Download this template to use for collecting records related to blood exposure in a Personal Service Setting.
Ontario Regulation 136/18 Personal Service Settings states that owners/operators of personal service settings must document ALL accidental blood and/or body fluid exposures that happen during a procedure for both clients AND operators. All fields must be filled out completely.
Records must be kept onsite for at least 1 year, and in a secure location for 2 years afterwards.
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DATE/TIME |
SERVICE |
INJURY |
SERVICE PROVIDER |
PERSON EXPOSED |
ACTIONS TAKEN |
|---|---|---|---|---|---|
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Date/Time of service: E.g. July 1st, 2019, 9:00AM |
Type of personal service: E.g. Manicure |
Body part exposed: E.g. Right hand, pinky finger cuticle |
First and last name with contact information E.g. Jane Smith (manicurist) 519-123-4567 |
First and last name with contact information E.g. Mary Jones 519-555-1234 |
E.g. Told client to wash their hands and see a doctor. Washed and disinfected scissors with bleach. |
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