Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

  • Conducted on

Facility Personnel

  • Facility Manager

  • Email

  • Maintenance Officer

Accreditation Details

  • Date of last Accreditation /Support Visit

  • Any issues raised in regards with Maintenance ?

External contractor Records

  • Current Fire Protection Certificate of Compliance sighted

  • Select Certificate Type;

  • Expiry Date of Certificate

  • Select Certificate Type;

  • Expiry Date of Certificate

Maintenance Job Log Book

  • Is the log book in a good condition?

  • As per the logbook , The jobs been completed are in a reasonable time?

  • Has the completed jobs been signed and dated ?

  • How many jobs are recorded in a day ( average ) ?

  • Additional Information

Maintenance Records

  • Daily maintenance schedule signed and is up to date ?

  • Weekly maintenance schedule signed and up to date?

  • Monthly maintenance schedule signed and up to date ?

  • Quarterly maintenance schedule signed and up to date?

  • Half yearly maintenance up to date?

  • Is the contractor log in register being completed?

  • Is the wheelchair maintenance book up to date?

  • Additional Information

Maintenance Room

  • Room has adequate storage facilities ?

  • Room has sufficient lighting?

  • Floors are able to be effectively cleaned?

  • Adequate ventilation provided within the room?

  • Room is clean, neat and hazard free?

  • Maintenance room is locked when not attended?

  • Additional Information

Grounds check

  • Is the Facility entrances clean ? ( this is a daily task )

  • Is the entrance clean with no litter around ?

  • The lights and light fittings are in a good working condition?

  • Is the paint work clean and in a good condition on walls, ceilings and other visible areas ?

  • Are the windows and fly screen are clean and in a good condition?

  • Facility's external high cleaning is clean ? ( Including no Cobwebs )

  • Additional Information

Interior check

  • Is the wood work in a good condition? ( skirting,sills, door frame etc )

  • Are the walls in a good condition?

  • Are the floor coverings clean and in good condition?

  • Are the lights working and light fittings are in good condition?

  • Are the high areas clean and in good condition? (Vents, air con units, etc )

  • Additional Information

Resident Rooms

    Room
  • Name of the Wing

  • Room Number

  • Type of Care

  • Is the door clean with no damage and in good condition ?

  • The door knob or handles are in a good condition?

  • All lights are in good working condition ?

  • All lights fittings are clean and in good condition ?

  • Does all the electrical equipment work properly ? (TV,digital etc )

  • Do all the remotes work and are in good condition ?

  • Is the call bell working and the cords are in good condition ?

  • Does the air conditioning work efficiently ?

  • Do the bed work correctly , check up and down motion and check the cable is in a good condition ?

  • Are the electrical equipment tested and tagged?

  • Is the wood work in a good condition? ( skirting,sills, door frame ect)

  • Are the walls in a good condition ?

  • Are the floor coverings clean and in a good condition?

  • Are the high areas clean and in good condition? (Vents, air con units, etc )

  • Additional Information

  • Type of Bathroom

  • Enter Bathroom Location

  • The door knob or handles are in a good condition?

  • All lights are in good working condition ?

  • All lights fittings are clean and in good condition ?

  • Is the call bell working and the cords are in good condition ?

  • Is the wood work in a good condition? ( skirting,sills, door frame ect)

  • Are the tiles in a good condition with no cracks and chipped tiles ?

  • Are the walls in a good condition?

  • Are the floor coverings clean and in a good condition?

  • Are the high areas clean and in good condition? (Vents, air con units, etc )

  • No leakage from taps and the taps are in good condition ?

  • The hot water temperature is

  • The cold water temperature is

  • Does the shower head in good condition and works correctly?

  • The hot water temperature is

  • The cold water temperature is

  • Does the toilet system work correctly?

  • Is the toilet in a good condition with no cracks and secure ?

  • Are the hand rails secure and in good condition ?

  • Additional Information

Chemical Storage Room

  • Premise has adequate storage facilities for storage of chemicals

  • Premises has sufficient lighting

  • Floors are able to be effectively cleaned

  • Walls and ceilings are able to be effectively cleaned

  • Adequate ventilation provided within the room

  • MSDS Register is available within the room?

  • PPE available in the room?

  • Chemical room is lockable and locked when not attended?

  • Fire extinguisher is located close by and in date?

  • Note any Maintenance requirements:

Waste Management

  • Waste area has adequate storage facilities for number of bins?

  • Floors are able to be effectively cleaned?

  • Adequate ventilation provided within the room?

  • Room is clean, neat and hazard free?

  • Have waste bins been kept clean by regular washing?

  • Area is odour free?

  • Waste bins are numbered?

  • Waste bins are filled by number order?

  • Correct bins are used for appropriate waste?

  • Cardboard boxes are flatten before placing in bin?

  • Note any Maintenance requirements:

Additional Information

  • Additional Notes/Comments

  • Action Required

  • Re-inspection Required

  • Time before next inspection

  • DECLARATION: I have read this report and understand the contents

  • Central Office signature

  • NOTE: assessment report contains findings from date/time of inspection only

Contact Details

  • Aegis Aged Care Group

  • Address: 90 Goodwood Pde Burswood Perth WA 6103

  • Telephone: (08) 6254 8200

  • Fax: (08) 6254 8299

  • Email: operations@aegiscare.com.au

  • Web: www.aegiscare.com.au


    www.aegiscare.com.au

  • ABN: 97 377 986 723

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