• Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Section 1 - Spot check details

  • Employee Name

  • Select date

  • Scheduled start time

  • Did the carer start on time

  • Actual finish time

  • Scheduled visit duration

Section 2 - Appearance

  • Identity badge on show

  • Appropriate footwear worn

  • Wearing ACS uniform

  • Jewellery worn meets with ACS standards/policy

Section 3 - Personal protective equipment

  • Gloves available

  • Gloves used

  • Aprons available

  • Aprons used

  • Hand gel available

  • Hand gel used

  • Protective arm sleeves available

  • Protective arm sleeves used

Section 4 Pre-work checks

  • Care plan reviewed

  • Risk assessment reviewed

  • Logged into Ezi-tracker with SU's permission

  • Comments:

Section 5 - Moving & handling technique (where provided)

  • All moves performed in an appropriate and safe manner

  • Hoist used in an appropriate and safe manner

  • Moving and handling equipment used where required<br>i.e. slide sheets/banana board/stand aids

Section 6 - Task performance (personal care, where provided)

  • All personal care is performed to meet the objectives outlined in the client's care plan

  • All personal care performed meets the company quality standards

Care plan objectives - all objectives outlined in the care plan met

  • All other tasks are performed as required to meet the objectives out-lined in the client's care plan

Section 7 - Approach to client/work

  • Employee displays a positive attitude and approach

  • Employee seeks to maintain the client's dignity and respect

Section 8 - Communication

  • Employee uses appropriate language and tone

  • Content and topic of conversation is appropriate and professionalism is maintaned

Section 9 - Record keeping

  • Progress sheet appropriately and legibly updated

Section 9a - Administration of medication

  • Is medication administered during the visit (if yes, please complete a Medication Competency Record)

Section 10 - Company & Client Confidentiality

  • Has the carer followed the ACS policy on Company and Client Confidentiality

Section 11 - Waste disposal

  • Waste disposed of appropriately (gloves, aprons, pads, etc)


  • Has the spot check been satisfactory

  • Employee feedback provided:

  • Improvements/Training needs identified (bullet point areas where additional training is required/when it will take place/method of delivery

  • Improvements/training identified

  • Employee signature

  • Spot checkers signature

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.