meetings, and communicate team decisions to team
members and to others as needed. They will arrange House Council meetings—resident
listening sessions.
Food Coordinator
The role of the Food Coordinator is to organize and conduct the weekly menu planning
meeting, coordinate the ordering of the food, monitor the freshness and adequacy of the
food supply, oversee the needed kitchen compliance issues including kitchen cleanliness
and refrigerator and food temperatures.
The Food Coordinator will also oversee compliance with record-keeping regarding food
and be responsible for monitoring appetites and food intake of residents and for
obtaining and recording weights as outlined by the clinical support team, or as
identified as necessary by the care partner. They will also be responsible for having
meetings with the dietician to review the menus and will need to communicate weight
losses/food concerns to the appropriate members of the Clinical Support Team.
Housekeeping Coordinator
The role of the Housekeeping Coordinator is to coordinate housekeeping activities and
to monitor the cleanliness of the house.
The Housekeeping Coordinator will order necessary supplies, observe and record
information about the overall cleanliness of the house. They will also coordinate and
monitor the laundering of household items and personal items of the residents.
Page34
Scheduling Coordinator
The role of the Scheduling Coordinator is to create a schedule in collaboration with the
team that provides adequate staff coverage, while meeting the requests for needed time
off.
The Scheduling Coordinator will be contacted if the team member is sick or will be
unable to work as scheduled. It will be the responsibility of the individual care partner
to attempt to find their replacement. If they are unable to do so they will notify the
Scheduling Coordinator. If the Scheduling Coordinator is unable to find replacement
they will notify the Guide. This Scheduling Coordinator will also be responsible for
submitting appropriate time records to administration as requested.
NOTE
Each coordinator will have time on the agenda of each weekly team meeting to complete
their work. They will communicate with other members of the team and problem solve
with the Guide whenever they feel it is necessary.
The team may choose to create other temporary or permanent coordinator rolls if they
feel this would be necessary. All Coordinators reports each day to the guide and the care
and clinical coordinators also report to the clinical support Team Coordinator.
Page35 MEETING GUIDELINES
Team Meetings
Team meetings will be held weekly at a time that is convenient for all members of the
team. A standard agenda will include our reports and necessary discussion from each of
the coordinators. Decisions will be made, whenever possible by consensus, that is, all
members of the team can buy into and support the decision.
Additional agenda items may be submitted by family, residents’, Clinical Support Team
members, the Guide, or other members of the organization. A log book to record the
attendance, topics, and decisions of team meetings should be kept in each house. The
purpose of all meetings is collaboration, problem solving, and team building.
Meeting Leader: The team coordinator chairs the meeting.
Participants
Only team members and guide participate. Any non-team members attend if invited or
if they request permission to attend and it is approved by the team. If the guide or
member of the CST attends they attend as coaches and do not participate in decision
making.
Meeting Organization: Meeting times, dates, and places are agreed upon by all participants.
Agenda
Agendas for all meetings are posted in a consistent and public place by the team coordinator at
least 5 days in advance.
Meetings may not last more than one half hour.
Attending meetings by phone should be an option for off duty staff.
Anyone may add an item for discussion to an agenda but it must be signed.
The agenda is prioritized by the team coordinator before the meeting. Each agenda item
is given time assignments based on the length the meeting and the amount of time the
coordinator feels is needed for an item.
Any unresolved items are placed on the agenda for the next meeting.
After the meeting the agenda is placed in a Team Communications notebook with the
decisions reached.
Page36 The Meeting
Meeting begins and ends on time.
The first agenda item is always the reading of the team’s code of ethics.
Agenda is followed with careful attention to the rules of discussion.
Leader must end discussion of each item after the time allotted is reached—unfinished
business goes to the next meeting agenda.
Rules of Discussion
1. Agenda item is read and explained.
2. Each person in turn around the circle weighs in on the item
A person may pass if they have no comment.
No one speaks except the person whose turn it is.
No one speaks in between people’s turns.
3. Leader summarizes opinions expressed.
4. Each idea is presented for consensus.
5. Each person weighs in using.
Thumbs up - I agree.
Thumbs down - No.
Thumbs sideways – It is not my favorite idea but I can accept it, live with it and promise to
support it in all ways verbally and non-verbally.
6. If consensus is reached on several options or choices a simple vote may be taken to
determine the most popular of the ideas that received consensus.
7. When a decision is reached, it is recorded on the agenda sheet.
8. The code of ethics is used to correct any behavior that is negative, e.g. “Mary, our code
of ethics says we will be courteous and you are not being courteous to Jane.”
9. The leader may table an item and place it on the next agenda if the discussion goes
overtime, is bogged down or people become too emotional and begin to argue.
Post-Meeting Work
After the meeting, the team coordinator is responsible for contacting the individual who posted
the agenda item and giving them feedback about the discussion and decisions reached.
Page37 Beauty Salon/Barber
The Beauty Salon is in the core of the building. Stylist and barbers will collaborate with
residents and house staff to create a weekly schedule which will be placed on the house
Outlook Calendar. The stylist will supply needed products and will maintain their material data
safety sheets in collaboration with the small house guide.
Information Technology
Hardware
Laptops for each leadership team member.
1 house desktop “all in one”.
2 tablets or laptops (based on EMR selected) for care partners.
Software
E-mail for all staff.
Electronic Medical Record with scan filing or add on scan filing program.
Scheduling software with Staff interface (On shift or similar).
Electronic messaging board.
House Calendars (Outlook or similar).
Menu planning software (Living Cookbook or similar) which provides recipes with
automatic calculation of ingredient quantities based on number of individuals to be
served, automatic calculation of nutritional value of the meals, ability to create and print
a weekly menu, and the ability to generate a shopping list based on the weekly menu.
Page38 Communication Plan
Communication System
The telephone system should have an umbrella phone number for Our Island Home
with a recording that asks the caller to select their desired party. The call is forwarded
by the system to the desired party. The central telephone system umbrella phone
number should not accept messages. Voice message capacity is needed on all telephones
within the system. All voice messages must give a return call time window. Leadership
members should include their business hours and an alternate contact person’s name
and number for urgent callers.
Leadership Team
All members of the leadership team needed non-fixed telephones with voicemail
capacity.
Each House Will Have:
2 House Portable Telephones
To be carried by Care Partners. These are the public telephone numbers for the houses
which will allow families and outside individuals to call the houses. These phones
should have messaging capacity which allows staff to ignore a call when they are
engaged in providing resident care. A schedule of responding to messages should be
created. The suggested window is no longer than two hours. The phones should have
key staff phone numbers programmed into the phones including: the Administrator, the
Director of Nursing, the House Nurse, the Activities Coordinator, the Social Worker,
and Dietary Leader.
2 House Nurse Telephones
Each house nurse will carry a phone. The telephone number of this phone is not given to
families or outside individuals. It is restricted to clinical use to prevent the nurse from
receiving constant interruptions while providing clinical care. The laboratory,
physicians, x-ray providers, and house staff, and other nurses are the intended incoming
callers. The nurse phone voice message should indicate a callback window of 30 minutes
or less.
Page39 Residents’ Telephones
Residents have the option of having individual telephones in their rooms. The house
will need one telephone designated for resident use. This is a portable phone separate
from the house phone.
Resident Call System
A wireless system is utilized. It needs to have a variety of triggering options including,
pendants (bracelet & necklace), wireless wall mount, the waiver will be required by the
Department of Health for wireless system. If pendants with GPS locators are available
and affordable these assist staff in locating residents. The resident call needs to trigger
on the house staff portable telephones and should include resident and room.
Wander Guard System
The minimum system requirements for the containment of individuals who have
cognitive impairment and require a secured environment. Typically, the security is at
the building level and not the house level. This allows residents to participate
throughout the building by securing all exit doors.
Administrative Report
Census, hospital transfers, admissions, changes in condition, falls, staff injuries and
other pertinent information will be reported by staff at the time of occurrence in the
Daily Electronic Administrative Report. The administrative team will consult the
electronic report upon arrival. Follow up to any concerns is conducted in the house with
the staff in the house. The Electronic Administrative Report replaces morning meeting.
Clinical Updates
In place of morning meeting the director of nursing or designee after reading the
electronic administrative report conducts rounds in each house to follow up on items in
the administrative report.
Daily Happenings
Physician appointments, beauty salon appointments, special resident activities, and
other important happenings will be entered into the house electronic calendar. House
staff review the calendar as part of morning report. Administration, leadership,
maintenance, laundry and housekeeping also have access to the house calendars and
enter scheduled activities for the information of the house staff.
Page40 Helpdesk/IT Support
Non-urgent matters: staff will have a helpdesk icon on their device for submission of the
ticket to IT.
Urgent matters: staff will call the help desk directly at ____________________________.
Electronic medical record issues: call_____________________________________.
Resident Emergency
Staff will deploy their emergency pendants which are programmed to notify the nurse
responsible for the house.
Resident Non-emergency
Staff will send a text message to the covering nurse and when the nurse is available at
care huddle will be held which brings together the necessary team members to
communicate and brainstorm to play and meet the new needs of the resident. The nurse
is responsible for documentation of the care huddle in the clinical record and the care
plan.
House communication to maintenance/housekeeping
Telephone to preprogrammed phone number.
Resident to Staff
Listening sessions are used to share information, elicit opinions, or have general
discussion around issues or operations. Listening sessions are typically house based and
include the house team and residents. They can be led by any team member or by a
resident. They occur weekly.
Page41 Dietary – Philosophy
The meals will be prepared in the house by the care partners in the open kitchen. This is
purposeful and is focused on achieving the following outcomes:
To restore residents to the normal adult privilege of having food available at will.
To reduce unexplained weight loss. The open design provides access to foods of choice,
as well as an increase in appetite which is provoked by the stimulation created by the
sounds, sights, and aromas of meal preparation, cooking and baking.
To provide fresher food, better control of food temperatures, and easier access to
alternative choices and additional food.
To promote choice regarding meal timing, storage, and preparation of the foods
preferred by those living in the house.
To offer opportunities for resident participation in meal preparation.
To restore the privileges of home—kitchens are a critical component of the construct of
home.
Page42 Dietary – Dining Plan
The dietary dining plan is supported by the utilization of menu planning software. In
preparation for the move the dietitian and dining leader will meet with residents several
times to identify 100 main dinner items, 15 simple vegetable sides, six starch sides, 30 lunch
items, soups, and comment breakfast items. These items and their recipes are entered into
the dining software. Staff will utilize the software in their biweekly menu planning
meetings with residents.
Menus
Care Partners with the assistance of the Dining Leader and the Registered Dietician meet
with residents biweekly to create the house menu. In addition to the house menu each
house will have always available food on hand which the residents may choose to select in
lieu of the menu items. Always available items will be identified for each house based on
resident preference interviews so that the preferred foods of residents will be included in
the always available food on hand.
Breakfast
In line with the resident-centered philosophy, residents awake on their own schedule and
are served their breakfast of choice from the menu in the location of their choice. Always
available breakfast items include yogurt, pastries, hot and cold cereal. Residents' breakfasts
are prepared by house staff. Only pasteurized eggs will be used and no cooking which
produces grease laden vapors will occur in the house.
Lunch and Dinner
The main meal of the day will be served in the evening, with a lighter lunch meal at noon
time. The menu will designate the preparation method for each meal.
Page43 Dietary – House Kitchens
Each house contains a fully operational kitchen and pantry available to the Care Partners, and
other members of the care team. A Dining Leader (DL) who is ServSafe® certified will oversee
the houses’ dining operations. The DL will ensure that all dining policies and procedures, D.PH.
regulations and ServSafe® standards are met in the house kitchen including house kitchen
sanitation; food and equipment temperature logs, pantry and refrigerator par levels. The dining
leader will also monitor food storage in the refrigerator and the pantry to assure that food
storage locations, temperatures, and packaging follow food safety standards.
The (DL) will also assure that the resident has a pleasant dining experience. Care partners with
the assistance of other team members are responsible for food preparation, meal service and
assurance of a pleasant dining experience. Any member of the care team may assist in meal
functions such as serving, providing direct assistance to residents during the meal, and meal set
up and clean up. All staff will be provided with training for their assigned roles as outlined in
the appendix.
Dietary – Utensil and Dishware Management
All houses are equipped with all tableware, linens, placemats and napkins and small cooking
utensils and serving dishes. These items will remain in the house and will be cleaned and
sanitized in the house dishwasher, or laundered in the house laundry. House Care Partners are
responsible for House kitchen sanitation and will follow a checklist to guide them in
accomplishing this task. The house kitchen will be cleaned after every dining experience and
will be completely sanitized once every 24 hours by the night shift care partner.
Dietary – Infection Control
Utilizing a Care Partner to provide elder care, participate in food preparation, housekeeping,
and laundry creates the potential for cross contamination. This risk is mitigated using training
as well as policies that introduce barrier precautions utilized to prevent cross contamination.
The worker is always, from an infection control perspective considered contaminated and
therefore in need of a barrier apron during food preparation activities.
Page44 BARRIER PRECAUTIONS POLICY
Purpose
Water impermeable apron barriers are used during food preparation to prevent
transmission of disease.
Standard
Barriers will be used by all staff involved in food preparation or handling. Apron will be
impermeable to water.
Process
1. Don apron.
2. Apply hairnet or cap.
3. Wash hands.
4. Use gloves for any direct food handling.
5. Remove apron.
6. Remove hair net.
7. Disinfect and dry apron.
8. Re-hang apron.
9. Wash hands.
Page45 Dietary – Resident Safety in the Kitchen
All residents and family are required to prepare food under the direct supervision of staff. Staff
retains the responsibility for maintaining the safe practices and general compliance with all
rules in the kitchen. Drawers are secured with magnetic safety locks and the stove is an
induction stove which does not produce high levels of heat.
All chemicals are locked in a cabinet with staff maintaining the key in a safe location. Small
appliances are returned to storage after use. Active coffee pots may not be left unattended in the
kitchen. Coffee and other hot liquids are placed in carafes immediately upon completion of
brewing.
Residents may not enter the kitchen during meal preparation. Kitchen gates are closed during
meal preparation.
Dietary – Food Delivery and Storage
Receiving Deliveries
1. Confirm vendor name, day and time of delivery, as well as driver’s identification before
accepting delivery.
2. Check frozen foods to ensure that they are all frozen solid and show no signs of thawing
and refreezing, such as the presence of large ice crystals or liquids on the bottom of
cartons.
3. Check the temperature of refrigerated foods.
a. For fresh meat, fish, and poultry products, insert a clean and sanitized
thermometer into the center of the product to ensure a temperature of 41 ºF or
below. The temperature of milk should be 45 ºF or below.
b. For packaged products, insert a food thermometer between two packages being
careful not to puncture the wrapper. If the temperature exceeds 41 ºF, it may be
necessary to take the internal temperature before accepting the product.
c. For eggs, the interior temperature of the truck should be 45 ºF or below.
4. Check dates of milk, eggs, and other perishable goods to ensure safety and quality.
5. Check the integrity of food packaging.
6. Check the cleanliness of crates and other shipping containers before accepting products.
7. Reject foods that are shipped in dirty crates.
8. Reject the following:
Frozen foods with signs of previous thawing.
Cans that have signs of deterioration, such as swollen sides or ends, flawed seals or
seams, dents, or rust.
Punctured packages.
Foods with outdated expiration dates.
Foods that are out of safe temperature zone or deemed unacceptable by the
established rejection policy.
Page46
All products will be stored using the first in first out method:
Label food receipt date and expiration date and food label sticker.
Store the oldest product at the front of the stock.
Store the newest product at the rear of the stock.
Cold foods will be immediately placed in the refrigerator verifying that the internal
refrigerator thermometer reading is 41° or lower.
Before use all foods will be checked for expiration date, and discarded if expired.
Food Storage Temperature and Requirements
Food Temperature Requirements
Meat 41°F or lower
(internal temperature)
Wrap meat in an airtight moisture proof material or in clean
sanitized container
Poultry 41°F or lower
(internal temperature)
Wrapped in an airtight moisture proof material or in clean
sanitized container
Fish
41°F or lower
(internal temperature)
Keep fillets and stakes in original packaging or tightly
wrapped in moisture proof material
store frozen fish in moisture proof wrapping
Eggs and egg
products
Store fresh eggs at an
air temperature of
45°F or lower
Examine for cracks or damage before storing
Keep eggs in refrigerator until use
Dairy Store for use at 41°F or
lower.
Verify expiration date before use
Page47
Page48
Page49 Dietary – Food Preparation
Cooking Qualifications
All care partners will complete name ServSafe® course before preparing food for the
people who live in the house.
All people who live in the house will receive a kitchen orientation that includes the
basics of safe food handling before they have access to the kitchen.
All family members will have an orientation that includes the basics of safe food
handling before they have access to the kitchen.
No person who lives in the house staff or family may access the kitchen if they show signs of
any of the following:
gastrointestinal illness
infected lesion
uncovered wound or a cut
upper respiratory infection
coughing sneezing runny nose
General Safety
If unsafe conditions are seen in the kitchen or other areas of the house, correct them or
report them immediately to the guide so they can be corrected.
Promptly report to the guide all accidents that occur on the job, even if no serious injury
is apparent.
During Food Preparation, the staff will:
Use dry oven mitts when handling hot utensils.
Wear aprons,
Cook in a minimum amount of water to avoid boiling over. This also reduces the
handling problem when pouring off hot liquids
Lift lids cautiously from hot pots or steam table so that steam may escape without
scalding hands or face.
Turn the handles of pots away from the edge of the stove so that the pots will not be
knocked off. But take care that the handle is not too near an open flame.
When moving heavy containers of hot food, have adequate assistance and know where
the container may be safely placed. Be sure that the work area is clear of fellow
associates and residents before moving hot containers, etc. When drawing hot water or
coffee from an urn, turn the spigot slowly to avoid splashing. Check carefully that all
valves and spigots are in proper position before filling the urn.
Keep oven doors closed when not in use.
Do not use pan coating sprays near any flame; turn off range before using pan coating
sprays near a range.
Page50
Knives and Food Preparation:
Wear cut gloves when cleaning and using knives and equipment with blades. Wear
disposable gloves over the cut resistant gloves.
When using knives, pay attention
Cut away from the body.
When drying a knife, keep the sharp edge away from you.
Keep all knives in their proper storage place when not in use. Do not leave knives in the
sink, or where they cannot be easily seen.
Staff in houses do not sharpen knives. Outside vendor will sharpen on a regular
schedule
If a knife falls, don’t grab it. Get out of the way! The floor can take it better than a hand
or foot
Use the proper knife for the procedure, i.e., boning knives, carving knives, pairing
knives, etc.
Knives are not can openers and should not be used as such
Use a cutting board. An anti-slip mat under the cutting board will keep it from slipping
Machines Used for Food Preparations
Use machinery and tools, including knives and slicing equipment ONLY for purposes in
which they were intended.
Turn switch “off” AND UNPLUG before cleaning or adjusting any machine. Keep
fingers, hands, utensils, etc., away from moving parts. Wait until machine stops before
removing food/scraping bowl.
All electrical appliances should be in the “OFF” position before being plugged into the
outlet.
Use “film wrap cutters” on film wrap boxes.
At no time should you attempt to repair equipment. Notify your supervisor
immediately of any equipment that is faulty or not functioning properly.
Broken China and Glassware
Use care in handling glasses and dishes. Use dust pan and brush or broom to sweep up
pieces of broken glass or china. Use a dampened paper towel for cleaning up slivers of
glass or china. Use a special garbage container for broken pieces. This container must be
labeled “Broken Glass / China” and have a secured lid. Do not place broken glass in
waste paper baskets or garbage or refuse cans.
Discard all food within the vicinity that may be received shards of broken glass or china.
Glass and metal pots do not mix, so keep glass and china articles out of the pot sink.
If you know or suspect that there is broken glass or dishware in soapy water, drain the
water first. Then remove the broken pieces carefully.
Page51
Use of Chemicals
All chemicals must be maintained in a locked cabinet.
Read and follow directions thoroughly before using any chemicals.
Never mix chemicals with anything but water.
Never allow chemicals to come into contact with food.
Always wear chemical resistant goggles, gloves, aprons, etc., recommended by the
manufacturer on the MSDS sheet.
Handwashing
Food handlers must wash their hands:
As they enter and leave the kitchen.
After using the restroom.
Before and after handling raw meat, poultry, and fish.
After touching the hair, face, or body.
After sneezing, coughing, or using a tissue.
After smoking, eating, drinking, or chewing gum.
After handling chemicals that might affect the safety of the food.
After taking out the garbage.
After clearing tables.
After touching clothing or aprons.
After touching anything else that may contaminate hands such as sanitized equipment,
work surfaces, or wash cloths.
Handwashing Procedure
No hand sanitizer is used in the kitchen
1. Wet hands with running water as hot as you can comfortably stand.
2. Apply soap.
3. Vigorously scrub hands and arms for 10 to 15 seconds.
4. Clean under fingernails and between fingers.
5. Rinse thoroughly under running water.
6. Dry hands and arms with a single use paper towel.
7. Turn off sink with a fresh paper towel.
Page52
Glove Use
A supply of NSF certified gloves will be kept on hand.
Gloves are never used in place of handwashing; hands must be washed before putting gloves
on and when changing to a new pair.
Gloves should be used when directly handling food only.
Gloves should be changed:
as soon as they become soiled or torn
before beginning a different task
at least every four hours during continual use
after handling raw meat and before handling cooked or ready to eat food.
Gloves should be removed by grasping them at the cuff and peeling them off inside out over
the fingers while avoiding contact with the palm and fingers.
Thawing Frozen Foods
Frozen foods will be thawed in a manner that prevents the growth of microorganisms. No food
may ever be thawed at room temperature
The acceptable methods for thawing food are demonstrated in the chart below.
Method Technique
In the refrigerator Leave food in the refrigerator at 41°F or
lower until thawed
Running water Submerge food under running potable water
at a temperature of 70°F or lower.
Microwave oven Used thawing cycle. Food must be used
immediately after thawing
Page53
Proper Handling of Glassware Dishes and Utensils
Proper handling will prevent contamination of food2
The food contact area of plates bowls glasses or cups should not be touched.
Glasses and dishes should not be stacked when serving.
Flatware and utensil should be held at the handle.
Minimize bare hand contact with food that is cooked or ready-to-eat.
Use ice scoops or tong to get ice.
2 Drawing: ServSafe® Essentials, 4th, Edition National Restaurant Association
Page54
Serving the Meal
1. The table will be set with care and in an attractive way using placemats or a tablecloth,
cloth napkins, flatware, dishes and glassware that is residential in appearance and
weight and provide excellent contrast with the table.
2. A centerpiece will be on the table.
3. Condiments will be provided in a home like/residential fashion. No individually
wrapped items will be used except for artificial sweetener. Butter dishes, creamers,
sugar bowls or shakers, jelly jars, will replace individually wrapped items.
4. All people who live in houses will be seated at or transferred to dining chairs if possible.
5. Quiet soothing music will be played in the dining room.
6. The meal will be served family style.
7. Hand sanitizing wipes are passed to each resident before serving begins.
8. Fluids will always be the first course. (aide to swallowing)
Page55 9. Meals will be served in courses.
10. Drinks will be served from pitchers.
11. Reasonably sized serving dishes with serving utensils will be placed on a table.
12. Serving dishes are passed around the table with staff assisting residents who have
difficulty.
13. No clothing protectors are utilized- cloth napkins may be tucked at the chin for those
residents who have difficulty.
14. At the end of the meal the table is cleared an old food from the table including food in
serving dishes is discarded.
15. The care partner is present during the meal seated at the table to:
a. monitor intake
b. replenish serving dishes
c. offer alternatives if residents are not eating the meal
d. encourage fluid intake
e. observe for any contamination of food during the passing of the serving plates.
Page56 Dishwashing
1. All dishes and other items are machine washed no hand washing is permitted
2. Set all controls for operation for the machine.
3. Place detergent in the dispenser
4. Check rinse solution dispenser. Add rinse solution as necessary.
5. Pre-rinse dishes using warm water, removing all food matter and scraping it into garbage
disposal, disposable gloves are to be worn. Difficult stains such as eggs and cereal can be
pre-washed with warm detergent water. Change water as necessary.
6. Place dishes in dish rack. Avoid overloading and nesting.
7. Close door and start machine.
8. Upon completion of dishwashing, the dishwasher:
a. Empties the dishes and places in storage.
b. Cleans the dishwashing area.
c. Cleans and polishes the outside of the machine.
Dishwasher Temperatures
Temperatures will be taken once after each meal. Upon completion of a dishwashing
cycle, a Care partner will record the temperatures displayed on the dishwasher panel:
Wash, Rinse.
A sticker will be placed in the dishwasher once a week (Friday) to check for accuracy of
dishwasher temp.
Corrective Action
When temperatures are out of the range listed on the temperature logs, a Care Partner
should report it immediately to maintenance and record action taken on the temp log.
If temperatures are not adequate, Care Partner are to follow the policy and procedure
including transferring to paper products until the problem is resolved
Page57
Page58 Dietary – Kitchen Workflow Maps3
Delineation of the Clean and Soiled Sides of the Kitchen
3 the kitchen workflow maps provided are samples. When construction drawings of OIH are completed
these will need to be redone based on design.
Page59
Utilization of Sinks
The kitchen is divided into 2 work zones – the soiled side and the clean side:
The sinks on the soiled side are designated (see the diagram) for handwashing and
dishwashing.
The sink on the clean side is designated for food preparation.
Each sink is to be used exclusively for the designated purpose.
Page60
Cooking Workflow
All cooking activities are conducted on the clean side of the kitchen.
Page61
Dish Flow from Dining Room to Dishwasher
All flow remains on the soiled side of the kitchen.
Page62
After Meal or Snack Management of Food
All food that goes to the table will be thrown away. Foods that has remained in the
kitchen may be saved if holding temperatures have been maintained.
Kitchen Cleaning Schedule
Breakfast Lunch and Dinner Evening Care Partners Kitchen Deep Clean
EVERY DAY EVERY DAY SUNDAY WEDNESDAY &
FRIDAY
Wash dishes & Empty Dishwasher Sanitize sinks
Clean Dry Storage shelving
&check expiration dates and
package security
Discard all food from table Sanitize down all flat surfaces
(counters, refrigerator door)
Clean Inside
Refrigerator/Freezer
Sweep kitchen and dining room Ice and Water Dispenser
Wipe down and store appliances Mop Kitchen Water Filter (Semi-monthly)
Store leftovers Clean hood
Wipe and sanitize counters & table Clean coffee pot Outside of oven
Wipe off placemats Clean table and chairs Clean the oven on the first of
every month
Check Refrigerator and Freezer
Temperatures
Clean Microwave inside and
out Clean Toaster
Clean stovetop Wash and fold kitchen linen Clean walls
Discard expired foods Clean under ice machine
Refrigerator & dishwasher temps Ensure all food is labeled and in
proper storage containers
Page63 Housekeeping
Housekeeping responsibilities are divided between the general housekeeper and the care
partners on each shift. The schedules and checklists for the cleaning may be found in the
appendix.
Management of Trash by Type
Type Disposed of by placing where (how)
Food In kitchen garbage disposal, large food items such as
bones, stalks etc. are placed in the kitchen general trash
Paper In recycle bin in soiled utility room
Foil cans and plastic In kitchen recycle bin – then moved to soiled utility
recycle bin
Cans In kitchen recycle bin – then moved to soiled utility
recycle bin
Plastic In kitchen recycle bin – then moved to soiled utility
recycle bin
1. All recyclable items, paper, newspapers, plastic, cans cardboard and glass can be co-
mingled (placed into same container) plastic bottles cans and glass should be rinsed
before disposing
2. When recycle bin (in kitchen) is full, Care Partner will seal the bag and place it in the
soiled utility room.
3. Recyclable container should be damp wiped and new plastic liner changed as needed.
4. Recyclable items will be picked up by housekeeping staff from the soiled utility room
once per day and transported to G1 trash chute room where items will be placed in a
recycle cart.
a. Housekeeper will leave a small cart in the elevator lobby, walk in the small house,
pick up the recyclable bags in soiled utility, walk back to lobby, and place it on the
transportation cart to take to larger cart on G1.
5. When recycle cart is full, it will be pushed to large utility truck at the G2 loading dock
and placed into 8 yard holding bin. (See attached map for route to be taken to G2)
All trash flows to the soiled utility room into large containers which are removed and cleaned
and replaced on a regular basis by the maintenance staff.
Page64 Laundry
Personal Laundry
Each home has a laundry room that is equipped with a washer and dryer (see
Equipment Section). Washing machine operating instructions including detergent types
and amounts will be posted next to the washing machine and dryer operating directions
will be posted next to the dryer. Each house will create a weekly laundry schedule based
on individual resident’s needs and utilization. The schedule will be posted in the
laundry room. Each resident’s personal laundry will be placed in a wheeled laundry
hamper lined with a yellow plastic bag which is kept in the resident room.
Process
Each residents clothing will be laundered separately.
1. Staff will wheel the laundry container to the laundry area
2. Sort and pretreat any stains and placed clothing in the washer with detergent.
3. Wash the clothing in the washing machine per posted directions.
4. After clothing has been placed in the washer the sorting table shall be disinfected.
5. When washing is complete the lint trap of the dryer will be cleaned and clothes will be
placed in the dryer.
6. The soiled yellow plastic bag in the hamper is discarded
7. The inside and outside of the laundry hamper is wiped down with disinfectant, and
allowed to air dry.
8. A clean yellow plastic liner is placed into the hamper.
9. After laundry is dry and folded it is placed in the hamper and transferred to the
resident’s room where it is stored in closets or drawers.
10. At the completion of each resident’s laundry the lint filter in the dryer will be checked
and any lint removed and tops of the washer dryer and folding table are wiped down
with disinfectant wipe.
Page65
Bed Linens
Bed linens sheets towels, washcloths and gowns is supplied by the facility will be laundered in
the central laundry.
1. Staff will place soiled bed linen into blue plastic bags immediately after removing from
the bed.
2. Bags will be tied closed and brought to the soiled utility room at the end of each care
episode, they will be placed in the container labeled soiled linen.
3. Soiled linen containers will be removed twice a day by maintenance and replaced with a
clean empty container
4. The containers will be cleaned and disinfected by maintenance before being returned to
the soiled utility.
5. Clean linen will be transported in a covered cart once a day by maintenance Delivery
will be based on replenishing par levels. Once delivered linen is stored linen closets
House Linens
Napkins, Table Cloths, Placemats, pot holders and kitchen wipes are washed each night
by the night staff.
Page66 Clinical – Reporting and Communication
Shift to Shift Report
The oncoming and outgoing team (nurses and care partners) in each home will make
walking rounds and discuss resident condition, needs, and state of the house.
Care Huddles
The care needs of the resident and resident changes in condition are addressed
immediately. Any member of the team can call for a care huddle which will bring
together the necessary team members to communicate and brainstorm a plan to meet the
resident’s needs. The nurse is responsible for documentation of the care huddle in the
clinical record and updates care plan.
Page67 Clinical – Care planning
1. The goal of the care planning process is to create an individualized person-centered
comprehensive plan of care. The process is interdisciplinary and includes the elder, the
care partner and the interdisciplinary team members who are providing services to the
elder. The primary nurse facilitates the meeting.
2. A Master Schedule of care planning dates is maintained by the MDS nurse and posted in
the house.
3. Family is invited to the meeting if they are guardians/POAs; or with the permission of
the elder.
4. The meeting location is determined by the elder’s preferences and is usually held in the
elder’s room or in the study.
5. The MDS is completed prior to the meeting and results are shared at the meeting.
6. The care plan is created during the meeting with the input of the elder.
7. At the meeting the current care plan is read, discussed with the elder, and modified or left
unchanged. If the elder is unable to present information regarding preferences the care
partner or family may provide the information if it is known to them.
8. New issues/problems are discussed and a plan of interventions is created.
9. Additions/ changes are made to the care plan as agreed to by the elder.
10. If the elder expresses preferences that include risk or refusal of routine care standards the
team discusses these with the elder following the Choice policy processes.
11. The primary nurse updates the care plan in the EMR, and enters a risk management
progress note as outlined in the choice policy.
Page68 Clinical – Medication Administration
Nurses will collaborate with pharmacists and physicians to minimize the number of
medications and to reduce pill burden on the resident and by minimizing the number of
administration times per day.
Medication administration times will be customized to the resident’s schedule and routines and
will never be administered if the resident is engaged in a meal or activity unless it is medically
necessary that the timing of administration is inflexible. Medications will only be crushed if the
resident has documented difficulty swallowing or has a personal preference for crushed
medications.
The administration of medications shall achieve the delivery of prescribed medications to the
individual including delivery of the right medication dose at the right time to the right person
via the right route. Medications are delivered to individual and administered from cabinets in
each room. Narcotics are retained under double lock and on count in the nursing office in each
house.
EQUIPMENT:
1. Hand sanitizer.
2. Picture of elder labeled with name.
3. Sharps container if elder is receiving injections.
4. Gloves, if elder receives injections.
5. Alcohol preps, if elder receives injections.
6. Syringes, if elder receives injections.
ORAL:
1. Nurse brings laptop on stand to meds cabinet in the elder’s room, places it next to the
cabinet and opens the laptop.
2. Washes hands at sink or with hand sanitizer.
3. Opens cabinet.
4. Pours medication into cup, checking each medication with the MAR for accuracy, (i.e.
dose, time, route).
5. Identifies elder by asking them to state their name, or by verifying identity with photo
posted in meds cabinet or in Electronic MAR
6. Remains with elder until medication has been consumed.
7. Documents administering the medication in the record.
8. Locks meds cabinet.
INJECTIONS FROM THE REFRIGERATOR:
1. Retrieves the medication from the refrigerator.
2. Follow Step 1 from administration of oral meds.
3. Follow Step 2 from administration of oral meds.
4. Follow steps listed under administering injections.
Page69
ADMINISTERING INJECTIONS:
1. Follow Step 1 from administration of oral meds.
2. Closes door.
3. Identifies elder as in Step 5 from administration of oral meds.
4. Positions the elder in the bed or chair; exposes the injection site and drapes.
5. Unlocks med cabinet.
6. Washes hands with hand sanitizer.
7. Draws up medication verifying dose, route, and time with MAR.
8. Puts on gloves.
9. Using standard procedure for injections administers the injection.
10. Places sharps in sharps container.
11. Removes and disposes of gloves.
12. Washes hands with hand sanitizer.
13. Documents the administration of injection in the MAR.
14. Assists elder out of bed or chair as indicated.
Clinical – Treatments
Treatment supplies are stored in the resident’s room in the bottom section of the locked
medication closet. Treatments are provided in the resident’s room and documented
immediately in the electronic medical record database.
Clinical – Emergency
Emergency medical supplies are stored on emergency carts which are centrally located in the
clean utility room. An AED is hung on the wall next to the cart. In case of medical emergency,
the nurse responsible for the house will respond. If additional assistance is needed the care
partner will phone the second nurse on duty.
Clinical – Nursing Rounds
Comprehensive clinical rounds are conducted each day on each shift by the house nurse.
Director of Nursing conducts clinical rounds into houses daily. The administrative nurse
conducts clinical rounds into houses daily
Page70 Clinical – MDS
Schedule will be distributed to all primary nurses, life enrichment, Rehab, Dietary, social
worker by email. The assigned staff member will complete all required scripted interviews. The
staff member completing the interview will code those sections of the MDS.
A – MDS Coordinator
B – Life Enrichment
C – Nursing
D – interviewer or SW observation
E – SW
F – interviewer or LE observation
G – J Nursing
K – Dietitian
L-N – Nursing
O – Nursing and Rehab
P – Nursing
Q – SW
S – MDS Coordinator
For Comprehensive OBRA assessments, CAAs will be worked as follows:
1-6 – Nursing
7-9 – SW
10 – LE
11 – Nursing
12, 13 – Dietitian
14-19 – Nursing
20 –SW
Page71 Clinical – Personal Care
Personal care is provided per standards policies and procedures of the organization in
accordance with the wishes and schedule presented by the resident. Individualized mornings
are component of the person-centered model of care.
Individualized mornings are defined as getting up at a natural wake-up time, eating breakfast
in the place and at the time the individual desires, and having care at the time the person
desires. Our island home is a no lift environment electronic ceiling lifts which are certified as
one person devices are used to transfer dependent residents.
Clinical – Nursing Care
Nursing care is conducted in accordance with the standards policies and procedures of the
organization.
A few considerations apply to person-centered care. Weights, blood pressures and other vital
signs:
These are measured based on the needs of the individual, in consideration of their
diagnoses and long-term patterns.
Minimizing the crushing of medication.
Careful monitoring and management of polypharmacy.
To the extent possible when attaining medication administration to twice per day per
resident.
Page72 Clinical – Responsibilities by Shift
NURSES CARE PARTNER
7-3 Provide clinical leadership and direction
Medication and treatment administration
Clinical Documentation
Management of Physician Orders
Clinical rounds
Care huddles
Care plan updates
Participation in the lunch meal at the table
provide support and assistance to the house
Care of residents based on the care plan
Prepare, serve and clean up after breakfast
Provide enrichment activities to residents
Prepare, serve, participate in, and clean up after
lunch
Housecleaning as assigned from the house
keeping plan
Documentation
3-
11
Provide clinical leadership and direction
Medication and treatment administration
Clinical Documentation
Management of Physician Orders
Clinical rounds
Care huddles
Care plan updates
Participation in the dinner meal at the table
provide support and assistance to the house
team including meals and housekeeping
Care of residents based on the care plan
Provide enrichment activities to residents
Prepare, serve, participate in, and clean up after
dinner
Housecleaning as assigned from the house
keeping plan
Documentation
Re-Stock supplies in individual rooms
Individual resident’s laundry per schedule
11-
7
Provide clinical leadership and direction
Medication and treatment administration
Clinical Documentation
Management of Physician Orders
Order reconciliation
Clinical rounds
Care huddles
Care plan updates
Provide break coverage for care partners in
each house
Care of residents based on the care plan
House laundry (napkins, kitchen towels etc.)
Deep cleaning of the kitchen including review
of all items in the refrigerator to determine if
they are stored in the correct location (shelf), if
the item is properly labeled and dated.
Discard items that have reached their expiration
date.
House cleaning as assigned from the house
keeping plan
Set the table for breakfast and set up
nonperishable breakfast foods
Prepare and refrigerate breakfast items based
on the menu
Check meal plan schedule and defrost any
items as necessary
Documentation
Page73 Therapy – OT/PT/Speech
All therapies are delivered in the individual house or in public spaces throughout the facility for
ambulatory therapy. Kitchens are utilized for OT/ PT. Individual resident rooms are available
for therapy.
Engagement/Enrichment
Calendars for planned engagement and socialization are created by the residents in the house
with the recreation staff and care partners. Special emphasis is placed on in room and in-house
activities.
Medical Records
Electronic medical records are utilized for all clinical documentation, including physician
orders.
Family/Visitors
Families are welcome in the home at any time. They may use the kitchen however they may not
bring in outside food to serve to any other resident except their family member or friend.
Families are encouraged to hold in-house celebrations for birthdays and other special occasions
and house parties and holidays are planned at meetings with residents and families together.
Families are welcome to join in the dining experience.
Page74 Equipment
In-house equipment including the stove refrigerator dishwasher garbage disposal whirlpool
tub, washer and dryer need to meet all local and state requirements. A routine maintenance
schedule is created based on the manufacturer’s recommended preventative maintenance
schedule. This schedule is electronic and completed maintenance is logged.
Repair of warrantied appliances is the responsibility of the supplier/manufacturer and out of
warranty repairs may be completed by maintenance or outside repair companies. (insert
maintenance schedule here after purchase). The operating instructions for each appliance in
each house should be posted in a plastic sleeve near the appliance. This assures that staff
operate equipment properly.
Appliance malfunctions of most appliances are typically handled by sharing with another
house. The most vulnerable appliance in the houses the dishwasher. Repairs to dishwashers are
often delayed and lengthy. This is extremely disruptive to the house and it is recommended that
an extra dishwasher is purchased at the time of construction and kept in storage on-site.
Page75 Training Plan
TOPIC
DESCRIPTION
TARGET AUDIENCE
LENGTH
Philosophy
An interpretation of the underlying
principles as well as major visible
differences between the current
model and the intended new model.
All staff in the
continuum of care
Families
Residents at all levels in
the continuum
1 hour
Leadership
Leadership in an empowered work
team setting including;
non-hierarchy leadership
moving from process to outcomes-
based management
leading with questions
outcomes supervision in an
empowered work team setting
root cause analysis
managing quality with house based
data
All who will assume a
leadership role in the
project.
6 hours
Communication
Communication skills required for
good transition to empowered work
team and learning circles for resident
communication.
All nurses and Care
Partners
1 hour
Choice
A discussion of the restoration of
choice and the responsibilities of
caregivers including discussion and
documentation
All staff.
30 minutes for
non-nursing
45 minutes for
nursing and
social worker
Habilitation
Philosophy of habilitation versus
dependence examples of
rehabilitative care therapist nurse
Care Partner collaboration
Care Partners
nurses
therapists
45 minutes
Person-Centered
Care
Philosophy, desired outcomes,
the planning process, structure and
organization of the person-centered
care plan meeting.
Entire interdisciplinary
team
4 hours
Clinical – Clinical
Rounds
How to conduct rounds which
maintain care plans compliance and
monitor levels of holistic wellness
All nurses 1 hour
Page76
TOPIC
DESCRIPTION
TARGET AUDIENCE
LENGTH
Convivium
The elements of convivium
role and responsibility of staff in
convivium
All nurses and Care
Partners, dietician and
dietary staff.
30 minutes
Food Safety
Safe food handling, storage, kitchen
sanitation and processes.
Care Partners
nurses
2 to 4 hrs.
Culinary training
Menus, following recipes, basic
cooking skills
Clinical –
Medication
Reduction program
Logistics of medication reduction
Reduction in crushing of meds
Minimization of the number of med
administration episodes.
Nurses will be
participating in the
actual reduction
One hour
Clinical – medication
reduction
maintenance
Logistics of maintaining low levels of
medication.
All nurses 30 minutes
Clinical – Chronic
Disease
Management and
Change in Condition
Protocols
Implementing change in condition
protocols
All nurses
30 minutes
Activities to
Engagement
Transition
Various types of instant connection
engagement.
small group engagement
integrating engagement into workflow
Care Partners
One hour
The Empowered
Work Team
Structure and
Operation
House government
Empowerment
supervision and direction within the
empowered environment
the team meeting
Nurses
Care Partners
other members of the
interdisciplinary team
One hour for
Care Partners
30 minutes for
nurses
Food coordinator
training
Supervising outcomes for kitchen
sanitation, food service requirements
and convivium, food ordering and
menu planning
Food coordinators
assigned to houses
2 hrs.
Care coordinator
training
Supervising outcomes for care plans,
supplies, and resident satisfaction
including engagement
Care coordinators
assigned to house
2 hrs.
Page77
TOPIC
DESCRIPTION
TARGET AUDIENCE
LENGTH
Housekeeping
coordinator training
Supervising outcomes for
housekeeping and laundry including
supplies and resident satisfaction
Housekeeping
coordinators assigned to
house
2 hrs.
House Orientation
Review of all the equipment in the
kitchen
lift training
review of the cleaning and use of the
top
All Full day for Care
Partners
half-day for
nurses
one hour for IDT
Workflow
Reconfiguration
A review of the operating plan with
workflow changes and a review of the
new expectations
Nurses
Care Partners
Nurses 30
minutes
Care Partners 1
hour
Needs driven
dementia
compromised care
Needs driven dementia compromised
approach to dementia care includes:
ABC Behavior mapping
Interventions that support the person
Identification of pain
Simple pleasures interventions
Nurses
Care Partners
Nurses 2 hours
Care Partners
assigned to
dementia units
for full day
Care Partners
assigned to
other units four
hours
Small house
differences –
operation
Major differences individuals can
expect to see in the small house
operation
Residents
Families
Vendors
other campus personnel
30 minutes
Safe kitchen
utilization
Kitchen practices required including
hand washing food storage and
allowable foods
Family members
Non-nursing staff and
residents and-other
campus staff
15 – 30 minutes
Waivers
Waivers should be added to the operating plan when they have been approved.
Page78 Appendix A – Housekeeping Schedules & Procedures
Page79
Page80
Page81 CLEANING BASEBOARDS
Purpose: To provide clean and attractive baseboards, that enhance the image of the home and
the quality of the environment.
Materials Required
1. Gloves
2. Cleaning cloth
3. Vacuum with hand attachment
4. Pail
Preparation
1. Remove furniture and equipment as needed.
Procedure
1. Vacuum
2. Wash the wood surface baseboard
a. Wipe a section of the baseboard with a dry-cleaning cloth, removing any dust
and dirt. Rinse with a clean cloth dipped in clear water, and dry with a third,
clean cloth to prevent streaking and water spotting.
3. Utilize the vacuum hand attachment to vacuum up all debris left behind on the carpet or
linoleum surface.
4. Clean up
b. Put vacuum in dirty utility room.
c. Bag all soiled cleaning cloths for daily laundering per facility policy.
Safety
1. Always practice standard precautions when cleaning any blood or body fluid spills, or
soil that could contain these or other potentially infectious material.
2. Be careful not to hurt yourself when moving furniture or other heavy objects. Always
practice proper lifting techniques and ask for assistance when appropriate.
BLOOD SPILL CLEAN-UP
Purpose: To remove any potential infectious materials by the physical removal of the blood.
Materials Required
1. Personal protective equipment
2. Wet Floor caution signs
3. Red plastic bags for infectious waste (biohazard)
4. Disposable absorbent wipes
5. Appropriate Disinfectant Cleaner
6. Fresh mop
7. Mop bucket and wringer
Page82 8. Hand pail
9. Cleaning cloths
10. Blood Spill Kit
Preparation
1. Wear the necessary personal protective equipment such as gloves, gown, mask, and eye
protection.
2. Gather all your required equipment and supplies.
3. Dispense cleaning solutions.
4. Set-up Wet Floor sign.
Procedure
2. Wipe up the spill
a. Contain and wipe up the spill with an absorbent towel or wipe.
b. Dispose of the wipes in a designated waste receptacle.
3. Clean the soiled surface
a. Clean the soiled surface with a cloth or mop and the disinfectant cleaner.
b. Allow the surface to remain wet and air dry per label instructions.
4. Clean up
a. Clean all equipment and return it to the appropriate area.
b. Bag all soiled mop heads and cleaning cloths for daily laundry.
c. Remove your personal protective equipment and wash your hands.
Safety
1. Use all chemicals in accordance with the manufacturer’s instructions.
2. Always wear appropriate personal protective equipment.
HEALTH AREA GENERAL CLEANING
Purpose: To provide a clean, orderly and attractive living area for residents, family members,
visitors, and staff, that enhances the image of the home.
Materials Required
1. Gloves
2. Disinfectant Cleaner as designated in the current approved cleaning supply list
3. Dust polish as designated in the current approved cleaning supply list
4. Clean cloths
5. Long handled duster
6. Vacuum cleaner
7. Mop
8. Dust pan and broom
9. Putty knife
10. Wet floor signs
Page83 11. Liners for waste containers
Preparation
1. Put on gloves
2. Properly dispense the disinfectant cleaner as designated in the current approved
cleaning supply list in the hand pail and mop bucket
3. Take equipment to assigned area.
Procedure
1. Remove general waste
a. Close, twist, and tie a knot in the top of the plastic trash can liner while it is still
in the container.
b. Use caution and look for protruding objects in the waste containers. NEVER
reach into or push on the bag to compress the trash.
c. Take it to the waste pick up at the outside service entry. NEVER carry a bag of
trash against any part of your body.
d. Wipe all surfaces of the waste container with cleaning solution and allow to air
dry.
e. Reline the container with an appropriate trash liner.
2. Remove the recycling
a. Remove the items that are recyclable waste from the area.
b. Place the recycling into the appropriate container for pick up.
c. Wipe all surfaces of the waste container with cleaning solution and allow to air
dry.
d. Reline the container with an appropriate trash liner.
3. High dust
a. Using the long handled duster, high dust the tops of items on the walls that are
at or above your shoulder height.
b. Include items such as pictures, plaques, mirrors, bulletin boards, tops of
partitions, vents, tops of cabinets, and window/door frames.
4. Damp dust
a. Begin dusting at the room entrance and work around the room. Damp dust the
top of an object first and work down to avoid soiling surfaces you have just
cleaned.
b. Fold the cloth into a series or squares to provide several potential cleaning
surfaces. A wadded cloth does not clean as efficiently.
c. Dampen the cloth in the cleaning solution and wring out all excess solution to
avoid drips.
d. Damp dust the door and wall features such as thermostat, light switches, ledges,
window sills.
e. Spot clean visible soil from doors, walls, windows, blinds.
f. Damp dust the furnishings/furniture such as telephones, chairs, tables, being
sure to include the legs/frames of the tables and chairs.
5. Clean the floor – hard surface
a. Remove any gum or sticky residue from the floor by gently prying it loose with
the putty knife. Take care not to scratch the floor.
Page84 b. Dust mop the floor.
c. Use the broom and dustpan to take up the soil.
d. Dispose of soil into appropriate container.
e. Post caution sign in doorway.
f. Mop.
g. Clean the edges of the floor.
h. In the open area of the floor, use a figure-eight motion and turn the mop over
every few strokes. Rinse and wring out the mop frequently.
i. Be sure to mop under and behind furniture including waste containers. Be sure
to straighten the furniture by placing the chairs under the tables.
j. Remove the wet floor sign after the floor is completely dry.
6. Clean the floor – carpet
a. Plug the vacuum into the wall outlet. Avoid running over the electrical cord with
the vacuum cleaner; manage the cord to work away from the outlet rather than
toward it.
b. Vacuum back and forth using overlapping passes.
c. Be sure to vacuum under and behind all furniture including waste containers.
d. Inspect the area for spots and stains and remove them per policy.
e. PERIODICALLY: Vacuum the carpet edges.
7. Clean up
a. Clean all equipment and return it to the appropriate place.
b. Bag soiled mop heads and cleaning cloths for daily laundry.
c. Remove personal protective equipment and wash your hands.
8. Clean high use items including phones, door knobs, light switches and hand rails with
“Virex 256”.
Safety
1. Always check electrical equipment prior to use (refer to procedure for care of electrical
equipment).
2. Always post caution signs appropriately.
3. Be careful not to hurt yourself when moving any furniture or other heavy objects.
Always practice proper lifting techniques and ask for assistance when appropriate.
4. Always use the cleaning chemical exactly as directed by the label following all
recommended safety precautions.
CARPET VACUUMING
Purpose: To maintain the carpet appearance and prevent damage.
Materials Required
1. Walk-behind vacuum machine
Page85 Preparation
1. Inspect the area and pick up any litter that is too large to be vacuumed up or that could
damage your machine.
2. Move all furniture to one side.
Procedure
1. Vacuum the carpet
a. Plug the vacuum into a wall outlet. Begin vacuuming nearest the outlet.
b. Vacuum in long, straight passes. Use overlapping passes.
2. Replace any furniture
a. Replace any furniture that you moved.
3. Clean up
a. Return all equipment and supplies to appropriate area.
Safety
1. Always check electrical equipment prior to use.
2. Avoid running over the electrical cord with the machine; manage the cord to work away
from the outlet rather than toward it.
3. Always post caution signs appropriately.
4. Never vacuum wet carpet.
5. Always unplug the machine prior to checking or working on it.
BATHROOM TOILET CLEANING
Purpose: To maintain a clean and attractive environment which reduces the likelihood of cross
infection and enhances the image of the facility.
Materials Required
1. Disinfectant Cleaner as designated in the current approved cleaning supply list.
2. Cleaning cloths
3. Bowl mop
4. General Toilet Bowl Cleaner as designated in the current approved cleaning supply list
5. Acid Toilet Bowl Cleaner as designated in the current approved cleaning supply list
6. Gloves and goggles
Preparation
1. Gather all equipment and supplies.
2. Put on gloves mask and goggles.
Procedure
1. Clean the toilets
a. Flush the toilet and reduce the water level by pumping with the bowl mop.
Page86 b. Apply general toilet bowl cleaner as designated in the current approved cleaning
supply list to the interior surfaces of the fixtures.
c. Clean the inside of the fixture with the bowl mop paying attention to the
underside of the flush rim (this prevents the accumulation of bacteria that can
spread disease and create unpleasant odors).
d. Wipe down all exterior surfaces of the fixture with a clean cloth that has been
dampened with the disinfectant cleaner as designated in the current approved
cleaning supply list.
e. Damp wipe all chrome (flush handles, etc.) with disinfectant cleaner as
designated in the current approved cleaning supply list and dry with a clean, dry
cloth to prevent spotting.
f. If necessary, use an acid bowl cleaner as designated in the current approved
cleaning supply list to descale the flush rim. Squeeze the acid bowl cleaner onto
the bowl mop, not into the bowl. Run the mop around the flush rim and then
around the rest of the bowl. Flush immediately. The need for this step is
dependent on water hardness. An aggressive bowl mop may be a substitute for
the step.
g. Dry the exterior, seat, and lid of the commode carefully.
h. Wipe up any spills.
2. Clean up
a. Bag the soiled cleaning cloths for daily laundering.
b. Return all chemicals to proper storage.
Safety
1. Always use all cleaning chemical exactly as directed by the label following all
recommended safety precautions.
2. Be careful not to splash any cleaning chemicals into your eyes, nose, mouth or onto your
skin. Always wear gloves and wear a mask or goggles if necessary for protection –
especially if there is a danger that chemicals could splash into your face and eyes.
3. Always practice standard precautions when cleaning any blood or body fluid spills, or
soil that could contain these or other potentially infectious material.
4. Be careful not to get the cleaning chemical on any surface for which it is not intended to
avoid damage – especially the acid bowl cleaner.
DISPENSER / PAPER TOWEL CLEAN AND REFILL
Purpose: To maintain an ample supply of dispensed items for the convenience of the residents
and their family, visitors and staff thus encouraging personal hygiene and therefore, the
reduction or elimination of cross infections.
Materials Required
1. Packets of paper towels
2. Damp cloth
3. Dry cloth
4. Disinfectant Cleaner as designated in the current approved cleaning supply list
Page87 5. Gloves
Preparation
1. Gather the disinfectant cleaner as designated in the current approved cleaning supply
list.
2. Put on gloves.
Procedure
1. Clean and refill the paper towel unit
a. Open or unlock the dispenser unit. Be careful not to let it fall open as it can
scratch the wall or hurt you.
b. Remove any paper towels and damp dust the inside of the unit to remove loose
paper dust.
c. Replace paper towels and add as necessary to fill the unit. Be sure to place them
folded side down, and interleave the bottom sheet with the top sheet of the
existing pile. Add as necessary to fill the unit. Do not over-fill as this will make it
difficult to pull the towels out. Check to be sure the towels release easily.
d. Close and lock (where appropriate) the dispenser making sure it is secure and
will not fall open and hurt someone.
e. Damp wipe the outside of the unit with the disinfectant cleaner (depending on
the type of area) and allow it to air dry it completely.
f. Report any broken or malfunctioning units to Plant Operations for repair.
2. Clean up
a. Bag all soiled cleaning cloths for daily laundering.
b. Return all equipment and extra product to proper storage.
c. Remove gloves and wash hands.
Safety
1. Be careful of sharp edges on dispensers – these can easily cut you. Report this condition
to your supervisor on off hours or Plant Operations so that the edges can be filed down
or the dispensers replaced.
2. Always be sure the dispensers are locked to prevent spilled product or injury.
3. Always use the cleaning chemical exactly as directed by the label following all
recommended safety precautions.
4. Be careful not to splash any cleaning chemicals into your eyes, nose, mouth or onto your
skin. Always wear gloves and wear a mask or goggles if necessary for protection –
especially if there is a danger that chemicals could drip down into your face.
5. Always practice standard precautions when cleaning any blood or body fluid spills, or
soil that could contain these or other potentially infectious material.
6. Be careful not to get the cleaning chemical on any surface for which it is not intended to
avoid damage.
BATHROOM TISSUE CLEAN / REFILL
Page88
Purpose: To maintain an ample supply of dispensed items for the convenience of the residents
and their families, visitors and staff thus encouraging personal hygiene and, therefore, the
reduction or elimination of cross infections.
Materials Required
1. Tissue rolls
2. Damp cloth
3. Dry cloth
4. Disinfectant Cleaner as designated in the current approved cleaning supply list
5. Gloves
Preparation
1. Gather the disinfectant cleaner as designated in the current approved cleaning supply
list and other supplies.
2. Put on gloves.
Procedure
1. Remove the tissue rollers, place on cleaned surface.
2. Damp wipe the inside of the unit to remove paper dust using the disinfectant cleaner as
designated in the current approved cleaning supply list.
3. Install the new roll of tissue
a. Install the new roll of tissue. Be sure the tissue unwinds over the top of the roll
(not from the underneath) since this allows it to be pulled out more easily and
avoids unrolling and wasted product. Be sure to “start” the tissue by pulling the
first sheet loose for the convenience of the elder.
4. Report any broken or malfunctioning units to Plant Operations for repair.
5. Clean up
a. Bag all soiled cleaning cloths for daily laundering.
b. Return all equipment and extra product to proper storage.
c. Remove gloves and wash hands.
Safety
1. Be careful of sharp edges on tissue roller units – these can easily cut you. Report this
condition to your supervisor so that the edges can be filed down or the roller unit
replaced.
2. Always use the cleaning chemical exactly as directed by the label following all
recommended safety precautions.
3. Be careful not to splash any cleaning chemicals into your eyes, nose, mouth or onto your
skin. Always wear gloves and wear a mask or goggles if necessary for protection –
especially if there is a danger that chemicals could drip down into your face.
4. Always practice standard precautions when cleaning any blood or body fluid spills, or
soil that could contain these or other potentially infectious material.
5. Be careful not to get the cleaning chemical on any surface for which it is not intended to
avoid damage.
Page89
REFRIGERATOR / FREEZER CLEANING
Purpose: To keep all refrigerators and freezers clean to prevent the spread of infection.
Materials Required
1. Gloves
2. Disinfectant cleaner as designated in the current approved cleaning supply list
3. Hand pail
4. Lint-free cleaning cloths
5. Small brush
Preparation
1. Put on gloves.
2. Properly dispense the disinfectant cleaner solution, as designated in the current
approved cleaning supply list, in the hand pail.
3. Take equipment to assigned area.
Procedure
1. Refrigerator/Freezer
a. Use a clean, lint-free cloth dampened in the disinfectant cleaning solution. Wring
out all excess solution to avoid drips. Damp wipe all exterior surfaces of the
refrigerator. Attention should be paid to handles where fingerprints and
smudges occur. For stubborn stains use an abrasive hand pad with the
disinfectant cleaner.
b. Damp wipe the interior surfaces of the refrigerator using a cloth dampened in
the appropriate cleaning solution. For stubborn stains use an abrasive hand pad
with the cleaner.
c. Defrost the refrigerator/freezer following the manufacturer’s recommendations.
d. NOTE: Night Shift Care partners, throw away old, outdated food and beverages
per your home procedure before cleaning the interior of the refrigerator.
2. Clean up
a. Clean all equipment. Return all equipment and supplies to the appropriate area.
b. Bag all soiled cleaning cloths for daily laundry.
c. Remove your personal protective equipment and wash your hands.
Safety
1. Always use the cleaning chemical exactly as directed by the label and following all
recommended safety precautions.
2. Be sure to wipe up any cleaning solution spills or water from the floor.
3. Be careful not to get the cleaning chemical on any surface for which it is not intended to
avoid damage.
Page90 FURNITURE / UPHOLSTERED DRY VACUUM
Purpose: To maintain upholstered furniture and keep it free from dust and lint, thus creating a
healthy and attractive environment.
Materials Required
1. Vacuum cleaner with attachments
2. Caution Sign
Preparation
1. Set up the caution sign.
Procedure
1. Dry vacuum the upholstered furniture
a. Using the upholstery tool (or other appropriate attachment), carefully vacuum all
surfaces of the furniture; remove and vacuum underneath all cushions.
b. Return the furniture to its proper position.
2. Clean up
a. Inspect the plug and coil the cord and wipe off the unit.
b. Check the bag and replace if necessary.
c. Store the vacuum in its assigned location.
d. Store the caution sign properly.
Safety
1. Always check electrical equipment prior to use. (Refer to the procedure for care of
electrical equipment.)
2. Avoid running over the electrical cord with the machine; manage the cord to work away
from the outlet rather than toward it.
3. Always post caution signs appropriately.
4. Always unplug the machine prior to checking or working on it.
FURNITURE / WOOD / KITCHEN TABLE CLEANING
Purpose: To provide a safe, clean, and attractive environment for residents and their families,
visitors, and staff.
Materials Required
1. Disinfectant Cleaner as designated in the current approved cleaning supply list
2. Clean water
3. Two hand pails
Page91 4. Clean, lint-free cleaning cloths
5. Approved polishing product as designated in the current approved cleaning supply list
6. Gloves
Preparation
1. Gather the designated polishing product and disinfectant as designated in the current
approved cleaning supply list.
2. If necessary, relocate the furniture to a utility area for cleaning.
3. Put on gloves.
Procedure
1. Clean the wood furniture
a. Using a clean cloth dampened in the cleaning disinfectant, rub the furniture
firmly to loosen the soil. Use up and down, then side-to-side strokes until the
entire surface area is covered.
b. Use a second clean cloth dampened in the cleaning disinfectant to remove the
loosened soil.
c. Rinse the furniture with a third clean cloth which has been dampened in clean
water.
d. Finally, rub the surface dry with a fourth clean, dry cloth.
2. Polish and oil
a. Pour a small amount of polish onto a clean, lint-free cloth that has been folded
neatly into squares.
b. Using even strokes, cover the entire surface of the wood being sure to rub the
polish or oil into the surface.
c. Allow the product to soak into the wood for a few minutes.
d. Using a second, clean cloth buff any remaining polish from the surface of the
wood. Repeat this procedure using clean cloths as necessary until all excess
polish or oil has been completely removed since any left could cause staining.
e. Return any furniture that was moved to its original position.
3. Clean up
a. Rinse, dry and store the hand pails.
b. Return chemicals to their proper storage location.
c. Bag any soiled cloths for daily laundering.
d. Remove gloves and wash hands.
Safety
1. Always use the cleaning chemical exactly as directed by the label following all
recommended safety precautions.
2. Be careful not to splash any cleaning chemicals into your eyes, nose, mouth or onto your
skin. Always wear gloves and wear a mask or goggles if necessary for protection –
especially if there is a danger that chemicals could drip down into your face.
3. Always practice standard precautions when cleaning any blood or body fluid spills, or
soil that could contain these or other potentially infectious material.
Page92 4. Be careful not to get the cleaning chemical on any surface for which it is not intended to
avoid damage.
5. Be careful not to hurt yourself when moving furniture or other heavy objects. Always
practice proper lifting techniques and ask for assistance when appropriate.
DAMP DUSTING OF GENERAL ARTICLES
Purpose: While a dusty environment presents a very negative image, it is the spread of infection
and the creation of poor indoor air quality that is the most serious consequence of dust
accumulation in a home.
Materials Required
1. Cleaning cloths
2. Disinfectant Cleaner as designated in the current approved cleaning supply list
3. Gloves
Preparation
1. Gather the disinfectant cleaner as designated in the current approved supply list.
2. Put on gloves.
Procedure
1. Damp dust
a. Fold the cloth in a series of squares to provide several potential cleaning surfaces
– a wadded cloth does not clean as efficiently.
b. Dampen the cloth with disinfectant cleaner. When using the disinfectant cleaner,
wet the surface you are cleaning and allow to air dry.
c. Begin damp dusting at the entrance door and work around the room. It is
usually best to damp dust the top of an object first and work down to avoid
soiling surfaces you have just damp dusted. You may need to damped the cloth
and work particularly hard on stubborn soil.
d. If streaking occurs, re-wet the surface and wipe with a clean, dry cloth.
e. Never shake the cloth. This can scatter the dust and germs. When it becomes too
soiled to continue, simply refold it so a clean surface is available or send it to the
laundry.
2. Clean up
a. Dirty cloths should be placed in bags and sent to the laundry at the end of the
shift for cleaning.
b. Remove gloves and wash hands.
Safety
1. Never stir up the dust in the room by using a dry cloth to dust or by shaking the soiled
cleaning cloth. This can cause infectious germs to be spread and compromises the
quality of the air that people must breathe.
Page93 2. Look before you dust – watch for rough spots or splinters that could cut or scratch your
hands.
3. Always use the cleaning chemical exactly as directed by the label, following all
recommended safety precautions.
4. Be careful not to splash any cleaning chemicals into your eyes, nose, mouth, or onto
your skin. Always wear gloves and wear a mask or goggles if necessary for protection –
especially if there is a danger that chemicals could splash or drip down into your face.
5. Always practice standard precautions when cleaning any blood or body fluid spills, or
soil that could contain these or other potentially infectious material.
6. Be careful not to get the cleaning chemical on any surface for which it is not intended to
avoid damage.
7. Be careful not to hurt yourself when moving furniture or other heavy objects. Always
practice proper lifting techniques and ask for assistance when appropriate.
GENERAL WASTE, COLLECTION, AND DISPOSAL
Purpose: To remove litter and trash from the home in a safe and efficient manner.
Materials Required
1. Cleaning cloth
2. Disinfectant Cleaner as designated in the current approved cleaning supply list
3. Hand pail
4. Plastic trash can liners
5. Large trash container
Preparation
1. Gather the disinfectant cleaner as designated in the current approved cleaning supply
list.
2. Put on gloves.
Procedure
1. Remove the general waste
a. Close, twist and tie a knot in the top of the plastic trash can liner while it is still in
the container. Remove the bag and check the interior of the container for visible
soil. NEVER reach into or push on the bag to compress the trash.
b. Carry the bag away from your body to avoid a needle stick or contaminating
your uniform.
c. Deposit the bag of trash into the container on the appropriate container located at
the outside service entrance. NEVER use your hands to push bags of trash down
into a container to make room for more.
d. Following the weekly “Trash Pick-Up” schedule, move the trash container from
the outside service entrance to the curb for pick-up.
2. Disinfect the container
Page94 a. Using a cleaning cloth dampened with disinfectant cleaner, wipe all visible soil
from the interior and exterior of the container. Then, using another cloth
dampened in disinfectant cleaner, wipe over the areas again.
3. Reline the trash container
a. Clean and disinfect the trash container and reline it with the appropriate plastic
bag.
4. Clean up
a. Return the collection container to the proper storage area.
b. Clean the container as above.
c. Bag all soiled cleaning cloths for daily laundering.
d. Remove gloves and wash hands.
Safety
1. Be careful not to allow any liquids to drip from the bags of trash onto the floor. Clean up
any leakage promptly so that it will not cause someone to slip and fall.
2. NEVER push on a bag of trash with your hands – even if you are wearing gloves. Even
though sharp objects such as needles are not supposed to be put into trash cans,
mistakes happen – you could get stuck with an infectious needle.
3. Never put broken glass into a trash container or bag. Take it directly to a compactor or
dispose of it in an otherwise safe manner.
4. Always wear gloves when handling trash bags.
5. Always practice standard precautions when cleaning any blood or body fluid spills, or
soil that could contain these or other potentially infectious material.
6. Be careful not to hurt yourself when moving heavy objects. Always practice proper
lifting techniques and ask for assistance when appropriate.
GLASS / PLEXIGLAS / PICTURES/ MIRROR CLEANING
Purpose: To maintain a clean and attractive environment which enhances the image of the
home.
Materials Required
1. Glass cleaner as designated in the current approved cleaning supply list
2. Cleaning cloth
3. Step ladder
4. Caution sign
5. Gloves
Preparation
1. Gather the designated glass cleaner.
2. Carefully set up the ladder, if needed, being sure to place it squarely on a level surface
and lock it open before climbing onto it. Post the caution sign.
3. Put on gloves.
Procedure
Page95 1. Clean the glass
a. Spray the entire surface with the glass cleaner.
b. Using a clean, cloth which has been neatly folded into squares, wipe the entire
surface. Repeat as necessary to remove all soil.
c. Using a dry cloth, wipe the surface until it is dry to prevent spotting.
2. Clean up
a. Return all products to the cart or to other proper storage.
b. Store the ladder and caution sign properly.
c. Bag the soiled cleaning cloths for daily laundering.
d. Remove gloves and wash hands.
Safety
1. Always take the time to position the ladder squarely on an even surface and lock it into
the open position before attempting to climb it. NEVER stand on the very top step of a
ladder.
2. If the picture or mirror has not been secured to the wall at all four corners, be sure to
hold it steady with one hand while wiping it so that it is not accidentally knocked off the
wall.
3. Always post caution signs appropriately.
4. Always use the cleaning chemical exactly as directed by the label following all
recommended safety precautions.
5. Be careful not to splash any cleaning chemicals into your eyes, nose, mouth or onto your
skin. Always wear gloves and wear a mask or goggles if necessary for protection –
especially if there is a danger that chemicals could drip down into your face.
6. Always practice standard precautions when cleaning any blood or body fluid spills, or
soil that could contain these or other potentially infectious material.
7. Be careful not to get the cleaning chemical on any surface for which it is not intended to
avoid damage.
HARD FLOOR / DUST MOPPING
Purpose: To remove soil, sand, grit and litter, to maintain the appearance of the floor and to
prevent damage to the surface.
Materials Required
1. Dust mop with Disinfectant Cleaner as designated in the current approved cleaning
supply list.
2. Broom
3. Putty knife
4. Dustpan and brush
5. Gloves
Preparation
1. Put on gloves.
2. Wipe up any liquid spills on the floor. You cannot dust mop a wet floor.
Page96 3. Scrape up gum and caked-on soil from the surface.
4. Sweep loose any soil and litter from the corners and crevices to the center of the area.
5. Attach a clean floor dusting cloth to the floor dusting cloth holder.
Procedure
1. Dust mop the floor
a. Dust mop the floor with the floor dusting cloth holder by pushing it away from
you.
b. Do not lift the mop head from the floor. Use the swivel motion of the floor
dusting cloth holder to change directions.
c. Move furniture out of the way. Replace these items after you have dust mopped
beneath them.
d. When the floor dusting cloth becomes excessively soiled, turn it over and use the
other side. After you have used both sides of the floor dusting cloth, dispose of it
properly and replace it with a new one.
e. After dust mopping the entire area, gently sweep the pile of litter and debris into
the dust pan using the small brush. Dispose of soil into an appropriate trash
container. Never leave a pile of debris in corner for later pick up.
2. Clean up
a. Properly dispose of soiled floor dusting cloths.
b. If you used a dust mop, remove the soiled mop head and bag it for laundry.
c. Return all equipment to the proper storage area.
d. Store all dust mops and brooms off the floor so they do not get soiled in the
closet.
e. Remove gloves and wash hands.
Safety
1. Never stir up the dust in the room by shaking the unit. This can cause infectious germs
to be spread and defeats the purpose of dusting.
2. Be careful not to hit anyone with the unit handle. Never leave the unit unattended – do
not prop it up against the wall or furniture since it could easily fall causing an accident.
HARD FLOOR CLEANING
Purpose: To protect and beautify the floor, to maintain uniform slip resistance, and to make the
floor easier to maintain.
Materials Required
1. Disinfectant Cleaner Pads as designated in the current approved cleaning supply list
2. Mop
3. Wet floor signs
Preparation
1. Put on gloves.
Page97 2. Properly dispense the designated cleaning solution into the mop bucket so it is half-full.
3. Set up the wet floor signs.
Procedure
1. Mop the floor
a. Place Cleaning Pad on the mop head.
b. Clean the edges of the floor and the baseboards first.
c. In the open area of the floor, use a figure-eight motion. Replace Cleaning Pad as
needed.
d. In heavily soiled areas, change the Cleaning Pad frequently.
2. For disinfecting
a. Use enough disinfectant solution to keep the floor wet while the disinfectant
cleaner works.
b. Change the disinfectant solution as soon as you see that it is soiled or as directed.
3. Remove wet floor signs
a. Remove the wet floor signs after the floor is completely dry.
4. Clean up
a. Rinse the mop head.
b. Remove gloves and wash hands.
Safety
1. Always post caution signs appropriately.
INFECTIOUS WASTE REMOVAL FROM THE ELDER’S ROOM
Purpose: To remove infectious trash from the home in a safe and efficient manner.
Materials Required
1. Cleaning cloth
2. Disinfectant Cleaner as designated in the current approved cleaning supply list
3. Bio-hazard or red plastic trash can liners (per homes’ policy)
4. Personal protective equipment – particularly gloves (preferably utility)
Preparation
1. Gather the designated disinfectant cleaner.
Procedure
1. Collect and dispose of the infectious waste
a. After putting on your gloves, close, twist and tie a knot in the top of the plastic
can liner while it is still in the container.
Page98 b. Use caution – look for protruding objects in the waste container. NEVER reach
into or push on the bag to compress the trash.
c. Remove the bag from the container. If the contents are heavy or if there is
potential for leakage, place the bag into a second red bag and properly close it.
d. Remove the bag of infectious waste from the elder’s room and place it in the
designated infectious waste container located in the locked electrical room.
NEVER use your hands to push bags of trash down into a container to make
room for more bags. If the infectious waste container in the electrical room is full,
arrange for disposal by notifying your supervisor.
e. Check the interior and exterior of the waste container in the elder’s room for
visible soil. If visible soil is present, use a cleaning cloth or abrasive hand pad to
remove all visible soil from the interior and exterior of the waste container. (If
blood or body fluids are present, follow your home specific procedure for clean-
up of a blood or body fluid spill.)
f. Wipe all surfaces of the container with a disinfectant cleaner and allow to air dry.
g. Reline the container with the appropriate red (biohazard) bag.
2. Clean up
a. Bag all soiled cleaning cloths for daily laundering.
b. Remove personal protective equipment and wash your hands.
Safety
1. Be careful not to allow any liquids to drip from the bags of trash onto the floor. Clean up
any leakage promptly and decontaminate it appropriately so that it will not cause
someone to slip and fall or otherwise compromise their health.
2. NEVER push on a bag of trash with your hands – even if you are wearing gloves. Even
though sharp objects such as needles are not supposed to be put into trash cans,
mistakes happen – you could get stuck with an infectious needle.
3. Never put broken glass into a trash container or bag. Dispose of it using a mechanical
device such as tongs, forceps, or brush and dustpan and place it in a sharps container.
4. Always hold bags away from your body to prevent contamination of your clothing and
to protect yourself from exposure to any sharps that were accidentally discarded into the
trash.
5. Always wear gloves when handling trash bags.
6. Always practice standard precautions when cleaning any blood or body fluid spills, or
soil that could contain these or other potentially infectious materials.
7. Be careful not to hurt yourself when moving heavy objects. Always practice proper
lifting techniques and ask for assistance when appropriate.
SINK CLEANING
Purpose: To maintain a clean and attractive environment which reduced the likelihood of cross
infection and enhances the image of the facility.
Materials Required
1. Disinfectant Cleaner as designated in the current approved cleaning supply list
2. Cleaning cloths
Page99 3. Gloves and goggles if splashing is likely to occur
Preparation
1. Gather the designated disinfectant cleaner.
2. Put on gloves.
Procedure
1. Clean the sinks.
a. Apply disinfectant cleaner to the interior surfaces of the fixtures.
b. Using a clean cloth that has been dampened with the disinfectant cleaner, the
exterior surface, all metal handles and faucets.
c. Wipe down the plumbing underneath the fixture as well.
d. Wipe all metal fitting dry to avoid spotting.
e. Use an abrasive hand pad with the bathroom cleaner to remove stains. Be sure to
follow the manufacturer’s recommendations for stain removal, especially on
specialty surfaces.
f. Rinse and dry with a clean cloth.
2. Clean up
a. Bag the soiled cleaning cloths for daily laundering.
b. Return all chemicals and equipment to proper storage locations.
c. Remove gloves and wash hands.
Safety
1. Always use all cleaning chemical exactly as directed by the label following all
recommended safety precautions.
2. Be careful not to splash any cleaning chemicals into your eyes, nose, mouth or onto your
skin. Always wear gloves and wear a mask or goggles if necessary for protection –
especially if there is a danger that chemicals could splash into your face and eyes.
3. Always practice standard precautions when cleaning any blood or body fluid spills, or
soil that could contain these or other potentially infectious material.
4. Be careful not to get the cleaning chemical on any surface for which it is not intended to
avoid damage.
5. Be sure to check underneath the lavatory and around the plumbing for sharp edges that
could cut your hand – proceed with caution.
MOP BUCKET AND WRINGER CARE AND STORAGE
Purpose: To keep all equipment in clean and working condition.
Materials Required
1. Disinfectant Cleaner as designated in the current approved cleaning supply list
2. Cleaning cloths
3. Assorted tools (screwdrivers, pliers, hammer, etc.)
4. Oils and lubricants
Page100 5. Spare parts (belts, wringer springs, hooks, etc.)
6. Gloves, goggles, and other appropriate personal protective equipment
Preparation
1. Gather the designated disinfectant cleaning solution.
2. Put gloves on.
Procedure
1. Store the mop bucket and wringer
a. Keep all working parts properly lubricated.
b. Keep screw and bolts tightened.
c. Keep casters properly lubricated and in good repair; replace as necessary.
d. Always clean both mop bucket and wringer at the end of each shift with
disinfectant cleaner, cleaning cloth, and abrasive hand pad. NEVER leave soiled
water in the bucket.
e. Remember that too much force on the wringer can break it.
f. Make sure that the bucket and wringer are big enough for the mop being used.
g. Remove loose mop strands and any other debris caught in the wringer.
2. Clean up
a. Return all equipment to the appropriate area.
b. Remove gloves and wash hands.
Safety
1. Use equipment only for the purpose for which it has been designed.
2. Always practice correct lifting techniques when lifting, pushing, pulling or moving
equipment.
3. Always practice standard precautions when cleaning any blood or body fluid spills, or
soil that could contain these or other potentially infectious material from equipment.
4. When cleaning or decontaminating equipment, be careful not to get chemicals on any
surface for which it is not intended to avoid damage.
5. Always wear gloves, a mask or goggles and any other appropriate personal protective
equipment when cleaning and repairing equipment.
6. Always store equipment properly and in a safe manner that does not present a hazard to
yourself or others.
MOPS AND DUST SET CARE AND STORAGE
Purpose: To keep all equipment in clean and working condition.
Materials Required
1. Disinfectant Cleaner as designated in the current approved cleaning supply list
2. Cleaning cloths
3. Gloves and Personal Protective equipment as needed
Page101 Preparation
1. Gather the designated disinfectant cleaning solution.
2. Put on gloves.
Procedure
1. Reusable dust mops
a. Do not use dust mops on wet or oily floors or to mop up spills.
b. Remove loose soil from mop frequently, with a vacuum if possible.
c. Use a brush to remove all foreign material and lint from mop head. Be sure you
brush mop head over trash container.
d. Do not shake a dust mop as this action causes the dust to fly into the air. The
dust could be redeposited on surfaces already clean. Also, dust in the air could
cause health problems for patients.
e. When not in use, store the mop with the head down and not touching the floor.
Do not stand it on the floor.
f. Be sure that the mop frame is of the proper size for the mop head.
g. Be sure the tie cords are in good repair and fastened properly. Return mop heads
to your supervisor for repair.
h. Soiled mop heads should be bagged and taken to daily laundry. Mop heads
should be changed at the frequency your home policy specifies.
i. Clean mop heads should be neatly stacked on the storage shelves.
j. Using the cleaning solution, clean the mop handle at the end of your shift.
2. Disposable dust mops
a. Do not use dust mops on wet or oily floors or to mop up spills.
b. Use a brush to remove loose soil from the cloth. Be sure you brush the cloth over
a trash container.
c. When one side of the cloth is excessively soiled, turn over to the other side.
Dispose of the cloth and replace with a new one after both sides have been used.
d. Do not shake a disposable dust mop as this action causes the dust to fly into the
air. The dust could be redeposited on surfaces already clean. Also, dust in the air
could cause health problems for patients.
e. When not in use, store the mop with the head down and not touching the floor.
Do not stand it on the floor.
f. Be sure the floor tool is of proper size for the disposable cloths.
g. Using the cleaning solution, clean the floor tool at the end of your shift.
3. Wet mops
a. Avoid twisting or squeezing the mop too hard because this can cause the strands
to break.
b. Inspect floor surfaces for splinters and rough surfaces which could catch and tear
the mop strands.
c. Worn mop heads should be replaced.
d. During your work shift, when not in use, keep mops in the bucket or wringer. Be
sure the mop handle is steady so as not to fall and hurt someone.
e. When storing clean mop heads, neatly stack them on the storage shelf.
f. Soiled mop heads should be bagged and taken to daily laundry. Mop heads
should be changed daily.
Page102 g. Never allow mop to remain in the cleaning solution except when they are being
used during your work shift. This will help prevent rotting of the strands or
“souring.”
h. Cut off loose and uneven yarn strands.
i. Be sure the wringer is the proper size for the mop head.
j. Using the cleaning solution, clean the mop handle at the end of your shift.
4. Clean up
a. Return all equipment to the appropriate area.
b. Remove gloves and wash hands.
Safety
1. Use equipment only for the purpose for which it has been designed.
2. Always practice standard precautions when cleaning any blood or body fluid spills, or
soil that could contain these or other potentially infectious material from equipment.
3. When cleaning or decontaminating equipment, be careful not to get any cleaning
chemicals on any surface for which it is not intended to avoid damage.
4. Always wear gloves, a mask or goggles and any other appropriate personal protective
equipment when cleaning and handling equipment.
5. Always store equipment properly and in a safe manner that does not present a hazard to
yourself or others.
OFFICE / DEN / FOYER CLEANING
Purpose: To provide a clean, attractive environment that enhances the image of the home.
Materials Required
1. Disinfectant Cleaner as designated in the current approved cleaning supply list
2. Furniture polish as designated in the current approved cleaning supply list
3. Hand pail
4. Clean cloths
5. Long handled duster
6. Putty knife
7. Wet floor signs
8. Vacuum cleaner
9. Clear plastic liners for waste containers
10. Gloves and other personal protective equipment as needed
Preparation
1. Gather the designated cleaning solution into the hand pail.
2. Take equipment to the assigned area.
3. Put on gloves and wear the appropriate personal protective equipment.
Procedure
Page103 1. Remove general waste
a. Close, twist, and tie a knot in the top of the plastic trash can liner while it is still
in the container.
b. Use caution and look for protruding objects in the waste containers. NEVER
reach into or push on the bag to compress the trash.
c. Place the bag of trash into the container on your cart or take it to the waste pick
up site. NEVER carry a bag of trash against any part of your body.
d. Wipe all surfaces of the waste container with cleaning solution and allow to air
dry.
e. Reline the container with an appropriate trash liner.
2. Remove recycling
a. Remove recycling waste from the area.
b. Place the recycling into the appropriate container on the cart or take it to the
recycling waste pick up site.
c. Wipe all surfaces of the waste container with cleaning solution and allow to air
dry. If the container is cardboard and is soiled or damaged, replace with a new
container.
d. Reline the container with an appropriate trash liner if required by your home.
3. High dust
a. Using the long handled duster, high dust the tops of items on the walls that are
at or above your shoulder height.
b. Include items such as pictures, plaques, mirrors, bulletin boards, tops of
partitions, vents, tops of cabinets, and window/door frames.
4. Damp dust
a. Begin dusting at the room entrance and work around the room. Damp dust the
top of an object first and work down to avoid soiling surfaces you have just
cleaned.
b. Fold the cloth into a series of squares to provide several potential cleaning
surfaces. A wadded cloth does not clean as efficiently.
c. Dampen the cloth in the cleaning solution and wring out all excess solution to
avoid drips.
d. Damp dust the door and wall features such as thermostat, light switches, ledges,
windowsills, and writing boards, including the marker holder.
e. Spot clean visible soil from doors, walls, windows, and blinds.
f. Damp dust the furnishings/furniture such as tables, lights, bookcases, file
cabinets, chairs, telephones, and desks.
g. NOTE: Do not disturb papers, or personal items on top of the furniture in offices.
h. PERIODICALLY: Polish and oil any wood furniture following the label
directions.
5. Clean the floor – carpet
a. Plug the vacuum into the wall outlet. Avoid running over the electrical cord with
the vacuum cleaner; manage the cord to work away from the outlet rather than
toward it.
b. Vacuum back and forth using overlapping passes.
c. Be sure to vacuum under and behind all furniture including waste containers.
d. Inspect the area for spots and stains and remove them.
e. PERIODICALLY: Vacuum the carpet edges.
Page104
6. Clean the floor – hard surface
a. Remove any sticky residue from the floor by gently prying it loose
with the putty knife. Take care not to scratch the floor.
b. Dust mop/sweep the floor.
c. Use the broom and dustpan to take up the soil.
d. Dispose of the soil into appropriate container.
e. Post caution sign in doorway.
f. Put Cleaning Pad on the mop head.
g. Clean the edges of the floor.
h. In the open area of the floor, use a figure-eight motion and turn the mop over
every few strokes. Rinse and wring out the mop frequently.
i. Be sure to mop under and behind furniture including waste containers. Be sure
to straighten the furniture by placing any chairs under tables, etc.
j. Remove the wet floor signs after the floor is completely dry.
7. Clean up
a. Clean all equipment and return it to the appropriate place.
b. Bag soiled cleaning cloths for daily laundry.
c. Remove gloves and personal protective equipment.
d. Wash your hands.
Safety
1. Always check electrical equipment prior to use (refer to procedure for care of electrical
equipment).
2. Always post caution signs appropriately.
3. Be careful not to hurt yourself when moving any furniture or other heavy objects.
Always practice proper lifting techniques and ask for assistance when appropriate.
4. Always use the cleaning chemical exactly as directed by the label following all
recommended safety precautions.
ELDER ROOM CLEANING
Purpose: To provide a clean, attractive, and safe environment for residents and their families,
visitors, and staff.
Materials Required
1. Gloves and personal protective equipment as needed
2. “Wet Floor” caution sign
3. Clear plastic liners for trash cans
4. Long handled duster
5. Dry, lint-free cleaning cloths
6. Hand pail
7. Disinfectant Cleaner as designated in the current approved cleaning supply list
8. Toilet tissue
Page105 9. Paper towels
10. Liquid soap
11. Bowl brush
12. Broom
13. Brush
14. Dustpan
15. Tongs or forceps
16. Putty knife
17. Vacuum with hand attachments
18. Cleaning Pads for mop
19. Clean wet mop-head and handle
20. Step stool or ladder
21. Clear plastic bags for used linen
Preparation
1. Inspect your clothing for general cleanliness and appearance. If your clothing is
excessively soiled, change into a clean article of clothing.
2. Wear gloves and appropriate personal protection equipment.
3. Stock your housekeeping tote with the required equipment and supplies.
4. Gather the required cleaning solutions.
Procedure
*THIS PROCEDURE IS ALSO FOLLOWED TO PREPARE AN ELDER’S ROOM PRIOR TO A
MOVE IN.
1. Enter the room carefully
a. Look for infection control signs that indicate the need for special precautions.
b. Put on the required personal protective equipment.
c. ALWAYS knock to be sure that the room is unoccupied.
d. Greet the elder and their family or visitors in a friendly, courteous manner.
Identify yourself and explain why you are there.
e. If a doctor, nurse, minister or other clinical person is in the process of any type of
procedure or discussion, excuse yourself and come back later. This is very
important.
f. Take the supplies and equipment you need into the room. Keep supplies within
your sight.
2. General inspection
a. Survey the area. Pick up loose trash.
b. Be alert for needles and other sharp objects. Pick up sharps using a mechanical
device such as a tongs, forceps, or brush and dustpan and place them into a
sharps container.
3. Remove general waste
a. Remove general waste from the patient room.
b. Use caution and look for protruding objects in the waste containers. NEVER
reach into or push on the bag to compress the trash.
Page106 c. Close, twist and tie a knot in the top of the plastic trash can liner while it is still in
the container.
d. Place the bag of trash into the container on your cart or take it to the waste pick-
up site.
4. Remove soiled and used linen
a. Remove all soiled linen, including, gowns, towels and wash cloths. Watch
carefully for needles and other sharp objects that may have been accidentally left
behind.
b. Roll the linen into a bundle for easy handling. Avoid excessive handling or
shaking of the linen.
c. Carry the linen away from your body.
d. Place the linen in the appropriate container. Secure the container for proper
transport to the laundry.
5. High dust wall articles
a. High dust the tops of items along the elder room and bathroom walls (picture
frames, clocks, etc.) that are at or above your shoulder height.
b. Use a long handled feather duster and make long, slow strokes.
c. If the elder is in bed, do not dust anything above or near the elder.
6. Damp dust the doors and wall features
a. Damp dust the door and wall features in the elder room.
b. Begin dusting at the entrance door and work around the room. Damp dust the
top of an object first and work down to avoid soiling surfaces you have just
dusted.
c. Fold the cloth in a series of squares to provide several potential cleaning surfaces.
A wadded cloth does not clean as efficiently.
d. Dampen the cloth in either all-purpose cleaner or disinfectant cleaner depending
on the requirements of the area and wring out the excess solution to avoid drips.
When using the disinfectant cleaner, wet the surface you are cleaning and allow
to air dry.
e. Damp dust items such as thermostats, light switches, and ledges.
f. Spot clean visible soil from doors, walls, windows and blinds. Pay attention to
heavily soiled and frequently touched surfaces.
g. Use the damp cloth on soil. Use the abrasive hand pad to clean stubborn spots
then re-wipe the area with the cleaning cloth.
h. Never shake the cloth. When it becomes too soiled to continue, simply refold it
so a clean surface is available or send to laundering.
7. Clean the room furnishings.
a. Clean all furnishings in the elder room including the bedside table, overbed
table, closet, and chairs.
b. Fold the cloth in a series of squares to provide several potential cleaning surfaces.
A wadded cloth does not clean as efficiently.
c. Dampen the cloth in either all-purpose cleaner or disinfectant cleaner (depending
on the requirements of the area) and wring out the excess solution to avoid drips.
When using the disinfectant cleaner, wet the surface you are cleaning and allow
to air dry.
d. Clean the top of an object first and work down to avoid soiling surfaces you have
just cleaned.
Page107 e. Use the damp cloth on soil. Use an abrasive hand pad to clean stubborn soil, then
re-wipe the surface with the cleaning cloth.
f. Pay attention to soiled or frequently touched surfaces such as bed controls, bed
rails, and TV controls.
8. Clean the telephone
a. Clean the phone, cord and dial plate using the disinfectant cleaner.
b. Thoroughly clean the hand piece and push buttons.
9. Clean and refill the soap dispenser
a. Inspect soap dispensers to ensure that there is an adequate supply of soap.
b. If a soap dispenser is a disposable unit and the soap level is low, replace the unit.
c. If a soap dispenser is a reusable unit, follow the instructions for opening,
cleaning, filling and replacing the dispenser. Be sure to wash and dry the inside
of the dispenser before adding fresh solution.
d. Clean the exterior of the dispenser with a damp cloth and disinfectant cleaner
and dry it completely.
e. Report any broken or malfunctioning units/items to Plant Operations for repairs.
10. Clean and refill the paper towel dispenser
a. Open or unlock the dispenser. Be careful not to let it fall open as it can scratch the
wall or hurt you.
b. Remove any paper towels and clean the inside of the dispenser using a damp
cloth and disinfectant cleaner to remove loose paper dust.
c. Replace paper towels. For folded paper towels, be sure to place them folded side
down and interleave the bottom of the new sheets with the top of the existing
sheets. Add as necessary to fill the unit. Do not overfill as this will make it
difficult to pull the towels out. Check to be sure the towels release easily.
d. Close and lock the dispenser making sure it is secure and will not fall open and
hurt someone.
e. Clean the outside of the dispenser with a damp cloth and disinfectant cleaner
and dry it completely.
11. Clean and refill the toilet tissue dispenser
a. Remove the tissue rollers.
b. Clean the inside and outside of the dispenser to remove paper dust using a damp
cloth and disinfectant cleaner.
c. Install the new roll of tissue. Be sure the tissue unwinds over the top of the roll
(and not from underneath) since this allows it to be pulled out more easily and
avoids unrolling and wasted product. Be sure to “start” the tissue by pulling the
first sheet loose for the convenience of the elder.
d. Report any broken or malfunctioning roller units to the appropriate person for
repair.
12. Clean the restroom walls and wall features
a. Clean the bathroom walls and features.
b. Fold the cloth in a series of squares to provide several potential cleaning surfaces.
A wadded cloth does not clean as efficiently.
c. Dampen the cloth in disinfectant cleaner and wring out all excess solution to
avoid drips. When using the disinfectant cleaner, wet the surface you are
cleaning and allow to air dry.
d. Begin cleaning at the door and work around the room in one direction.
Page108 e. Clean the top of an object first and work down to avoid re-soiling surfaces you
have just cleaned.
f. Use a damp cloth on soil. Use an abrasive hand pad on stubborn soil, then re-
wipe the surface with the cleaning cloth.
g. Pay attention to soiled and frequently touched surfaces such as towel bars, grab
rails, pull cords, light switches, and ledges.
13. Begin cleaning the toilet
a. Flush the commode and reduce the water level by pumping with the bowl mop.
b. Apply disinfectant bathroom cleaner to the bowl mop.
c. Clean the inside of the toilet with the bowl mop paying attention to the
underside of the flush rim where bacteria can accumulate and cause unpleasant
odors.
d. Let the disinfectant bathroom cleaner remain on the toilet and continue to the
restroom sink.
14. Clean the bathroom sink
a. Apply disinfectant or bathroom cleaner to the interior surfaces of the sink.
b. Clean the inside of the sink, the exterior surface of the sink, and all metal handles
and faucets using a clean cloth dampened with the disinfectant or bathroom
cleaner.
c. Use a damp cloth on soil. Use an abrasive hand pad with the disinfectant
bathroom cleaner to remove stubborn soil. Always follow the fixture
manufacturer’s recommendations for stain removal, especially on specialty
surfaces.
d. Clean any surfaces around the sink such as vanities or countertops.
e. Clean the plumbing underneath the sink.
f. Wipe all metal fixtures to avoid spotting.
g. Rinse the sink and dry with a clean cloth.
h. Wipe up any spills.
15. Clean shower
a. Apply disinfectant bathroom cleaner to a cleaning cloth and clean the interior
surfaces of the tub and shower including the curtain, walls, soap dish, faucets,
and shower head.
b. Use the abrasive hand pad, if necessary, to remove soap scum, especially from
the walls and floors of a tiled shower stall and from doors. IF the unit is
fiberglass, be sure to follow the manufacturer’s recommendations regarding both
general cleaning and stain removal.
c. Rinse thoroughly using the shower spray if possible.
d. Dry all surfaces carefully to prevent slips and falls.
e. Clean all chrome handles and fittings and dry with a clean, dry cloth to prevent
spotting.
f. Wipe up any spills.
g. Inspect vinyl shower curtain for stains or damage. Replace stained or damage
curtains with a new one. Bag the soiled curtain.
h. Inspect fabric shower curtains for soil or damage. Remove soiled or damaged
curtains laundering or dry cleaning. Hang a new curtain.
16. Finish cleaning the toilet
Page109 a. Clean all exterior surfaces of the fixture with a clean cloth and disinfectant
bathroom cleaner. Pay close attention to the toilet seat and lid.
b. Clean all chrome flush handles, grab rails, etc., then dry with a clean, dry cloth to
prevent spotting.
c. Flush the toilet.
d. Dry the exterior, seat, and lid of the commode carefully.
e. Wipe up any spills on the toilet, floor, or walls.
17. Clean the mirror
a. Fold a clean, lint-free cloth into squares. Spray one side of the cloth with glass
cleaner.
b. Clean the entire mirror.
c. Spray glass cleaner directly on small spots and wipe until completely clean.
Repeat as necessary to remove all soil.
d. Wipe up any overspray.
18. Clean and reline the waste containers
a. Check the interior of the waste container for visible soil. If soil is present, use a
cleaning cloth or abrasive hand pad to remove all visible soil from the interior
and exterior of the container. (If blood or body fluids are present, follow your
specific procedure for clean-up of blood or body fluid spill.)
b. Wipe all surfaces of the container with disinfectant cleaner and allow to air dry.
c. Bag the soiled cloths for daily laundering.
d. Reline the trash container with the appropriate bag.
19. Replenish the linen
a. Remove your gloves and wash hands.
b. Pick up clean linen from the clean utility room or elder’s personal supply and
neatly place it on the towel bars or other appropriate fixtures.
20. Dust mop the bathroom floor
a. Place the floor dusting cloth on the floor dusting cloth holder.
b. Inspect the floor for debris and wet spots. Dry all wet spots. You cannot dust
mop a wet floor.
c. Remove any gum or other sticky residue from the floor by gently prying it loose
with the putty knife (be careful not to scratch the floor finish).
d. Don’t lift the cloth off the floor once you have started. Use the swivel motion of
the frame and wrist action to change direction.
e. Move the furniture and replace after dust mopping. Dust under and behind the
bed.
f. After dust mopping the entire area, gently sweep the pile of litter and dirt into
the dustpan using the small broom. Be careful not to stir up the dust. Dispose of
the soil into an appropriate trash container. Never leave a pile of debris in a
corner for later pick-up.
21. Wet mop the bathroom floor
a. Place the “Wet Floor” caution sign outside the room.
b. Immerse the mop in the bucket of disinfectant cleaner to “dwell” on the floor.
This will allow the disinfectant to work.
c. Push the mop around the baseboards first paying attention to removing the soil
from the corners. Avoid splashing the walls and furniture. In open areas, use the
Page110 figure eight stroke, overlapping each stroke. Turn the mop head over every five
or six strokes. Mop a ten foot by ten foot area then rinse and wring out the mop.
d. Repeat these steps until the entire floor has been mopped.
e. Allow the floor to air dry.
22. Clean the room entrance
a. Spot clean visible soil from the room door with a clean cloth and disinfectant
cleaner. Pay extra attention to the door knob, hand plate, and chart holder.
23. Inspect your work
a. Look over the room carefully and mentally check that you have performed all
the required steps and that the room meets your standards.
b. Notify the elder, family or visitors that you are through and thank them – remind
them that the floor will be slippery until it is completely dry and ask them to be
cautious.
c. Leave the wet floor sign at the room entrance while you clean the next room. By
the time you need the sign for the next room, the floor in this room should be
dry.
24. Clean-up after each room
a. Remove all cleaning supplies form the room.
b. Change the Cleaning Pad if it is excessively soiled or after wet mopping four
rooms.
c. Change the wet mop head and the floor dusting cloth when soiled (or per
policy).
d. Bag all soiled cleaning cloths for daily laundering.
25. Clean-up at the end of your shift.
a. Bag all soiled mop heads and cleaning cloths for daily laundering.
b. Clean all equipment and return it to the proper place.
c. Restock all cleaning and room supplies on the cart.
d. Remove gloves and your personal protective equipment.
e. Wash your hands.
Safety
1. Follow the safety precautions explained in each procedure step.
ELECTRICAL ROOM / STAIRWELL CLEANING
Purpose: To maintain clean, attractive, and safe stairwells that enhance the image of the home.
Materials Required
1. Disinfectant Cleaner as designated in the current approved cleaning supply list
2. Dust pan and broom
3. Putty knife
4. Hand pail
5. Cleaning cloths
6. Mop and Cleaning Pads
Page111 7. Long handled duster
8. Wet floor sign
9. Gloves and personal protective equipment as needed
Preparation
1. Properly dispense the appropriate cleaning solution into the hand pail and mop bucket.
2. Take equipment to assigned area. Mop bucket, wringer and mop should be placed on
the bottom landing on the uppermost flight of stairs.
3. Put on gloves and wear the appropriate personal protective equipment.
Procedure
1. High dust
a. Use high duster to clean lights and other high surfaces.
2. Damp dust the door and features
a. Dip the cleaning cloth into the solution, wring it out and damp dust the railing,
doorknobs, and vents.
b. Spot clean fingerprints and marks from wall around light switches, railings and
doors.
3. Clean the landings and steps – Sweep
a. Remove any gum or sticky residue from the floor by gently prying it loose with
the putty knife. Take care not to scratch the floor.
b. Start at the top landing and work down, vacuum the landings and steps.
c. PERIODICALLY: Vacuum the edges and corners of the landings and steps.
4. Mop the floor.
a. Post caution signs at doorway.
b. Start at the furthest point away from the door, working toward the door. Dip
mop into solution and wring out excess liquid.
5. Clean up
a. Clean all equipment and return it to the appropriate place.
b. Bag soiled mop heads and cleaning cloths for daily laundry.
c. Remove gloves and other personal protective equipment.
d. Wash your hands.
Safety
1. Place caution signs at doorway.
2. Make sure landings and stairs are never blocked or cluttered with trash or items for
storage.
3. Report loose treads, railings, and burned out light bulbs.
4. Do not walk on wet floor or step.
5. Always check electrical equipment prior to use (refer to procedure for care of electrical
equipment).
6. Avoid running over the electrical cord with the vacuum cleaner; manage the cord as so
to work away from the outlet rather than toward it.
Page112 TELEPHONE CLEANING
Purpose: To provide clean telephones to help reduce the possibility of cross infection, and to
enhance the image of the home.
Materials Required
1. Disinfectant Cleaner as designated in the current approved cleaning supply list
2. Cleaning cloths
3. Gloves
Preparation
1. Put on gloves and other personal protective equipment.
2. Gather the designated disinfectant cleaning solution.
Procedure
1. Clean the phone
a. Spray the cleaning cloth with cleaning solution.
b. Remove handset from receiver unit and wash base of phone, cord and handset.
c. Let air dry.
d. Return handset to proper position.
2. Notes
a. If cleaning electric phones, never spray the cleaning solution directly onto electric
phones. Always spray the cleaning solution into the cleaning cloth and then
proceed with above procedure.
3. Clean up
a. Bag soiled cleaning cloths for daily laundry.
b. Remove your gloves and wash your hands.
Safety
1. Always use the cleaning chemical exactly as directed by the label following all
recommended safety precautions.
2. Be careful not to get cleaning chemicals on any surfaces for which it is not intended to
avoid damage.
SHOWER CLEANING
Purpose: To maintain a clean and attractive environment which reduces the likelihood of cross
infection and enhances the image of the home.
Materials Required
1. Disinfectant Cleaner as designated in the current approved cleaning supply list
2. Cleaning cloths
3. Hand pail
Page113 4. Gloves and goggles as splashing is likely to occur
Preparation
1. Gather the designated cleaning solution.
2. Put on gloves and goggles.
Procedure
1. Clean the showers
a. Apply disinfectant cleaner to the interior surfaces of the fixture including the
curtain, walls, soap dish, faucets, and shower head.
b. Use the hand pad, if necessary, to remove soap scum, especially from the walls
and floors of a tiled shower stall and from doors – rinse thoroughly using the
shower spray if possible.
c. If the unit is fiberglass, be sure to follow the manufacturer’s recommendations
regarding both general cleaning and stain removal.
d. Dry all surfaces carefully to prevent slips and falls.
e. Damp wipe all chrome handles and fittings and dry with a clean, dry cloth to
prevent spotting.
f. Inspect the shower curtain for visible soil and, if soiled, replace it with a clean
one – bag the soiled curtain per hospital procedure for laundering or dry
cleaning.
g. Wipe up any spills.
2. Clean up
a. Bag the soiled cleaning cloths for daily laundering.
b. Clean and rinse the hand pail and brush.
c. Return all chemicals and equipment to proper storage.
d. Remove personal protective equipment and wash your hands.
UTILITY ROOM CLEANING
Purpose: To maintain a clean and attractive environment for residents and their families and
employees, which helps reduce the likelihood of cross infection.
Materials Required
1. Gloves and goggles as splashing is likely to occur
2. Disinfectant Cleaner as designated in the current approved cleaning supply list
3. Hand pail
4. Cleaning cloths
5. Long handled duster
6. Red plastic liners for infectious waste containers
7. Clear plastic liners for waste containers
8. Paper towels
9. Liquid or cartridge soap
10. Mop bucket and wringer
11. Dust pan and broom
Page114 12. Putty knife
13. Wet floor sign
Preparation
1. Put on gloves and goggles.
2. Gather the designated disinfectant cleaning solution.
3. Take equipment to assigned area.
Procedure
1. Remove general waste
a. Close, twist, and tie a knot in the top of the plastic trash can liner while it is still
in the container.
b. Use caution and look for protruding objects in the waste containers. NEVER
reach into or push on the bag to compress the trash.
c. Place the bag of trash into the container on your cart or take it to the waste pick
up site. NEVER carry a bag of trash against any part of your body.
d. Wipe all surfaces of the waste container with cleaning solution and allow to air
dry.
e. Reline the container with an appropriate trash liner.
2. High dust
a. Using the long handled duster, high dust the tops of items on the walls that are
at or above your shoulder height.
b. Include items such as, mirrors, bulletin boards, vents, tops of cabinets, and
window/door frames.
3. Damp dust
a. Begin dusting at the room entrance and work around the room. Damp dust the
top of an object first and work down to avoid soiling surfaces you have just
cleaned.
b. Fold the cloth into a series of squares to provide several potential cleaning
surfaces. A wadded cloth does not clean as efficiently.
c. Dampen the cloth in the cleaning solution and wring out all excess solution to
avoid drips.
d. Damp dust the door and wall features such as thermostat, light switches, ledges,
windowsills, and writing boards, including the marker holder.
e. Spot clean visible soil from doors, walls, windows, blinds.
f. Damp dust the furnishings/furniture such as shelving, and lights.
4. Clean and refill the dispensers
a. Inspect the soap dispenser to ensure that there is an adequate supply of soap.
b. If soap dispenser is a disposable unit and the soap level is low, replace the unit.
c. If soap dispenser is a reusable unit follow your facility procedure for opening,
cleaning, and filling the dispenser. Be sure to wash and dry the inside of the
dispenser before adding fresh soap.
d. Clean the exterior of the dispenser with a damp cloth and cleaning solution.
e. Open the paper towel dispenser. Be careful not to let it fall open as it can scratch
the wall or hurt you.
Page115 f. To remove loose paper dust, remove any paper towels and clean the inside of the
dispenser using a damp cloth and cleaning solution.
g. Replace paper towels. For folded paper towels, be sure to place them folded side
down and interleave the bottom of the new sheet with the top of the existing
sheets. Add as necessary to fill the unit. Do not overfill, as this will make is
difficult to pull the towels out. Check to be sure the towels release easily.
h. Close and lock the dispenser making sure it is secure and will not fall open and
hurt someone.
i. Clean the outside of the dispenser with a damp cloth and cleaning solution.
j. Report any broken or malfunctioning units to Plant Operations for repairs.
5. Clean the sink
a. Apply disinfectant to the interior surfaces of the sink.
b. Clean the inside of the sink, the exterior surface of the sink, and all metal faucets
and handles using a clean cloth dampened with the disinfectant cleaner.
c. On stubborn soil, use an abrasive hand pad with the disinfectant cleaner. Always
follow the fixture manufacturer’s recommendations for stain removal, especially
on specialty surfaces.
d. Clean any surfaces around the sink such as vanities or countertops.
e. Clean the plumbing under the sink at the frequency required by your facility.
f. Dry all metal fixtures with a clean cloth to avoid spotting.
g. Rinse the sink and dry with a clean cloth.
6. Clean the floor
a. Inspect the floor for debris and wet spots. Dry all wet spots. You cannot dust
mop a wet floor.
b. Remove any gum or sticky residue from the floor by gently prying it loose with
the putty knife. Take care not to scratch the floor.
c. Dust mop the floor.
d. Use the brush and dustpan to take up the soil.
e. Dispose of soil into appropriate container.
f. Post caution sign in doorway.
g. Dip the mop into the solution and wring out excess liquid.
h. Clean the edges of the floor.
i. In the open area of the floor, use a figure-eight motion and turn the mop over
every few strokes. Rinse and wring out the mop frequently.
j. Be sure to mop under and behind furniture including waste containers.
k. Remove the wet floor sign after the floor is completely dry.
7. Clean up
a. Clean all equipment and return it to the appropriate place.
b. Bag soiled mop heads and cleaning cloths for daily laundry.
c. Remove personal protective equipment and wash your hands.
Safety
1. Always post caution signs appropriately.
Page116 VACUUM CLEANERS (WET AND DRY) CARE AND STORAGE
Purpose: To keep all equipment in clean and working condition.
Materials Required
1. Disinfectant Cleaner as designated in the current approved cleaning supply list
2. Cleaning cloths
3. Assorted tools (screwdrivers, pliers, hammer, etc.)
4. Oils and lubricants
5. Spare parts (belts, winger springs, hooks, etc.)
6. Gloves, goggles, and other appropriate personal protective equipment
Preparation
1. Gather the appropriate cleaning solution.
Procedure
1. Store the vacuum cleaner
a. Check to be sure the belts, brushes and motor are in good condition and
operating properly before each use: check the condition of the beater bar before
and after each use, cleaning and replacing as necessary.
b. Check dry vac bags before and after each use: empty bags when they become
half full to prevent motor damage – do not allow bags to overfill.
c. Check filters before each use and clean or replace them as necessary.
d. Empty and rinse wet vac canisters.
e. If the unit has been used to clean a blood or body fluid spill, be sure to
decontaminate per OSHA guidelines.
f. If the unit has an automatic shut-off feature, check the mechanism before and
after each use to make sure water has not entered the motor.
g. Store wet vacs in an open position to allow air flow and prevent mildew.
2. Clean up
a. Return all equipment to the appropriate area.
b. Remove personal protective equipment and wash hands.
Safety
1. Use equipment only for the purpose for which it has been designed.
2. Always practice correct lifting techniques when lifting, pushing, pulling or moving
equipment.
3. Always practice standard precautions when cleaning any blood or body fluid spills, or
soil that could contain these or other potentially infectious material from equipment.
4. When cleaning or decontaminating equipment, be careful not to get chemicals on any
surface for which it is not intended to avoid damage.
5. Always wear gloves, a mask or goggles and any other appropriate personal protective
equipment when cleaning and repairing equipment.
Page117 6. Always store equipment properly and in a safe manner that does not present a hazard to
yourself or others.
7. Inspect the electrical cord and plug before and after each use; report any frayed or cut
wires to your supervisor and do not plug in the unit if these conditions are present.
8. Always follow manufacturers recommended care procedures.
VENTS / DRY VACUUM
Purpose: To maintain air circulation vents and keep them free from dust and lint, thus creating
a healthy and attractive environment.
Materials Required
1. Vacuum cleaner with attachments
2. Step ladder
3. Caution sign
Preparation
1. Post the caution sign.
2. Carefully set up the ladder, if needed, being sure to place it squarely on a level surface
and lock it open before climbing onto it.
Procedure
1. Dry vacuum the vents
a. Using the correct attachment, thoroughly vacuum the vent being careful not to
extend your reach.
b. After completing a vent, carefully climb down from the ladder and relocate it so
that the next vent is accessible.
c. Continue in this manner until all vents in the assigned area have been completely
vacuumed.
2. Clean up
a. Inspect the plug and coil the cord and wipe off the unit.
b. Check the bag and replace if necessary.
c. Store the vacuum in its assigned location.
d. Store the ladder and caution sign properly.
Safety
1. Always take the time to position the ladder squarely on an even surface and lock it into
the open position before attempting to climb it. NEVER stand on the very top step of a
ladder.
2. Always check electrical equipment prior to use.
3. Avoid running over the electrical cord with the machine; manage the cord to work away
from the outlet rather than toward it.
4. Always post caution signs appropriately.
5. Always unplug the machine prior to checking or working on it.
Page118 WINDOWS / INTERIOR CLEANING
Purpose: To maintain a clean and attractive environment which enhanced the image of the
home.
Materials Required
1. Glass Cleaner as designated in the current approved cleaning supply list
2. Step ladder
3. Caution sign
4. Squeegee
5. Gloves and goggles as splashing is likely to occur
Preparation
1. Properly dispense the designated glass cleaning solution.
2. Put on gloves and goggles.
3. Move the furniture away from the window area and place a drop cloth on the floor if
needed.
4. Never move scientific instruments, computers or therapy equipment. Ask your
supervisor for advice and assistance if these items are in the way of cleaning.
5. Raise blinds all the way to the top of the window (or open all the way to the sides).
Open draperies all the way.
6. Carefully set up the ladder, if needed, being sure to place it squarely on a level surface
and lock it open before climbing onto it. Post caution sign.
Procedure
1. Wash the interior window
a. Wash the frame by spraying the frame with cleaning solution or by wiping with
a cleaning cloth soaked in the cleaning solution in your hand pail and wrung as
dry as possible. Then wipe the same area with a clean, dry cloth to prevent
spotting.
b. Apply the glass cleaner liberally to the window glass. Using a clean, lint-free
cloth, make continuous strokes starting at the top of the window and work
toward the bottom. Be sure to cover the entire surface. Pay close attention to the
corners. Squeegee or wipe the window clean and dry.
c. Wipe up any spills.
d. Clean the sill as you did the frame.
e. Return blinds and drapes to their original position.
2. Clean up
a. Empty and rinse out the hand pail. Wipe it dry and store properly.
b. Store the ladder and caution sign properly.
c. Bag the soiled cleaning cloths for daily laundering.
d. Remove gloves and goggles and wash hands.
Page119
Safety
1. Always take the time to position the ladder squarely on an even surface and lock it into
the open position before attempting to climb it. NEVER stand on the very top step of a
ladder.
2. Always post caution signs appropriately.
3. Always use the cleaning chemical exactly as directed by the label following all
recommended safety precautions.
4. Be careful not to splash any cleaning chemicals into your eyes, nose, mouth or onto your
skin. Always wear gloves and wear a mask or goggles if necessary for protection –
especially if there is a danger that chemicals could drip down into your face.
5. Always practice standard precautions when cleaning any blood or body fluid spills, or
soil that could contain these or other potentially infectious material.
6. Be careful not to get the cleaning chemical on any surface for which it is not intended to
avoid damage.
7. Be careful not to hurt yourself when moving furniture or other heavy objects. Always
practice proper lifting techniques and ask for assistance when appropriate.
HOOD / OVEN CLEANING
Purpose: To reduce the risk of fire and to provide a sanitary environment.
Materials Required
1. General purpose detergent as designated in the current approved cleaning supply list
2. Hot water
3. Clean soft clothes
4. Stainless Steel polish cleaner as designated in the current approved cleaning supply list
5. Gloves and goggles as splashing is likely to occur
Preparation
1. Gather the designated cleaning supplies.
2. Put on gloves and goggles.
3. Prepare gallon bucket of water with general purpose detergent.
4. Remove all items from the stovetop.
Procedure
1. Remove screens from slats of hood.
2. If screens have a large buildup of grease, spray with a degreaser prior to placing in the
dishwasher.
3. Run the screens through the dishwasher cycle.
4. Wipe hood thoroughly.
5. Rinse with hot damp cloth and allow to air dry.
6. Stainless steel polish cleaner may also be used.
7. Remove gloves and goggles and wash hands.