Infection Control Policy
Professional Infection Control Policy template for Adult Family Homes. Includes editable Word (.docx) and printable PDF formats.
[YOUR ADULT FAMILY HOME NAME HERE]
Infection Control Policy
TEMPLATE • Inspection-Ready AFH Standard
1. Hand Hygiene & PPE Protocol
This agreement is entered into on this _____ day of ____________, 20___, between [ADULT FAMILY HOME NAME] (Provider) and [RESIDENT / POA NAME].
2. Sanitization & Laundry Procedures
FINANCIAL TERMSBase Rate & Payment Schedule: Resident agrees to pay Provider a monthly base fee of $______ payable in advance on the first (1st) day of each calendar month.
3. Outbreak Management & Isolation Plan
Provider Signature / Date
Resident / POA Signature / Date
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Document Section Breakdown (4 Sections)
Hand Hygiene & PPE Protocol
Glove, mask, and sanitization standards for staff during daily care.
Sanitization & Laundry Procedures
Disinfection schedule for common areas, bedrooms, kitchen, and soiled linens.
Outbreak Management & Isolation Plan
Symptom screening, visitor restrictions, and public health reporting.
Staff Training & Verification Sign-Off
Annual staff infection control training verification log.
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