2023 Site Inspection Arjo Beta

• Conducted on

  Date

• Prepared by

• Location
  Address

Part 1 Site Inspection Review

• Team members are up to date on required Arjo trainings

  Yes

  No

  N/A

• Annual competency assessment completed. (Check training report) Not required in 2023

  Yes

  No

  N/A

• Have team members participated in a building evacuation/fire drill within the last 12 months. Drill conducted within 45 days of a facility move

  Yes

  No

  N/A

• New team member participated in an evacuation drill within 30 days of employment

  Yes

  No

  N/A

• Do all team members know what constitutes a product complaint and how to document and submit them? (Do team members know what a nonconformity is?)

  Yes

  No

  N/A

• Are all team members up to date on required immunizations if not vendor credentialed?

  Yes

  No

  N/A

• Are all required team members up to date on vendor credentialing?

  Yes

  No

  N/A

• All Service Consultants have up to date DQ files

  Yes

  No

  N/A

• Previous cushion testing logs are available for review

  Yes

  No

  N/A

• SteriFab Treatment Logs are available and correct

  Yes

  No

  N/A

• Quarterly Ecolab reports are available for review for a rolling 12 months (digital or paper)

  Yes

  No

  N/A

• Quarterly Terminix visit reports available for review for a rolling 12 months (digital or paper)

  Yes

  No

  N/A

• Any waste manifests for hazardous waste shipped to a disposal site. (Maintain the waste manifest for one year)

  Yes

  No

  N/A

• Battery disposal invoices/ receipts. The receipt must include the name of the company, address and phone number accepting the batteries. If using an LQHUW check on EPA ID number. SQHUW no EPA # required. (File onsite for 3 years then dispose.)

  Yes

  No

  N/A

• 5 years of OSHA 300A Logs on file

  Yes

  No

  N/A

• Post disaster evaluation forms drill/evacuation completed within last 12 months. Disaster documents available for review

  Yes

  No

  N/A

• Safety meeting and local training rosters are available for review

  Yes

  No

  N/A

• All team members have signed a signature log or signature sheets

  Yes

  No

  N/A

• Up to date facility local supplier list

  Yes

  No

  N/A

• Up to date facility equipment (fixed assets) list

  Yes

  No

  N/A

• Most recent selfinspection and improvement plan available for review. (Paper or digital – keep rolling 6 months)

  Yes

  No

  N/A

• Most recent audit report and associated documents indicating status of findings. (Paper or digital report keep until next scheduled audit)

  Yes

  No

  N/A

• Business Licenses/Tax Permits (City and State)

  Yes

  No

  N/A

• Regulatory licenses as required by state: (e.g. Bedding/Sanitation permits/licenses)

  Yes

  No

  N/A

• POL001 Quality Policy & POL002 Environmental Policy

  Yes

  No

  N/A

• Service Center Organizational Chart

  Yes

  No

  N/A

• Proof of Liability Insurance

  Yes

  No

  N/A

• Locally developed Emergency Evacuation Route/Map

  Yes

  No

  N/A

• Quality 1 – What If

  Yes

  No

  N/A

• Quality 2 – What do they need from me?

  Yes

  No

  N/A

• Code of Conduct

  Yes

  No

  N/A

• Federal Labor Law Posters (5 in 1 OSHA Poster)

  Yes

  No

  N/A

• State Labor Law Posters, as required by State

  Yes

  No

  N/A

• EVerify Posting / EEO Poster Supplement

  Yes

  No

  N/A

• Right to Work (English/Spanish)

  Yes

  No

  N/A

• Pay Day Notice (US Only), if required by State

  Yes

  No

  N/A

• Notice of Workers’ Compensation Carrier by State (May be included in State Labor Law)

  Yes

  No

  N/A

• Emergency Procedures Flip Chart Completed with current management information

  Yes

  No

  N/A

• OSHA Form 300A (If between February 1st and April 30th )

  Yes

  No

  N/A

• Labor Relations Act (NLRA) Posting (may be included in the 5 in 1 OSHA poster)

  Yes

  No

  N/A

• Federal Motor Carrier Safety Administration HOS Poster

  Yes

  No

  N/A

• Current HR Department _Who’s Who (found on ADP)

  Yes

  No

  N/A

• Building Exit Signs (1C138 or equivalent)

  Yes

  No

  N/A

• Post identifying signage on doorway or room. Restrooms clearly identified and labeled

  Yes

  No

  N/A

• Emergency lighting signage identifying all emergency lights

  Yes

  No

  N/A

• Fire extinguisher signage identifying fire extinguisher locations

  Yes

  No

  N/A

• No smoking facility post by each entrance

  Yes

  No

  N/A

• Infection Control / Hand Hygiene Procedures posted at each sink

  Yes

  No

  N/A

• First aid signage posted by first aid kits

  Yes

  No

  N/A

• Current hazard communication SOP (unless located within SDS binder) SOPSVCUS0046 on NA site

  Yes

  No

  N/A

• Areas of warehouse are taped correctly with appropriate signage/poster

  Yes

  No

  N/A

• Warehouse is clean and organized – clear evidence of daily/2x monthly mopping and trash bins regularly emptied

  Yes

  No

  N/A

• IT room/area is kept free of debris and is readily accessible

  Yes

  No

  N/A

• Shipping and receiving area has proper signage and postings. Battery and Chemical Postings

  Yes

  No

  N/A

• Hazardous substances are properly labeled and stored. (e.g. EcoLab chemicals)

  Yes

  No

  N/A

• Flammable liquids kept in closed containers and stored in an approved fire locker. (if needed)

  Yes

  No

  N/A

• ABC fire extinguishers, mounted, identified and fully charged. Annual tag documented with monthly check dates

  Yes

  No

  N/A

• Breakroom and bathrooms are clean and orderly

  Yes

  No

  N/A

• Service center has appropriate and functioning lighting in all areas. Emergency lighting available

  Yes

  No

  N/A

• All storage locations/shelving labeled

  Yes

  No

  N/A

• Hand Hygiene visual work instruction

  Yes

  No

  N/A

• PPE visual work instruction

  Yes

  No

  N/A

• How to Prevent Infection / Did You Wash Your Hands?

  Yes

  No

  N/A

• Chemical Testing and Hand Mixing Process visual work instruction

  Yes

  No

  N/A

• QC process visual work instruction: Visual work instructions appropriate for each service center (e.g. SteriFab Application; RotoProne Visual Standards)

  Yes

  No

  N/A

• Eye Wash Station has identifying and visible posting

  Yes

  No

  N/A

• Processing area has appropriate slippery floor or equivalent posting for when there is a potential for wet/slippery floors

  Yes

  No

  N/A

• Dirty hold area taped and labeled. All dirty products are covered with blue covers or bags

  Yes

  No

  N/A

• Approved Sharps container; a mail back regulated medical waste container and/or a red plastic bag are available for use

  Yes

  No

  N/A

• Regulated Waste log maintained. Required in PA, otherwise only if handled regulated waste.

  Yes

  No

  N/A

• SDS binder if required by local/state laws

  Yes

  No

  N/A

• Employees have access to appropriate PPE and know how and when to use it

  Yes

  No

  N/A

• Chemical spill kit is available, and employees know how to use it. (Check shelf life)

  Yes

  No

  N/A

• Eyewash station drains properly, covers and unit are clean and calcium free – eye wash station checks correctly documented

  Yes

  No

  N/A

• SteriFab sprayers have marbles for proper disbursement Correct log being used for SteriFab Correct Sanitation (Law) Labels are attached to assets Oklahoma: Revenue Stamp is attached to Sanitation Label

  Yes

  No

  N/A

• Processing carts are available with all necessary supplies. Secondary containers have correct HMIS/WHMIS labels

  Yes

  No

  N/A

• Clean assets are covered/bagged in clear plastic

  Yes

  No

  N/A

• Quality processing area has all necessary tools and equipment. Calibrated equipment have stickers displaying current calibration dates

  Yes

  No

  N/A

• Employees know process for missing/expired calibration dates or test equipment failure

  Yes

  No

  N/A

• Weights are verified and labeled correctly. 100g weight available if needed

  Yes

  No

  N/A

• Cushion tester is labeled correctly including a current PM sticker

  Yes

  No

  N/A

• All employees know how to use and test cushion tester, logging results correctly

  Yes

  No

  N/A

• All paint and approved chemicals are labeled correctly and not expired

  Yes

  No

  N/A

• Any parts used in quality processing, including replacement cushions, are covered or placed in containers with correct labeling

  Yes

  No

  N/A

• Process for accessories is followed (Lift Poles, IV Poles, O2 Holders, Trapeze)

  Yes

  No

  N/A

• All used batteries stored properly in closed plastic container with vented lid

  Yes

  No

  N/A

• Evidence that quality processing area garbage cans emptied daily when used

  Yes

  No

  N/A

• Evidence that qualityprocessing area is mopped when used. Mops and rags cleaned and maintained correctly

  Yes

  No

  N/A

• Team members know how to access appropriate information on Connect SharePoint site Product information Quality Process Decks Approved Suppliers Link to NA Documentation site

  Yes

  No

  N/A

• All employees know how to locate SDS documents on 3E site. Know and understand how to read and use SDS

  Yes

  No

  N/A

• Customer owned products stored in appropriate hold location and labeled correctly

  Yes

  No

  N/A

• Assets used for customer demo and/trials stored in appropriate location and labeled correctly. Demo tag in use

  Yes

  No

  N/A

• Product files available for all frame products in the service center

  Yes

  No

  N/A

• All products in “Ready” meet quality and infection control standards. Good aesthetics QRG and/or QR Code PM and battery stickers

  Yes

  No

  N/A

• All assets in “Ready” have all required legible manufacture labels

  Yes

  No

  N/A

• Pumps must be in an individual bag with QC sheet visible inside bag and stored correctly

  Yes

  No

  N/A

• Skin IQ on a Citadel frame is installed with the cover folded down and the fan unplugged

  Yes

  No

  N/A

• Assets requiring repair identified with down tag and found in correct ERP system location

  Yes

  No

  N/A

• Assets in “Repair” have appropriate quality control checklists on them

  Yes

  No

  N/A

• All repair parts are stored and labeled appropriately

  Yes

  No

  N/A

• Chemicals, lubricants and paint are labeled, stored correctly and not expired

  Yes

  No

  N/A

• Repair area has all necessary equipment, and calibrated tools have stickers displaying current calibration dates

  Yes

  No

  N/A

• Tools and equipment used in repair area are labeled and stored appropriately

  Yes

  No

  N/A

• Geotab telematics device installed and working

  Yes

  No

  N/A

• Service Consultants know how to view previous DVIR in Geotab Drive. Hard copy DVIR on file for 90 days

  Yes

  No

  N/A

• Truck cab/exterior is clean and free of trash and debris

  Yes

  No

  N/A

• Truck cargo area is clean and all equipment loading and functioning

  Yes

  No

  N/A

• Required equipment to secure frames is available, including foam for truck sides

  Yes

  No

  N/A

• Product is loaded appropriately

  Yes

  No

  N/A

• Dirty/clean product is clearly identified and separated

  Yes

  No

  N/A

• PPE located in vehicle along with First Aid Kit

  Yes

  No

  N/A

• Fire Extinguishers are in cab and fully charged; emergency triangles are available

  Yes

  No

  N/A

• Preventive Maintenance Receipts uploaded to Holman

  Yes

  No

  N/A

• Repair Receipts uploaded to Holman

  Yes

  No

  N/A

• If using hard copy DVIR, required DVIR in vehicle: Previous driver DVIR Current driver DVIR

  Yes

  No

  N/A

• Required paperwork in vehicle binder Valid insurance/registration Valid fuel card HOS Public Safety Letter 150 air mile map/CA 100 air mile map

  Yes

  No

  N/A

• View all truck cargo area posting. Loading Inventory Diagram Wall Position Loading Diagram Proper Use of Ratchet

  Yes

  No

  N/A

Part 2 Operational Checks

• Do all team members know how to use TCard system? Are they completing TCard activities?

  Acceptable

  Needs Improvement

• Check on use of the Daily/Weekly Walkabout form

  Acceptable

  Needs Improvement

• Check prior day's DVIR report for Pre/Post trip Inspections. Verify there are no missing inspections when comparing to truck trips in GeoTab

  Acceptable

  Needs Improvement

• All required team members compliant with use of Truce

  Acceptable

  Needs Improvement

• Vehicle maintenance up to date – no past due PMs or required inspections

  Acceptable

  Needs Improvement

• Check schedule for any necessary changes to cover planner and ensure changes will not result in HOS violations

  Acceptable

  Needs Improvement

• Review MyMediset / Reservation Monitor for any issues. What are the daily practices for managing open and aging orders?

  Acceptable

  Needs Improvement

• Review IW73 / IW72 for any pending order issues. What are the daily practices for managing open and aging orders?

  Acceptable

  Needs Improvement

• Download report from either IH08 or Z15_D102 for storage location 9100 (Quality Processing)

• Are all products in dirty storage found in the report? What is the process for reconciliation?

  Acceptable

  Needs Improvement

• Review most recent past inventory report. All missing assets been located and/or reconciled. Are month;y inventory reports acceesible?

  Acceptable

  Needs Improvement

• Random Check of Ready assets: *Asset is clean and covered with clear plastic *Copy of SAP QC sheet found on asset *QRG and/or QR Code attached *Blue return cover included *Correct labels on asset *Battery and PM dates are not expired/past due

  Compliant

  Non-Compliant

  N/A

• Random check on 2 PM documents both electronic and hard copy files. Review for PM Date in Class Overview: and 2 yrs of PM checklists in file. Checklist attached to WO in SAP

  Acceptable

  Needs Improvement

• Box units needing repair have been shipped to designated depot and transferred correctly in SAP

  Acceptable

  Needs Improvement

• All shipments from distribution warehouse are opened, verified and received in SAP

  Acceptable

  Needs Improvement

• Down tag check – product handled appropriately within requirement timeframe

  Acceptable

  Needs Improvement

• Product disposal – check paperwork and SAP SO for correctness. No evidence of scrapped products >30 days in overflow or repair

  Acceptable

  Needs Improvement

• Quality processing observation of team member

  Acceptable

  Needs Improvement

• Team members demonstrate knowledge and skill with all required SAP transactions. Review hygiene transactions, truck movements, SO transactions and overall documentation

  Acceptable

  Needs Improvement

• Review SAP service order documentation 6 random serial numbers and 3 random service orders completed in the most recent 3 months. *ZCRE / *ZSRPM / *ZSRBAT / *ZSRRTR / *ZSRUPG