Template

EVS Patient Visitation Cleanliness Evaluation

by James Rose, from the Community

20+

This EVS patient visitation and cleanliness evaluation helps hospital environmental services teams assess room and restroom hygiene and gather patient feedback. It includes scripted introductions, a patient satisfaction questionnaire, visual observation checkpoints for rooms and restrooms, and prompts to note improvement areas across Nursing, Facilities, Food & Nutrition, and EVS. Use it to standardize rounds and elevate cleanliness and patient experience.

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Digitize any process, procedure or policy

Eliminate mistakes made by paper-based processes

Create and share professional reports instantly

Confirm accountability and compliance with a digital log

With SafetyCulture you can

Digitize any process, procedure or policy

Eliminate mistakes made by paper-based processes

Create and share professional reports instantly

Confirm accountability and compliance with a digital log

About author

Community

This community page makes available free workplace checklists and templates created by other users within the SafetyCulture community. SafetyCulture has re-published this content and where possible, has credited the original author. SafetyCulture has not verified the accuracy, reliability or suitability of any community content. You agree that your use of any of this content is in accordance with SafetyCulture’s Terms and Conditions.

Template
Patient Visitation / Cleanliness Evaluation - EVS**
This document outlines a structured approach for Environmental Services (EVS) preceptors to evaluate room cleanliness and patient satisfaction in hospital settings. It includes a patient satisfaction questionnaire, visual observation checklist, and assessment criteria for multiple hospital service areas. The evaluation covers housekeeping interactions, room and restroom cleanliness, and identifies areas for improvement across nursing, facilities engineering, food and nutrition, and environmental services departments. The form emphasizes professional customer service and ensures consistent quality standards in healthcare facility maintenance.
by James Rose, from the Community
Downloads: 40+
Get
Template
EVS Customer Rounds Checklist
Use this EVS customer rounds checklist to assess cleanliness, responsiveness, and supply availability across hospital areas, including patient rooms, nurses stations, restrooms, corridors, elevators and stairwells. Auditors can rate items (Excellent/Good/Fair/Poor), add notes and photo evidence, specify locations and room numbers, record interviewee details, and capture digital signatures. Export findings as PDF, Word, Excel, or web link to share results and drive environmental services quality and patient satisfaction.
by Cory Crook, from the Community
Downloads: 20+
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Patient Sign in Sheet Template
Use this Patient Sign in Sheet Template to track patient attendance. This can help record information such as the time of appointment, assigned doctor, and time of patient's arrival. Use SafetyCulture to generate offline reports and track patient attendance.
by SafetyCulture
Downloads: 20+
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Template
EOC Rounding Checklist for Patient Floors
Use this Environment of Care rounding checklist to evaluate patient floor safety, cleanliness, equipment condition, fire protection, and infection control. Inspect doors, exits, electrical outlets, medical gas, EVS closets, signage, ceiling tiles, beds, and windows. Capture notes and photos, log deficiencies, assign corrective actions with due dates, and track follow-up to closure. Standardize rounds across units and support accreditation readiness.
by Richard Martinez, from the Community
Downloads: 0
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Patient Visitation / Cleanliness Evaluation - EVS**

This document outlines a structured approach for Environmental Services (EVS) preceptors to evaluate room cleanliness and patient satisfaction in hospital settings. It includes a patient satisfaction questionnaire, visual observation checklist, and assessment criteria for multiple hospital service areas. The evaluation covers housekeeping interactions, room and restroom cleanliness, and identifies areas for improvement across nursing, facilities engineering, food and nutrition, and environmental services departments. The form emphasizes professional customer service and ensures consistent quality standards in healthcare facility maintenance.

by James Rose, from the Community

40+

Get

Template

EVS Customer Rounds Checklist

Use this EVS customer rounds checklist to assess cleanliness, responsiveness, and supply availability across hospital areas, including patient rooms, nurses stations, restrooms, corridors, elevators and stairwells. Auditors can rate items (Excellent/Good/Fair/Poor), add notes and photo evidence, specify locations and room numbers, record interviewee details, and capture digital signatures. Export findings as PDF, Word, Excel, or web link to share results and drive environmental services quality and patient satisfaction.

by Cory Crook, from the Community

20+

Get

Template

Patient Sign in Sheet Template

Use this Patient Sign in Sheet Template to track patient attendance. This can help record information such as the time of appointment, assigned doctor, and time of patient's arrival. Use SafetyCulture to generate offline reports and track patient attendance.

by SafetyCulture

20+

Get

Template

EOC Rounding Checklist for Patient Floors

Use this Environment of Care rounding checklist to evaluate patient floor safety, cleanliness, equipment condition, fire protection, and infection control. Inspect doors, exits, electrical outlets, medical gas, EVS closets, signage, ceiling tiles, beds, and windows. Capture notes and photos, log deficiencies, assign corrective actions with due dates, and track follow-up to closure. Standardize rounds across units and support accreditation readiness.

by Richard Martinez, from the Community

Get

EVS Patient Visitation Cleanliness Evaluation

About author

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Patient Visitation / Cleanliness Evaluation - EVS**

EVS Customer Rounds Checklist

Patient Sign in Sheet Template

EOC Rounding Checklist for Patient Floors

You might also like

Patient Visitation / Cleanliness Evaluation - EVS**

EVS Customer Rounds Checklist

Patient Sign in Sheet Template

EOC Rounding Checklist for Patient Floors