Correct ConsentForms areAvailable,andStaff can Speakto all PartsClearSeparationof Cleanand DirtyALL Sharpsare Securedor inConstantSupervisionSinks and IceMachines areFree ofCalciumBuild-upCLEARSeparation ofFull/Partialand EmptyOxygen TanksALLBathroomsare Cleanand StockedALL Specimensare TransportedAppropriatelyThrough the HallCurtains areClean and inGoodConditionNOHighDustNO Food orUncoveredDrinks inPatient CareAreasCeilingTiles arein GoodConditionNOCardboard inPatient CareAreasBleachWipes –4MinutesStaff CanSpeakto Processfor RoomTurnoverALL ElectricalPanels, EGRESS,Fire Extinguishersand Fire PullStations areUnobstructedNOBugs inLightsHydrogenPeroxide(GreenTop)-5MinutesALL RequiredEquipmenthas Up-to-Date PMStickersNOSuppliesStored onFloorNOProtectedHealthInformation(PHI)VisibleALL LogsCompletedArea isClean andFree ofClutterNO PorousItemsUnderSinksLinen isStored andCoveredAppropriatelyHandSanitizersare Full/NotEmptyComputer(s)areSecured if Notin UseGrey PDIWipes –3MinutesALLSprinklershave 18”ClearanceALLMedicationsSecuredCorrect ConsentForms areAvailable,andStaff can Speakto all PartsClearSeparationof Cleanand DirtyALL Sharpsare Securedor inConstantSupervisionSinks and IceMachines areFree ofCalciumBuild-upCLEARSeparation ofFull/Partialand EmptyOxygen TanksALLBathroomsare Cleanand StockedALL Specimensare TransportedAppropriatelyThrough the HallCurtains areClean and inGoodConditionNOHighDustNO Food orUncoveredDrinks inPatient CareAreasCeilingTiles arein GoodConditionNOCardboard inPatient CareAreasBleachWipes –4MinutesStaff CanSpeakto Processfor RoomTurnoverALL ElectricalPanels, EGRESS,Fire Extinguishersand Fire PullStations areUnobstructedNOBugs inLightsHydrogenPeroxide(GreenTop)-5MinutesALL RequiredEquipmenthas Up-to-Date PMStickersNOSuppliesStored onFloorNOProtectedHealthInformation(PHI)VisibleALL LogsCompletedArea isClean andFree ofClutterNO PorousItemsUnderSinksLinen isStored andCoveredAppropriatelyHandSanitizersare Full/NotEmptyComputer(s)areSecured if Notin UseGrey PDIWipes –3MinutesALLSprinklershave 18”ClearanceALLMedicationsSecured

SMART BINGO - Call List

(Print) Use this randomly generated list as your call list when playing the game. There is no need to say the BINGO column name. Place some kind of mark (like an X, a checkmark, a dot, tally mark, etc) on each cell as you announce it, to keep track. You can also cut out each item, place them in a bag and pull words from the bag.


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  1. Correct Consent Forms are Available,and Staff can Speak to all Parts
  2. Clear Separation of Clean and Dirty
  3. ALL Sharps are Secured or in Constant Supervision
  4. Sinks and Ice Machines are Free of Calcium Build-up
  5. CLEAR Separation of Full/Partial and Empty Oxygen Tanks
  6. ALL Bathrooms are Clean and Stocked
  7. ALL Specimens are Transported Appropriately Through the Hall
  8. Curtains are Clean and in Good Condition
  9. NO High Dust
  10. NO Food or Uncovered Drinks in Patient Care Areas
  11. Ceiling Tiles are in Good Condition
  12. NO Cardboard in Patient Care Areas
  13. Bleach Wipes –4 Minutes
  14. Staff Can Speak to Process for Room Turnover
  15. ALL Electrical Panels, EGRESS, Fire Extinguishers and Fire Pull Stations are Unobstructed
  16. NO Bugs in Lights
  17. Hydrogen Peroxide (Green Top)-5 Minutes
  18. ALL Required Equipment has Up-to-Date PM Stickers
  19. NO Supplies Stored on Floor
  20. NO Protected Health Information (PHI)Visible
  21. ALL Logs Completed
  22. Area is Clean and Free of Clutter
  23. NO Porous Items Under Sinks
  24. Linen is Stored and Covered Appropriately
  25. Hand Sanitizers are Full/Not Empty
  26. Computer(s)are Secured if Not in Use
  27. Grey PDI Wipes –3 Minutes
  28. ALL Sprinklers have 18” Clearance
  29. ALL Medications Secured