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Employees Name: ____________________________ Job Title: _______________________

What did you do to help the unit comply with Joint Commission requirements and prepare for the site visit?

The above participated in preparing the unit for the Joint Commission visit and demonstrated an
understanding of how UCH and AIP PACU meet Joint Commission requirements.

Managers Name & Signature: ____________________________________________
Date: ________________

Validators Name & Signature: ______________________________________________
Job Title: __________________ Date: ___________
PACU Joint Commission Compliance
Preparation Assistance