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Ecolab Floor Care Survey
Hospital Name:
*
Your
Email Address:
*
Floor Care Survey
Select the floor care items you'd like to discuss:
Basic Floor Care and Cleaning
Floor Finish
Floor Stripper
Carpet Care
Currently Used Products
1. What type of product is currently being used to clean floors?
Neutral pH Floor Cleaner
Alkaline Floor Cleaner
Disinfecting Floor Cleaner
Neutral Floor Clean
Are you satisfied with the cleaning performance of your Neutral Floor Cleaner?
No
Yes
Describe what you like about your current product:
Do you have issues with foaming in the Auto Scrubber?
No
Yes
Do you have No/Low maintenance vinyl flooring?
No
Yes
Who is the manufacturer of your Low/No Maintenance Flooring?
*
Forbo
Mannington
Shaw
Other
Alkaline Floor Clean
Do you have issues with staff using too much alkaline floor cleaner and damaging the floor finish?
No
Yes
Disinfecting Floor Clean
When are your floors disinfected?
*
Daily/All Patient Rooms but not public areas
Daily/All floors every day
Low and High Level (C. Diff) Contact isolation
Only for High Level (C. Diff) Contact isolation
Select Product:
Quat (Quaternary Ammonium Compound)
Phenolic
Chlorine Bleach or Bleach Tablets
OxyCide
Other
Other
Why was this disinfectant (Quat) selected?
Do you have issues with stickiness, build-up or discoloration on your floors?
No
Yes
Are you taking measures to reduce or remove stickiness?
No
Yes
Why was this disinfectant (Phenolic) selected?
Do you have issues with damage to the floor finish?
No
Yes
Are you taking measures to reduce the damage?
No
Yes
Why was this disinfectant (Chlorine Bleach or Bleach Tablets) selected?
Does your staff complain about strong chlorine odor and/or irritation?
No
Yes
Do you have issues with the cleaning performance of bleach or film residues?
No
Yes
Have you experienced problems with bleach corroding equipment?
No
Yes
Why was this disinfectant (Oxycide) selected?
Are you having any challenges we need to address?
No
Yes
List challenges to address:
*
Why was this disinfectant (other) selected?
Special Needs
2. Do you have special needs regarding cleaning your floors?
No
Yes
Issue:
Various types of floors adjacent to one another
Old VCT Floors mixed with LVT
Linoleum (i.e. Forbo Marmoleum)
Rubber (i.e. Nora)
Asbestos Tile
Natural Stone
Other
Other
Bathrooms
3. Do you have tile flooring in bathrooms that are grouted?
No
Yes
Do you have any concerns with cleaning the tile or grout or the removal of odor?
No
Yes
What are your concerns?
*
Floor Finish
1. What kind of floor(s) do you apply finish (wax) to? (Select
all
that apply):
VCT
Luxury Vinyl
Terrazzo
Marble
Wood
Other
Other
Select type of Terrazzo:
*
Cement-Based Terrazzo
Epoxy-Based Terrazzo
Have you observed spots or damage to floor finish near sanitizer dispensers?
*
Yes
No
2. Do you have floors or areas of the facility that you have not applied finish and are currently maintaining as low-maintenance?
Yes
No
Describe Area:
*
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3. Are you, your patients or staff concerned with odor when applying floor finish to the floors?
Yes
No
4. Is drying time between coats an issue for facility access to areas?
Yes
No
5. Have you observed spots or damage to floor finish near sanitizer dispensers? Or, do you experience issues with sticky or hazy floors?
Yes
No
6. How often are you able to perform a full strip and re-coat on your floor finish?
More Than Annually
Less Than Annually
Semi-Annually
Quarterly
7. Would you prefer a higher gloss floor finish that requires frequent maintenance?
Yes
No
8. Do you have areas where a Matte finish would be preferred (Matte finishes are often used to reduce gloss and reduce adverse patient reaction to high gloss reflection)?
Yes
No
9. Would you prefer a finish that is Green Seal Certified?
Yes
No
Floor Stripper
1. Do you have linoleum floors that need to be stripped?
Yes
No
2. Is your finish currently Maxx Durable?
Yes
No
3. Do you need to remove more than 10 coats of conventional finish?
Yes
No
4. Would you prefer first pass effective stripping? (stripping of floor finish in one effective pass)
Yes
No
5. Do you need Green Seal Certified Stripper?
Yes
No
Carpet Care
1. Do you use a carpet spotter?
Yes
No
2. Do you have issues with old or set stains?
Yes
No
3. Do you have issues with "unknown" stains or spots?
Yes
No
4. Do you have issues with Biological stains/odors (i.e. urine, feces, vomit)?
Yes
No
5. Are you concerned with spots in carpet or upholstery where there are ink, glue, oils or adhesive?
Yes
No
6. Do you ever have a need to remove gum from carpet or furniture?
Yes
No
7. Do you currently use a carpet and/or upholstry pre-spray or extraction cleaner for restorative cleaning?
Yes
No
8. Do you have a carpet encapsulation machine (i.e. Windsor/Karcher icap)?
Yes
No
9. Do you use a Prespray as part of your process for cleaning carpet/upholstry?
Yes
No
.
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