EXHIBIT C- AGENCY PHARMACY CLEANING LOG REQUIREMENT.pdf

Attachment 2 Daily Cleaning Log for Controlled Clean Room Environments

Month: ______________ Year: 20_____

Prior to the start of cleaning, prepare and document preparation of cleaning solution on the Daily Cleaning Solution Preparation Log

ISO CLASS 5 HOODS AND ISO CLASS 8 COMPOUNDING ROOM (BUFFER AREA)

1. REMOVE ALL COMPOUNDING COMPONENTS/SOLUTIONS FROM HOODS AND COMPOUNDING ROOM

2. WIPE THE FRONT FACE OF HOODS WORKING TOP TO BOTTOM.

3. SOAK ALL ANCILLARY COMPOUNDING EQUIPMENT SUCH AS CLAMPS, SCISSORS, and CRIMPERS IN THE HOOD BUCKET FOR APPROXIMATELY 5 MINUTES. LAY OUT TO DRY ON TOP OF COMPOUNDING ROOM CART.

4. STARTING AT THE INNERMOST PART OF CLEAN ROOM, CLEAN THE FOLLOWING AREAS WORKING TOWARDS THE

ANTEROOM:

a. TABLES, CARTS, SHELVES, CHAIRS, INCLUDING LEGS AND CASTERS

b. DOOR JAMS AND DOOR HANDLES

5. REMOVE TRASH AND CLEAN ALL TRASH BINS AND OUTER SURFACES OF SHARPS CONTAINERS.

6. MOP FLOORS STARTING AT FARTHEST POINT FROM THE ENTRANCE AND WORKING TOWARDS THE ANTEROOM.

FLOORS WILL BE THE LAST AREA CLEANED TO PREVENT WALKING OVER THEM.

ANTEROOM/CHANGE ROOM (TO BE CLEANED AFTER THE COMPOUNDING ROOM HAS BEEN CLEANED)

1. WIPE DOWN ALL SHELVES. RACKS, TABLES, CARTS AND STOOLS (INCLUDING LEGS AND CASTERS)

2. WIPE DOWN THE INSIDE AND OUTSIDE SURFACES OF THE SINK

3. CLEAN THE DOOR JAMS INCLUDING THE DOOR HANDLES

4 REMOVE TRASH AND CLEAN ALL TRASH BINS

5. MOP FLOORS STARTING AT FARTHEST POINT FROM THE ENTRANCE AND WORKING TOWARDS THE EXIT.

FLOORS WILL BE THE LAST AREA CLEANED TO PREVENT WALKING OVER CLEANED AREAS.

EXHIBIT C

DOCUMENT CLEANING BY CHECKING, SIGNING, AND DATING THE APPROPRIATE DATELINE:

1st 12th 23rd

2nd 13th 24th

3rd 14th 25th

4th 15th 26th

5th 16th 27th

6th 17th 28th

7th 18th 29th

8th 19th 30th

9th 20th 31st

10th 21st

11th 22nd

NOTE: Weekly/Monthly Cleaning will be performed and documented as per policy on the Weekly/Monthly Cleaning Log for Pharmacy Clean Room Areas. Indicate N/A on the day that the Weekly/Monthly Cleaning was performed in lieu of daily cleaning.

Signature of Pharmacy Manager after document review Date

Attachment 3

Weekly/Monthly Cleaning Log for Controlled Clean Room Environments

Month: _________________ Year: 20____

Prior to the start of cleaning, prepare and document preparation of cleaning solution on the Daily Cleaning Solution Preparation Log

MONTHLY CLEANING OF PHARMACY CLEAN ROOM (ISO CLASS 8)

TO BE PERFORMED ON A ROTATING BASIS WEEKLY DURING THE MONTH, i.e. Week 1 – January, Week 2 – February, Week 3 – March

ONCE A MONTH THE FOLLOWING AREAS WILL BE CLEANED ALONG WITH ALL THE WEEKLY AREAS AS LISTED BELOW:

1. CLEAN THE CEILINGS AND TOP OF HOODS (AVOID TOUCHING HEPA GRILLS AND DAMPER)

WEEKLY CLEANING REQUIREMENTS WITHIN THE CLASS 100 HOODS AND CLASS 1,000 COMPOUNDING ROOMS

1. CLEAN WALLS AND DOORS (BOTH SIDES INCLUDING HANDLES AND JAMS) USING TOP TO BOTTOM STROKES.

2. CLEAN THE SIDES, FRONT, LEGS AND BACK (IF APPLICABLE) OF EACH HOOD WORKING TOP TO BOTTOM.

3. SOAK ALL ANCILLARY COMPOUNDING EQUIPMENT SUCH AS CLAMPS, SCISSORS, and CRIMPERS IN THE HOOD

BUCKET FOR APPROXIMATELY 5 MINUTES. LAY OUT TO DRY ON TOP OF CLEAN ROOM CART.

4. STARTING AT THE INNERMOST PART OF THE ROOM, CLEAN THE FOLLOWING, WORKING TOWARDS EXIT:

a. INTERIOR AND EXTERIOR OF CART PASS THROUGHS.

b. TABLES, CARTS, SHELVES, RACKS AND CHAIRS INCLUDING LEGS AND CASTERS.

c. REMOVE TRASH (if applicable) AND CLEAN ALL TRASH BINS AND OUTER SURFACES OF SHARPS CONTAINERS.

d. MOP THE FLOOR STARTING AT THE FARTHEST POINT FROM THE ENTRANCE AND WORK TOWARDS THE EXIT.

WEEKLY CLEANING REQUIREMENTS WITHIN THE CLASS 100,000 ROOM (CHANGE/ANTE ROOM)

1. MOVE ON TO THE CHANGE ROOM

a. CLEAN WALLS AND DOORS (BOTH SIDES INCLUDING HANDLES AND JAMS) USING TOP TO BOTTOM STROKES

b. WIPE DOWN ALL GARMENT SHELVES, RACKS, TABLES, CARTS AND STOOLS (INCLUDE ALL LEGS, CASTERS)

c. USING A FRESH WIPE, CLEAN ANY STORAGE BINS INSIDE AND OUT

d. CLEAN THE SINK, OUTER SURFACE OF DRYER, DOORS, AND DOOR HANDLES

e. REFILL ALL SOAP DISPENSERS, WIPE DOWN ALL TRASH BINS

f. MOP THE FLOOR LAST STARTING AT THE FARTHEST POINT FROM THE ENTRANCE AND WORK TOWARDS THE

EXIT

WEEKLY CLEANING OF PRODUCT AND SUPPLY CONTAINERS

CLEAN ALL BATCH TOTES. TOTES WILL BE CLEANED INSIDE AND OUT. CLEANING THE OUTSIDE AFTER INSIDE. TOTES WILL BE INVERTED TO

ASSURE DRYING.

Document cleaning by checking, signing and dating the box below. Be certain to indicate if it is a Monthly Cleaning by circling the Y next to monthly on the appropriate dateline.

WEEK 1 __________________________ Monthly: Y N WEEK 3 _________________________ Monthly: Y N

WEEK 2 __________________________ Monthly: Y N WEEK 4 _________________________ Monthly: Y N

WEEK 5 __________________________ Monthly: Y N

Signature of Pharmacy Manager after document review Date