Aegis Aged Care - Facility Maintenance Audit

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Conducted on

  Date

Facility Personnel

• Facility Manager

• Email

• Maintenance Officer

Accreditation Details

• Date of last Accreditation /Support Visit

  Date

• Any issues raised in regards with Maintenance ?

  No

  Yes

External contractor Records

• Current Fire Protection Certificate of Compliance sighted

  Yes

  No

  N/A

• Select Certificate Type;

  Exit & Emergency Lights

  Portable Fire Equipment

• Expiry Date of Certificate

  Date

• Select Certificate Type;

  Exit & Emergency Lights

  Portable Fire Equipment

• Expiry Date of Certificate

  Date

Maintenance Job Log Book

• Is the log book in a good condition?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Has the completed jobs been signed and dated ?

  Yes

  No

  N/A

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

• Additional Information

  Yes

  No

Maintenance Records

• Daily maintenance schedule signed and is up to date ?

  Yes

  No

  N/A

• Weekly maintenance schedule signed and up to date?

  Yes

  No

  N/A

• Monthly maintenance schedule signed and up to date ?

  Yes

  No

  N/A

• Quarterly maintenance schedule signed and up to date?

  Yes

  No

  N/A

• Half yearly maintenance up to date?

  Yes

  No

  N/A

• Is the contractor log in register being completed?

  Yes

  No

  N/A

• Is the wheelchair maintenance book up to date?

  Yes

  No

  N/A

• Additional Information

  Yes

  No

Maintenance Room

• Room has adequate storage facilities ?

  Yes

  No

  N/A

• Room has sufficient lighting?

  Yes

  No

  N/A

• Floors are able to be effectively cleaned?

  Yes

  No

  N/A

• Adequate ventilation provided within the room?

  Yes

  No

  N/A

• Room is clean, neat and hazard free?

  Yes

  No

  N/A

• Maintenance room is locked when not attended?

  Yes

  No

  N/A

• Additional Information

  Yes

  No

Grounds check

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

  Yes

  No

  N/A

• Is the entrance clean with no litter around ?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Additional Information

  Yes

  No

Interior check

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

  Yes

  No

  N/A

• Are the walls in a good condition?

  Yes

  No

  N/A

• Are the floor coverings clean and in good condition?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Additional Information

  Yes

  No

Resident Rooms

Room

• Name of the Wing

• Room Number

• Type of Care

  Select Low Care High Care Dementia Extra Services

  • Low Care
  • High Care
  • Dementia
  • Extra Services

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• All lights are in good working condition ?

  Yes

  No

  N/A

• All lights fittings are clean and in good condition ?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Does the air conditioning work efficiently ?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Are the electrical equipment tested and tagged?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Are the walls in a good condition ?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Additional Information

  Yes

  No

• Type of Bathroom

  Select En Suite Shared Bathroom

  • En Suite
  • Shared Bathroom

• Enter Bathroom Location

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

  Yes

  No

  N/A

• All lights are in good working condition ?

  Yes

  No

  N/A

• All lights fittings are clean and in good condition ?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Are the walls in a good condition?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• The hot water temperature is

  Select Very Hot ( over 75 Deg C Acceptable ( 50 - 75 ) Not Hot ( below 50 Deg C)

  • Very Hot ( over 75 Deg C
  • Acceptable ( 50 - 75 )
  • Not Hot ( below 50 Deg C)

• The cold water temperature is

  Select cold Hot

  • cold
  • Hot

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

  Yes

  No

  N/A

• The hot water temperature is

  Select Very Hot ( over 75 Deg C Acceptable ( 50 - 75 ) Not Hot ( below 50 Deg C)

  • Very Hot ( over 75 Deg C
  • Acceptable ( 50 - 75 )
  • Not Hot ( below 50 Deg C)

• The cold water temperature is

  Select cold Hot

  • cold
  • Hot

• Does the toilet system work correctly?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Are the hand rails secure and in good condition ?

  Yes

  No

  N/A

• Additional Information

  Yes

  No

Chemical Storage Room

• Premise has adequate storage facilities for storage of chemicals

  Yes

  No

  N/A

• Premises has sufficient lighting

  Yes

  No

  N/A

• Floors are able to be effectively cleaned

  Yes

  No

  N/A

• Walls and ceilings are able to be effectively cleaned

  Yes

  No

  N/A

• Adequate ventilation provided within the room

  Yes

  No

  N/A

• MSDS Register is available within the room?

  Yes

  No

  N/A

• PPE available in the room?

  Yes

  No

  N/A

• Chemical room is lockable and locked when not attended?

  Yes

  No

  N/A

• Fire extinguisher is located close by and in date?

  Yes

  No

  N/A

• Note any Maintenance requirements:

Waste Management

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

  Yes

  No

  N/A

• Floors are able to be effectively cleaned?

  Yes

  No

  N/A

• Adequate ventilation provided within the room?

  Yes

  No

  N/A

• Room is clean, neat and hazard free?

  Yes

  No

  N/A

• Have waste bins been kept clean by regular washing?

  Yes

  No

  N/A

• Area is odour free?

  Yes

  No

  N/A

• Waste bins are numbered?

  Yes

  No

  N/A

• Waste bins are filled by number order?

  Yes

  No

  N/A

• Correct bins are used for appropriate waste?

  Yes

  No

  N/A

• Cardboard boxes are flatten before placing in bin?

  Yes

  No

  N/A

• Note any Maintenance requirements:

Additional Information

• Additional Notes/Comments

• Action Required

  Select None Correction Action Record Record of Conversation Warning Letter

  • None
  • Correction Action Record
  • Record of Conversation
  • Warning Letter

• Re-inspection Required

  Yes

  No

  N/A

• Time before next inspection

  Week

  Fortnight

  1 Month

  3 Months

  6 Months

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

• Central Office signature

  Sign

• 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