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PRINTED: 11/30/2020 FORM APPROVEDDEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION(X1) PROVIDER/SUPPLIER/CIA IDENTIFICATION
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Start by reviewing the survey questions and guidelines provided.
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Gather necessary information such as patient records, employee training records, and infection control policies.
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Fill out each question accurately and thoroughly, providing any supporting documentation when required.
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Who needs infection control survey and?

01
Healthcare facilities such as hospitals, clinics, nursing homes, and dental offices are typically required to fill out infection control surveys to ensure compliance with guidelines and regulations.
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Any organization or establishment that deals with patient care or medical services may need to fill out an infection control survey.
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Infection control survey is a process used to evaluate and monitor infection control practices within a healthcare facility.
Healthcare facilities such as hospitals, clinics, and long-term care facilities are required to file infection control surveys.
Infection control surveys are typically filled out by designated infection control personnel within the healthcare facility.
The purpose of infection control survey is to identify areas of improvement in infection control practices and prevent the spread of infections.
Information such as hand hygiene practices, use of personal protective equipment, cleaning and disinfection protocols, and outbreak control measures must be reported on infection control surveys.
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