INSPECTORS found blood on trolley beds, walls, lamps and underneath worktops in an accident and emergency ward.
Healthcare Improvement Scotland found the blood and body fluid contamination in the ward and resuscitation room at St John's, Livingston, West Lothian during an inspection in August.
Inspectors ordered immediate action to improve the standard of cleanliness. They made four requirements and three recommendations "which NHS Lothian is fully expected to address".
The report into the inspection said: "We found that the standard of environmental cleaning was satisfactory.
"However, in the accident and emergency department, the standard of patient equipment cleanliness was poor.
"We inspected six patient trolley beds and found all six beds were contaminated, some with body fluids. We inspected five mattress covers and all five covers were damaged."
The report said NHS Lothian ensure that compliance monitoring is carried out for all standard infection control precautions, that staff adhere to further guidance, that correct procedures are used for the management of blood spillages and ensure correct cleaning systems are in place.
Susan Brimelow, HEI Chief Inspector, said: "Overall, our inspection found evidence that St John's Hospital is complying with the majority of infection prevention and control standards. The hospital environment was clean, and we observed good staff compliance with sharps management and hand hygiene practices.
"However, we did identify areas where improvements are needed.
Sarah Ballard-Smith, deputy executive nurse director, NHS Lothian, said: "We recognise there are things that can be improved and they were addressed as a matter of urgency.
"One area was rectified immediately and this was proven by the subsequent unannounced visit by inspectors."
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