2024 Site Inspection Workbook

• Site conducted

  Select

• Conducted on

  Date

• Prepared by

• Location
  Address

Pre-Visit Work

• Have ready for review or scan and upload, email prior to arrival. 2 weeks to visit community request - deadline for email = 3 business days before arrival

• 1. 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

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• 4. Safety meeting and local training rosters are available for review.

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• 7. Check in with team on MyLearning course status

  Yes

  No

  N/A

• 8. Are 4 most recent Pest control reports available?

  Yes

  No

  N/A

• 9. Are the 4 most recent Ecolab reports available?

  Yes

  No

  N/A

Safety Checks

• 10. Locally developed Emergency Evacuation Route/Map

  Yes

  No

  N/A

• 11. Emergency Procedures Flip Chart - Completed with current management information, available at each entrance.

  Yes

  No

  N/A

• 12. Appropriate exit signs

  Yes

  No

  N/A

• 13. Emergency lighting signage identifying all emergency lights.

  Yes

  No

  N/A

• 14. First aid signage posted by first aid kits

  Yes

  No

  N/A

• 15. Current hazard communication SOP (unless located within SDS binder) SOP-SVC-US-0046 on NA site

  Yes

  No

  N/A

• 16. Chemical solutions and or Hazardous substances are clearly labeled with hazard and expiration dates and stored properly. (e.g. EcoLab chemicals)

  Yes

  No

  N/A

• 17. Any chemical solutions that is taken out of its original container must be properly labeled with the product in the bucket/container and have a HMIS/WHIMS label (includes cleaning cart buckets).

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• 20. Fire extinguisher signage identifying fire extinguisher locations ABC fire extinguishers, mounted, identified and fully charged. Annual tag documented with monthly check dates.

  Yes

  No

  N/A

• 21. Eye Wash Station has identifying and visible posting, drains properly, covers and unit are clean and calcium free – eye wash station checks correctly documented

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

Fleet

• 24. Geotab telematics device installed and working.

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• 27. If using hard copy DVIR, required DVIR in vehicle:<br>Previous driver DVIR<br>Current driver DVIR

  Yes

  No

  N/A

• 28. All required team members compliant with use of Truce

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• 30. Vehicles have a binder with all the required documents. Refer to SOP-SVC-73 Rev 2 Annex 1 for required documents.

  Yes

  No

  N/A

• 31. Driver qualification: have all drivers show you their license and medical certificate. Are all compliant?

  Yes

  No

  N/A

• 32. PPE located in vehicle along with First Aid Kit.

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• 34. Truck cab, exterior and cargo areas are clean and all equipment loading and functioning.

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• 36. View all truck cargo area postings.<br>Loading Inventory Diagram<br>Wall Position Loading Diagram<br>Proper Use of Ratchet

  Yes

  No

  N/A

• 37. Observation of product loaded appropriately.

  Yes

  No

  N/A

• 38. Dirty/clean product is clearly identified and separated.

  Yes

  No

  N/A

Operational

• 39. Warehouse and Common areas are clean and organized. <br>*Clear evidence of bi-monthly mopping in warehouse; weekly cleaning of common areas <br>*All trash bins and laundry carts have clean liners and/or plastic liners are replaced daily <br>*Evidence of daily mopping and trash bins emptied in Processing area

  Yes

  No

  N/A

• 40. T-Card System is being used correctly. Initialed and dates showing.

  Yes

  No

  N/A

• 41. Evidence of appropriate signage in all locations. i.e. Dirty, Processing, Ready, etc.

  Yes

  No

  N/A

• 42. Quality processing observation of team member. If Contract Worker have they been trained correctly?

  Yes

  No

  N/A

• 43. All products not currently be worked on are appropriately covered; blue for dirty/clear for clean.

  Yes

  No

  N/A

• 44. Processing carts have needed supplies, are neat and labeled. Correct HMIS for One Step and Two Step.

  Yes

  No

  N/A

• 45. Team members are wearing appropriate PPE. Are they removing it before leaving the Dirty and Processing areas?

  Yes

  No

  N/A

• 46. Tools/Test equipment are appropriately stored in Processing and Repair areas and available for use.

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• 48. Mattress tester has current PM label and correct log is in use.

  Yes

  No

  N/A

• 49. (if required) Steri-Fab sprayers have marbles for proper disbursement. Correct log being used and completed correctly. Law labels available.

  Yes

  No

  N/A

• 50. All parts are easily viewed and clearly labeled.

  Yes

  No

  N/A

• 51. Repair area and parking bays are clean and orderly.

  Yes

  No

  N/A

• 52. Random Check of Ready assets:<br>*Product is clean and covered with clear plastic<br>*Copy of Inspection Lot found on product<br>*QRG attached/ QR codes appropriately located<br>*Blue return cover included<br>*Correct labels on product; LOOK for new Arjo Rental Sticker<br>*Battery and PM dates are not expired/past due<br>*Box units are in clear plastic bags on top of the plastic bed cover w/Inspection Lot visible<br>*Beds are in Transport configuration; Collapsed to transport length, mattress deflated and siderails lowered on Citadel, Frame is lowered.

  Yes

  No

  N/A

• 53. Down tag check – product handled appropriately within requirement timeframe. Products in repair must be covered in clear plastic with a copy of the completed Inspection Lot and Down Tag indicating the required repair and any parts ordered.

  Yes

  No

  N/A

• 54. Random check with team member on knowledge of how to find: controlled procedures, SDS website or other online tools. List team member name and action performed below:

  Yes

  No

  N/A

• 55. Any competency gaps at SVC?

• 56. Employees understand customer complaint process - how service swaps are handled?

• 57. Overall, any notable observed issues?

SAP

• 58. Review MyMediset / Reservation Monitor for any issues. What are the daily practices for managing open and aging orders? WI-SVC-US-0122

  Compliant

  Non-Compliant

  N/A

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

  Compliant

  Non-Compliant

  N/A

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

  Compliant

  Non-Compliant

  N/A

• 61. Box units needing repair have been shipped to designated depot and transferred correctly in SAP. (Weekly basis) If Box units are still in SVC do they have a correctly completed Down Unit Tag including FTRE.

  Compliant

  Non-Compliant

  N/A

• 62. Product disposal – check paperwork and SAP SO for correctness. No evidence of scrapped products >60 days repair.

  Compliant

  Non-Compliant

  N/A

• 63. All shipments from distribution warehouse are opened, verified and received in SAP. (received parts should have note for FRT or placed in appropriate storage location)

  Compliant

  Non-Compliant

  N/A

• 64. Review most recent past inventory report. All missing assets been located and/or reconciled.

  Compliant

  Non-Compliant

  N/A

• 65. All product files are available. (Look at a small sample size, 10-15 Serial numbers) Check on 2 PM documents that you pull from Sample -verify both electronic and hard copy files. Check Power BI for most recent ZSM and verify the PM Inspection Lot is attached to the SO in SAP. Review for PM Date in Class Overview:

  Compliant

  Non-Compliant

  N/A

• 66. Random selection of 2 ZSM order and review for failed ZRCE thourgh service order completion Review 2 FTRE's or RE3 service orders from Oxando through repair. (see WI-SVC-US-0141-A)

  Compliant

  Non-Compliant

  N/A

• 67. Team members demonstrate knowledge and skill with all required SAP transactions. Are Contract Workers present? Do they have an SAP Login and have they been trained to transact a Hygiene order? Review hygiene transactions, truck movements, SO transactions and overall documentation.

  Compliant

  Non-Compliant

  N/A

Sign-off

• Completed by

  Sign