11-435-002-got;
COA1,10 ftonp ftmilto I,=
WA amp Risk
f ftlailqtR&
LOW
L
Who has the uftrftY W lamporarl4l Stop all constw*n e clue to lmv�rlen irfection omitrol or
Vvt* akffloftal precautlons shovid be con"red based on thts slasownonn
hne Colftri, W. and SftV *f4w
a" 11
%M3 exoss" ran or vibrallon be generated du " cvA-uctlzn Dowdes? Whm vffl thus "nil
fdwyl-v spauk Ift of madvoss (0,0.1 pedent moms, moftstom lvorr%, sto.)
00010 Dnaft the p!AM for min)MI11m; on and Its Irnpad an pasent=rs swvkxw
4 Pnftn ffti*4 wmis bsthrom ~1 Dootors 4wooM wft
ModwatencludirLWwrkhours
atep 8
8" 14,
tdw* issues related to v*rda!)oNpWmbh;;. s In tamns of the woummos of probabie outagelt
Do plans allow for adequate number of pV=M wWrmn*A and Isdatim roctms?
Vlatof arld powbolated wd toppawt/ &med off &ft con ft COO ss mquftd
NA
WOPT
Step is
*r of weber d I& re a to )s
C*iW poftntW hak amage, the Ask dus compromItio o1smems of to buld1n;
Do the plans allow fdr the required number & type of hW g sinks?
washIn
ow#41 orstruftn? ffscla what Mom wl be taken to keepwaiercliAcIthe NOW
Yea
WOW r* of walar *map to Ni" ft-n ft #xWtf. ftmzft Am w* be iWaled as m*ad
I all j 4*j
&N
ldwt�/ coMainmont ffleazwet Describe how the barriers vAl be zonA%**cL Desafto hzw negrM
AIA Wdo[rles for anw)
-got;
w
9H3 107 Agreement
[e]:40L 1:41VTrika-110 Al I I 1 [6160
11 rel g
0
L 48" L
q I
5"NOMINAL
NOTE- INSTALL VISQUEEN TO FIT TIGHT FOR DUST PROTECTION
SCALE: N.T.S.
nil
M SCALE: 3/8" = V-0"
1 1
41�
Tre. Haddad
'Iftlebtroom
L
SOUTH MIAMI HOSPITAL
4th FLOOR PAVILION
6200 SW 73 STREET
SOUTH MIAMI, FLORIDA 33143
OWNER.
BAPTIST HEALTH SOUTH FLORIDA, INC.
8900 North Kendall D(jve,
Miami, 'Florida 33176
ISSUE RECORD:
04/11/11
D I
INFE TI N CONTROL
RISK ASSESSMENT
& NOTES
QHEET No.
� A1.0
COA1,10 ftonp ftmilto I,=
WA amp Risk
f ftlailqtR&
LOW
L
Who has the uftrftY W lamporarl4l Stop all constw*n e clue to lmv�rlen irfection omitrol or
Vvt* akffloftal precautlons shovid be con"red based on thts slasownonn
hne Colftri, W. and SftV *f4w
a" 11
%M3 exoss" ran or vibrallon be generated du " cvA-uctlzn Dowdes? Whm vffl thus "nil
fdwyl-v spauk Ift of madvoss (0,0.1 pedent moms, moftstom lvorr%, sto.)
00010 Dnaft the p!AM for min)MI11m; on and Its Irnpad an pasent=rs swvkxw
4 Pnftn ffti*4 wmis bsthrom ~1 Dootors 4wooM wft
ModwatencludirLWwrkhours
atep 8
8" 14,
tdw* issues related to v*rda!)oNpWmbh;;. s In tamns of the woummos of probabie outagelt
Do plans allow for adequate number of pV=M wWrmn*A and Isdatim roctms?
Vlatof arld powbolated wd toppawt/ &med off &ft con ft COO ss mquftd
NA
WOPT
Step is
*r of weber d I& re a to )s
C*iW poftntW hak amage, the Ask dus compromItio o1smems of to buld1n;
Do the plans allow fdr the required number & type of hW g sinks?
washIn
ow#41 orstruftn? ffscla what Mom wl be taken to keepwaiercliAcIthe NOW
Yea
WOW r* of walar *map to Ni" ft-n ft #xWtf. ftmzft Am w* be iWaled as m*ad
Steps
Does the Infacticrt controf W agras W!th ft ffftlnvn mimbor of sk" for this pm, ify opm
'aW (Vie
ldwt�/ coMainmont ffleazwet Describe how the barriers vAl be zonA%**cL Desafto hzw negrM
AIA Wdo[rles for anw)
pressure *9 berraftinod wt.in the *vk tons. What W* of Mallom wM be vW4W Attach drrMngs
9
NA
CwW%0wz=# Is wX)M Doc!or* tuft Ar
do room *9 be weatod wW* of om*vftn me,
NpGal" 94, to be m0wainod of -a al.
iT
Does the InWom =,&d staff game WM ft puns moft to o"M ohd sow U1,12ty tooms?
a"
Work hm,m W ft work be parlormed durft dILpak hours? What V1 be your wont whadvie?
NA
Vtr* WN be dwv dwft normal worwiv houm
1.3 www*M WTQWIMV, KWW, E 8warl; St UA* EOM11446;W-HoushnTA. EMUMPDOW, OFN CA
FIN" U*MN4 moo* COAK, ktftlmw*% MIt
FWN rfdvm 11W Z"s Swt*, EC$1 ft 5ft" W14, MN
DWAM the ftowng containment Jou" %ti the prq�W ewr (comment as to' how these Wl be
s6ftseed),
Traft ftw - A%v
Housekeeping — Dtlyp mopW of alon as modoa Cajw at j4#*w sy" vowumd as mqAvd,
Debris remove! - Do" romos d In wmvd owt be f" a Ad after wwt Q0 MW P&v to ftm
1977M4
stop 1t
RSV*w law 6
Inbation Control Agreement Risk Assessment (11C RA)
B. infection Control Agreement Risk Aseg"mont (IORA)
Matrix of Precautions — Appendix A
Ift j Lvz Oft-,
w
9H3 107 Agreement
[e]:40L 1:41VTrika-110 Al I I 1 [6160
11 rel g
0
L 48" L
q I
5"NOMINAL
NOTE- INSTALL VISQUEEN TO FIT TIGHT FOR DUST PROTECTION
SCALE: N.T.S.
nil
M SCALE: 3/8" = V-0"
1 1
41�
Tre. Haddad
'Iftlebtroom
L
SOUTH MIAMI HOSPITAL
4th FLOOR PAVILION
6200 SW 73 STREET
SOUTH MIAMI, FLORIDA 33143
OWNER.
BAPTIST HEALTH SOUTH FLORIDA, INC.
8900 North Kendall D(jve,
Miami, 'Florida 33176
ISSUE RECORD:
04/11/11
D I
INFE TI N CONTROL
RISK ASSESSMENT
& NOTES
QHEET No.
� A1.0