Your State Health Care Association would probly have something available if your facility is a member facility.
If you have any contacts in the teaching field at any of your local nursing schools, they might be able to help with a ready-made check list.
Both source would likely have checklists for both LVN/LPN & CNAs.
angie, if you forward your fax number i will have my staff ed . fax you a few examples. he is off today but will get it to you by fri, monday at the latest.