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CLIA WAIVED POINT OF CARE QUALITY CONTROL LOG

Point of Care QC LogMichael2018-06-02T09:59:49-05:00

Quality Control Entry Type*
Control Date*
MM slash DD slash YYYY
Clean / Maintenance Date*
MM slash DD slash YYYY
Was a sterilizer monitoring spore strip sent for testing?*
- Yes
- No
Lot Number*
Calibration Number*
Expiration Date*
MM slash DD slash YYYY
Calibrated Date*
MM slash DD slash YYYY
Low Control Pass*
- Yes
- No
Normal Control Pass*
- Yes
- No
Abnormal Control Pass*
- Yes
- No
High Control Pass*
- Yes
- No
Neg(-) Control Pass*
- Yes
- No
Pos(+) Control Pass*
- Yes
- No
Was the equipment allowed to air dry for 15 minutes.*
- Yes
- No
Run By Signature*
Run By*
Verified By Signature*
Verified By*

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