ABCDEFGHIJKLMNOPQRSTUVWXYZ
1
PEMERINTAH KABUPATEN LAMONGAN
2





RUMAH SAKIT UMUM DAERAH KARANGKEMBANG
3
Jl. Raya - Jombang Km. 2 Babat, Lamongan, Jawa Timur 62271
4
Telepon (0322) 4651378, Faksimile (0322) 4651378,Pos-el rsudkarangkembang@gmail.com
5
Laman : www.lamongankab.go.id
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7
FORMAT AUDIT KEPATUHAN CUCI TANGAN
8
9
Ruang : Laundry
10
Periode : Januari 2026
11
NoTanggalNama PetugasRuangan5 Momen Cuci Tangan6 Langkah Cuci TanganWaktuNumDenum%
12
12345123456Handrub (20 -30 detik)Handwash (40-60 detik)
13
1
01/01/2026
NurlindaLaundry 1010100%
14
2
01/01/2026
AlfaridLaundry 1010100%
15
3
02/01/2026
RifoLaundry 77100%
16
4
02/01/2026
NurlindaLaundry 1010100%
17
5
02/01/2026
AlfaridLaundry 1010100%
18
6
03/01/2026
NurlindaLaundry 1010100%
19
7
03/01/2026
AlfaridLaundry 1010100%
20
8
05/01/2026
NurlindaLaundry 1010100%
21
9
05/01/2026
AlfaridLaundry 1010100%
22
10
06/01/2026
NurlindaLaundry 1010100%
23
11
06/01/2026
AlfaridLaundry 1010100%
24
12
07/01/2026
NurlindaLaundry 1010100%
25
13
07/01/2026
AlfaridLaundry 1010100%
26
14
08/01/2026
NurlindaLaundry 1010100%
27
15
08/01/2026
AlfaridLaundry 1010100%
28
16
09/01/2026
RifoLaundry 77100%
29
17
09/01/2026
NurlindaLaundry 1010100%
30
18
09/01/2026
AlfaridLaundry 1010100%
31
19
10/01/2026
NurlindaLaundry














1010100%
32
20
10/01/2026
AlfaridLaundry 1010100%
33
21
12/01/2026
NurlindaLaundry 1010100%Nurlinda
34
22
12/01/2026
AlfaridLaundry 1010100%
35
2313/01/2026NurlindaLaundry 1010100%
36
2413/01/2026AlfaridLaundry 1010100%
37
25
14/01/2026
NurlindaLaundry 1010100%
38
26
14/01/2026
AlfaridLaundry 1010100%
39
2715/01/2026NurlindaLaundry 1010100%
40
2815/01/2026AlfaridLaundry 1010100%
41
29
16/01/2026
NurlindaLaundry 1010100%
42
30
16/01/2026
AlfaridLaundry 1010100%
43
31
17/01/2026
NurlindaLaundry 1010100%
44
32
17/01/2026
AlfaridLaundry 1010100%
45
33
19/01/2026
NurlindaLaundry 1010100%
46
34
19/01/2026
AlfaridLaundry 1010100%
47
35
20/01/2026
NurlindaLaundry 1010100%
48
36
20/01/2026
AlfaridLaundry 1010100%
49
37
21/01/2026
NurlindaLaundry 1010100%
50
38
21/01/2026
AlfaridLaundry 1010100%
51
39
22/01/2026
NurlindaLaundry 1010100%
52
40
22/01/2026
AlfaridLaundry 1010100%
53
41
23/01/2026
RifoLaundry 77100%
54
42
23/01/2026
NurlindaLaundry 1010100%
55
43
23/01/2026
AlfaridLaundry 1010100%Nurlinda
56
44
24/01/2026
NurlindaLaundry 1010100%
57
45
24/01/2026
AlfaridLaundry 1010100%
58
46
26/01/2026
NurlindaLaundry 1010100%
59
47
26/01/2026
AlfaridLaundry 1010100%
60
48
27/01/2026
NurlindaLaundry 1010100%
61
49
27/01/2026
AlfaridLaundry 1010100%
62
50
28/01/2026
NurlindaLaundry 1010100%
63
51
28/01/2026
AlfaridLaundry 1010100%
64
52
29/01/2026
NurlindaLaundry 1010100%
65
53
29/01/2026
AlfaridLaundry 1010100%
66
54
30/01/2026
RifoLaundry 77100%
67
55
30/01/2026
NurlindaLaundry 1010100%
68
56
30/01/2026
AlfaridLaundry 1010100%
69
5731/01/2026NurlindaLaundry 1010100%
70
5831/01/2026AlfaridLaundry 1010100%
71
JUMLAH568568100%
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73
Keterangan :
Auditor
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Jika dilaksanakan beri tanda (√)
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Jika tidak dilaksanakan beri tanda (-)
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Jika tidak ada pelunag beri tanda (x)
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Patuh = 1
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Tidak Patuh = 0
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Kepatuhan Cuci tangan =
80
Numerator (Jumlah kepatuhan cuci tangan yang dilaksanakan)
81
Denumerator( Jumlah peluang kegiatan cuci tangan yang diobservasi)
82
Target >85%
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perhari 3 orang
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85
86
PEMERINTAH KABUPATEN LAMONGAN
87





RUMAH SAKIT UMUM DAERAH KARANGKEMBANG
88
Jl. Raya - Jombang Km. 2 Babat, Lamongan, Jawa Timur 62271
89
Telepon (0322) 4651378, Faksimile (0322) 4651378,Pos-el rsudkarangkembang@gmail.com
90
Laman : www.lamongankab.go.id
91
92
FORMAT AUDIT KEPATUHAN CUCI TANGAN
93
94
Ruang : Laundry
95
Periode : Februari 2026
96
NoTanggalNama PetugasRuangan5 Momen Cuci Tangan6 Langkah Cuci TanganWaktuNumDenum%
97
12345123456Handrub (20 -30 detik)Handwash (40-60 detik)
98
1
02/02/2026
NurlindaLaundry 1010100%
99
2
02/02/2026
Moh. Zuni Al FaridLaundry 1010100%
100
3
03/02/2026
NurlindaLaundry 1010100%