Aegis Aged Care - Internal Workplace Cleaning Audit

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Inspection Details

• Facility Manager

• Email

• Date of Last Aegis Internal Audit

  Date

• Number of Non Compliances Last Aegis Audit

• Evidence of Non Compliances closed out

  Yes

  No

  N/A

• Details of Non Compliance:

Non Compliance Item

• Type of Non Compliance

• Date Item Completed

  Date

• Evidence of Item Completed

  Media

General Requirements

• Date of last Accreditation /Support Visit

  Date

• Details of Accreditation / Support Visit: Laundry, Cleaning, Waste Management

• % of Staff Mandatory Training Completed

• Details of Training not completed:

Communication

• Evidence of Facility Staff Meeting Minutes - Qtr

  Yes

  No

  N/A

• Date of Last Meeting

  Date

• Details of Minutes

• Evidence of Facility Resident Meeting Minutes - Qtr.

  Yes

  No

  N/A

• Date of Last Meeting

  Date

• Details of Minutes

• Evidence of Infection Control Meeting Minutes - Qtr.

  Yes

  No

  N/A

• Date of Last Meeting

  Date

• Details of Minutes

• Evidence of OSH Meeting Minutes - Qtr.

  Yes

  No

  N/A

• Date of Last Meeting

  Date

• Details of Minutes

• Evidence of Quality Meeting Minutes - 2 monthly

  Yes

  No

  N/A

• Date of Last Meeting

  Date

• Details of Minutes

• Evidence of Resident Satisfaction Survey - 6 monthly

  Yes

  No

  N/A

• Date of Last Survey

  Date

• % above Satisfactory

• Details of Survey

• Do Cleaning & Laundry staff have access to Aegis SharePoint & Aegis Cleaning/Laundry Handbook?

  Yes

  No

  N/A

• Details of System for Access;

Supplier Records

• Where would you locate Supplier Contract information?

• Evidence of Waste Management Reports

  Yes

  No

  N/A

• Date of Report

  Date

• Evidence of Fire Protection Certificate of Compliance

  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

Records

• Weekly Cleaning Schedule Records are Completed

  Yes

  No

  N/A

• Record details

• Weekly Cleaning Audits are Completed

  Yes

  No

  N/A

• Vacant Room Clean Records are completed

  Yes

  No

  N/A

• Record details

• Laundry Cleaning Schedule Records are completed

  Yes

  No

  N/A

• Record details

• Resident Lost Clothing Records are completed

  Yes

  No

  N/A

• Record details

• Resident Lost Clothing system in place

  Yes

  No

  N/A

• Record details

• Maintenance Log Book system in place?

  Yes

  No

  N/A

• Record details

• Maintenance jobs are completed in a timely manner?

  Yes

  No

  N/A

• Record details

• Electrical tagging of items are within date code?

  Yes

  No

  N/A

• Record details

• Fire Service Equipment tagged and within date code?

  Yes

  No

  N/A

• Record details

• MSDS records are in place; SharePoint, Master Copy & Main Chemical Storage Room

  Yes

  No

  N/A

• Record details

Admin / Reception / Foyer

• Name of cleaner responsible for area:

• Floors are clean and stain free?

  Yes

  No

  N/A

• Staff are wearing an Aegis uniform with name badge?

  Yes

  No

  N/A

• Signage is displayed as per Aegis Signage Policy; signage template, font, logo, created date, laminated, no visible fixings?

  Yes

  No

  N/A

• Reception counter is neat, signing book displayed, Aegis brochures are on displayed and neat, Department of Health and Ageing brochures are displayed?

  Yes

  No

  N/A

• Curtains/blinds are clean, dust free and in good repaired?

  Yes

  No

  N/A

• Picture frames and light fittings are dust free and clean?

  Yes

  No

  N/A

• Shelving, ledges and window frames are dust free?

  Yes

  No

  N/A

• Wall and furniture surfaces are clean and unmarked?

  Yes

  No

  N/A

• Area is odour free?

  Yes

  No

  N/A

• Archive room is organised and hazard free?

  Yes

  No

  N/A

• Note any Maintenance requirements:

Common Areas / Corridors

• Common Area / Corridor

Common Area / Corridor

• Name of cleaner responsible for area and wing name:

• Floor coverings (Flotex, Carpet, Vinyl, Tiles) clean and stain free?

  Yes

  No

  N/A

• Area is odour free?

  Yes

  No

  N/A

• Wall surfaces / skirting boards are clean and unmarked?

  Yes

  No

  N/A

• Curtains/blinds are clean, dust free and in good repaired?

  Yes

  No

  N/A

• Picture frames, light fittings and air vents are dust free and clean?

  Yes

  No

  N/A

• Furniture is clean, stain/dust free and in good condition?

  Yes

  No

  N/A

• Shelving, ledges and window frames are dust free?

  Yes

  No

  N/A

• Internal windows are clean?

  Yes

  No

  N/A

• Hand basin is clean with hand wash and paper towels?

  Yes

  No

  N/A

• Bins are clean, not over flowing and garbage bag lined?

  Yes

  No

  N/A

• General good housekeeping practices observed?

  Yes

  No

  N/A

• Signage is displayed as per Aegis Signage Policy; signage template, font, logo, created date, laminated, no visible fixings?

  Yes

  No

  N/A

• Note any Maintenance requirements:

Dining Rooms

Dining Room

• Name of cleaner responsible for dining room and name of wing:

• Floor coverings (Flotex, Carpet, Vinyl, Tiles) clean and stain free?

  Yes

  No

  N/A

• Area is odour free?

  Yes

  No

  N/A

• Wall surfaces / skirting boards are clean and unmarked?

  Yes

  No

  N/A

• Curtains/blinds are clean, dust free and in good repaired?

  Yes

  No

  N/A

• Picture frames, light fittings and air vents are dust free and clean?

  Yes

  No

  N/A

• Furniture is clean, stain/dust free and in good condition?

  Yes

  No

  N/A

• Shelving, ledges and window frames are dust free?

  Yes

  No

  N/A

• Internal windows are clean?

  Yes

  No

  N/A

• Bins are clean, not over flowing and garbage bag lined?

  Yes

  No

  N/A

• General good housekeeping practices observed?

  Yes

  No

  N/A

• Signage is displayed as per Aegis Signage Policy; signage template, font, logo, created date, laminated, no visible fixings?

  Yes

  No

  N/A

• Note any Maintenance requirements:

Lounge Areas

• Lounge Area

Lounge Room

• Name of cleaner responsible for lounge room and name of wing:

• Floor coverings (Flotex, Carpet, Vinyl, Tiles) clean and stain free?

  Yes

  No

  N/A

• Area is odour free?

  Yes

  No

  N/A

• Wall surfaces / skirting boards are clean and unmarked?

  Yes

  No

  N/A

• Curtains/blinds are clean, dust free and in good repaired?

  Yes

  No

  N/A

• Picture frames, light fittings and air vents are dust free and clean?

  Yes

  No

  N/A

• Furniture is clean, stain/dust free and in good condition?

  Yes

  No

  N/A

• Furniture is placed in an orderly manner?

  Yes

  No

  N/A

• Shelving, ledges and window frames are dust free?

  Yes

  No

  N/A

• Internal windows are clean?

  Yes

  No

  N/A

• General good housekeeping practices observed?

  Yes

  No

  N/A

• Signage is displayed as per Aegis Signage Policy; signage template, font, logo, created date, laminated, no visible fixings?

  Yes

  No

  N/A

• Note any Maintenance requirements:

Resident Room

Resident Room

• Name of cleaner responsible for resident room, name of wing and room number:

• Floor coverings (Flotex, Carpet, Vinyl, Tiles) clean and stain free?

  Yes

  No

  N/A

• Room is odour free?

  Yes

  No

  N/A

• Wall surfaces / skirting boards are clean and unmarked?

  Yes

  No

  N/A

• Curtains/blinds are clean, dust free and in good repaired?

  Yes

  No

  N/A

• Picture frames, light fittings and air vents are dust free and clean?

  Yes

  No

  N/A

• Furniture is clean, stain/dust free and in good condition?

  Yes

  No

  N/A

• Furniture is placed in an orderly manner?

  Yes

  No

  N/A

• Shelving, ledges and window frames are dust free?

  Yes

  No

  N/A

• Internal windows are clean?

  Yes

  No

  N/A

• Resident fridge is clean inside/outside and food items are within date code?

  Yes

  No

  N/A

• Bins are clean, not over flowing and garbage bag lined?

  Yes

  No

  N/A

• Bathroom basin is clean, hand soap is available and paper towels are available?

  Yes

  No

  N/A

• Toilet is clean and stain free?

  Yes

  No

  N/A

• Shower tiles are clean and stain free including the grout?

  Yes

  No

  N/A

• Shower head is clean and in good condition?

  Yes

  No

  N/A

• No leaking tap ware?

  No

  Yes

• General good housekeeping practices observed? (No visible OSH risk items)

  Yes

  No

  N/A

• Signage is displayed as per Aegis Signage Policy; signage template, font, logo, created date, laminated, no visible fixings?

  Yes

  No

  N/A

• Note any Maintenance requirements:

Common Bathroom / Toilet

Common Bathroom / Toilet

• Name of cleaner responsible for common bathroom/toilet, name of wing:

• Floor Tiles clean and stain free?

  Yes

  No

  N/A

• Room is odour free?

  Yes

  No

  N/A

• Wall surfaces / skirting boards are clean and unmarked?

  Yes

  No

  N/A

• Shelving, ledges and window frames are dust free?

  Yes

  No

  N/A

• Internal windows are clean?

  Yes

  No

  N/A

• Bins are clean, not over flowing and garbage bag lined?

  Yes

  No

  N/A

• Light fittings are dust free, clean and in working order?

  Yes

  No

  N/A

• Air vents are dust free and clean?

  Yes

  No

  N/A

• Bathroom basin is clean, hand soap is available and paper towels are available?

  Yes

  No

  N/A

• Toilet is clean and stain free?

  Yes

  No

  N/A

• Shower tiles are clean and stain free including the grout?

  Yes

  No

  N/A

• Shower head is clean and in good condition?

  Yes

  No

  N/A

• No leaking tap ware?

  No

  Yes

• General good housekeeping practices observed? (No visible OSH risk items)

  Yes

  No

  N/A

• Signage is displayed as per Aegis Signage Policy; signage template, font, logo, created date, laminated, no visible fixings?

  Yes

  No

  N/A

• Note any Maintenance requirements:

Staff Room

• Name of cleaner responsible for area:

• Floor coverings (Vinyl, Tiles) clean and stain free?

  Yes

  No

  N/A

• Fridge is clean inside and out, frost free and food safe?

  Yes

  No

  N/A

• Sink is clean with hand wash and paper towels?

  Yes

  No

  N/A

• Bins are clean, not over flowing and garbage bag lined?

  Yes

  No

  N/A

• Dining tables and chairs are clean, stain/dust free and in good condition?

  Yes

  No

  N/A

• Picture frames, light fittings and air vents are dust free and clean?

  Yes

  No

  N/A

• Shelving, ledges and window frames are dust free?

  Yes

  No

  N/A

• Wall surfaces / skirting boards are clean and unmarked?

  Yes

  No

  N/A

• Internal windows are clean?

  Yes

  No

  N/A

• Curtains/blinds are clean, dust free and in good repaired?

  Yes

  No

  N/A

• Signage is displayed as per Aegis Signage Policy; signage template, font, logo, created date, laminated, no visible fixings?

  Yes

  No

  N/A

• General good housekeeping practices observed?

  Yes

  No

  N/A

• Note any Maintenance requirements:

Cleaners Room and Equipment

• Cleaner's Room

Cleaner

• Cleaning trolley is set up correctly and in a clean orderly manner?

  Yes

  No

  N/A

• Chemicals are placed within the locked compartment?

  Yes

  No

  N/A

• Cleaning Schedule record is on a clip board on the trolley?

  Yes

  No

  N/A

• Equipment is clean?

  Yes

  No

  N/A

• Take photo of equipment.

  Media

• Cleaning equipment are in good condition?

  Yes

  No

  N/A

• Equipment electrical cords are in good condition and tagged?

  Yes

  No

  N/A

• Room is clean, neat and hazard free?

  Yes

  No

  N/A

• Minimal chemicals only are stored within cleaners room?

  Yes

  No

  N/A

• Chemicals are all labelled?

  Yes

  No

  N/A

• Only Aegis approved chemicals are used?

  Yes

  No

  N/A

• Cleaners room is locked when not attended?

  Yes

  No

  N/A

• Note any Maintenance requirements:

Laundry

• Laundry Room

Laundry

• Area is odour free?

  Yes

  No

  N/A

• Laundry room layout has a clean and dirty area?

  Yes

  No

  N/A

• Room is clean, neat and hazard free?

  Yes

  No

  N/A

• Dirty linen bags are stored correctly on trolleys?

  Yes

  No

  N/A

• Chemicals are placed within the locked compartment or the room is lockable?

  Yes

  No

  N/A

• Chemicals are all labelled?

  Yes

  No

  N/A

• Only Aegis approved chemicals are used?

  Yes

  No

  N/A

• Equipment is clean?

  Yes

  No

  N/A

• Take photo of equipment.

  Media

• Cleaning equipment are in good condition?

  Yes

  No

  N/A

• Equipment electrical cords are in good condition and tagged?

  Yes

  No

  N/A

• Dryer filters are lint free and cleaned daily?

  Yes

  No

  N/A

• Note any Maintenance requirements:

Chemical Storage Room

• General design and construction of premises appropriate

  Yes

  No

  N/A

• 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:

Maintenance Room

• Room has adequate storage facilities for items?

  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

• 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:

Animal and Pests

• Practical measures to eradicate and prevent harbourage of pests used (eg good housekeeping, no stock stored on floors, not over stocked, pest controller)

  Yes

  No

  N/A

• No signs of insect infestation or rodent activity in premises

  Yes

  No

  N/A

• Note any Maintenance requirements:

Health and Hygiene

• Hand washing facilities (including those at toilets) have warm running water through single spout, single use towels (or air dryer) and soap

  Yes

  No

  N/A

• Cleaning and Laundry staff wash hands before commencing/recommencing work and after using the toilet, coughing, sneezing, smoking, handling cleaning equipment, after/before tasks etc.

  Yes

  No

  N/A

• Cleaning and Laundry staff avoid unnecessary contact with resident personal items/clothing by using PPE

  Yes

  No

  N/A

• Cleaning and Laundry staff have clean waterproof coverings on bandages

  Yes

  No

  N/A

• Cleaning and Laundry staff understand the risk of Viral Gastro-enteritis within the workplace (vomiting, gastro); facility has system in place for staff to report illness.

  Yes

  No

  N/A

• Ask staff member what they would do if feeling ill with gastro and/or vomiting before work and/or at work?

• Cleaning and Laundry staff understand the procedures to follow within an Outbreak with their duties?

  Yes

  No

  N/A

• Ask staff member how they would carry out their duties within an Outbreak?

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

• Facility Manager signature

  Sign

• 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