Audit

Inspection Details

Facility Manager

Email

Date of Last Aegis Internal Audit
Number of Non Compliances Last Aegis Audit

Evidence of Non Compliances closed out

Details of Non Compliance:

Non Compliance Item

Type of Non Compliance

Date Item Completed
Evidence of Item Completed
General Requirements
Date of last Accreditation /Support Visit

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

Date of Last Meeting

Details of Minutes

Evidence of Facility Resident Meeting Minutes - Qtr.

Date of Last Meeting

Details of Minutes

Evidence of Infection Control Meeting Minutes - Qtr.

Date of Last Meeting

Details of Minutes

Evidence of OSH Meeting Minutes - Qtr.

Date of Last Meeting

Details of Minutes

Evidence of Quality Meeting Minutes - 2 monthly

Date of Last Meeting

Details of Minutes

Evidence of Resident Satisfaction Survey - 6 monthly

Date of Last Survey
% above Satisfactory

Details of Survey

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

Details of System for Access;

Supplier Records

Where would you locate Supplier Contract information?

Evidence of Waste Management Reports

Date of Report

Evidence of Fire Protection Certificate of Compliance

Select Certificate Type;

Expiry Date of Certificate

Select Certificate Type;

Expiry Date of Certificate
Records

Weekly Cleaning Schedule Records are Completed

Record details

Weekly Cleaning Audits are Completed

Vacant Room Clean Records are completed

Record details

Laundry Cleaning Schedule Records are completed

Record details

Resident Lost Clothing Records are completed

Record details

Resident Lost Clothing system in place

Record details

Maintenance Log Book system in place?

Record details

Maintenance jobs are completed in a timely manner?

Record details

Electrical tagging of items are within date code?

Record details

Fire Service Equipment tagged and within date code?

Record details

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

Record details

Admin / Reception / Foyer

Name of cleaner responsible for area:

Floors are clean and stain free?

Staff are wearing an Aegis uniform with name badge?

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

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

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

Picture frames and light fittings are dust free and clean?

Shelving, ledges and window frames are dust free?

Wall and furniture surfaces are clean and unmarked?

Area is odour free?

Archive room is organised and hazard free?

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?

Area is odour free?

Wall surfaces / skirting boards are clean and unmarked?

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

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

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

Shelving, ledges and window frames are dust free?

Internal windows are clean?

Hand basin is clean with hand wash and paper towels?

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

General good housekeeping practices observed?

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

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?

Area is odour free?

Wall surfaces / skirting boards are clean and unmarked?

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

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

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

Shelving, ledges and window frames are dust free?

Internal windows are clean?

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

General good housekeeping practices observed?

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

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?

Area is odour free?

Wall surfaces / skirting boards are clean and unmarked?

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

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

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

Furniture is placed in an orderly manner?

Shelving, ledges and window frames are dust free?

Internal windows are clean?

General good housekeeping practices observed?

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

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?

Room is odour free?

Wall surfaces / skirting boards are clean and unmarked?

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

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

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

Furniture is placed in an orderly manner?

Shelving, ledges and window frames are dust free?

Internal windows are clean?

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

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

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

Toilet is clean and stain free?

Shower tiles are clean and stain free including the grout?

Shower head is clean and in good condition?

No leaking tap ware?

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

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

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?

Room is odour free?

Wall surfaces / skirting boards are clean and unmarked?

Shelving, ledges and window frames are dust free?

Internal windows are clean?

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

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

Air vents are dust free and clean?

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

Toilet is clean and stain free?

Shower tiles are clean and stain free including the grout?

Shower head is clean and in good condition?

No leaking tap ware?

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

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

Note any Maintenance requirements:

Staff Room

Name of cleaner responsible for area:

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

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

Sink is clean with hand wash and paper towels?

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

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

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

Shelving, ledges and window frames are dust free?

Wall surfaces / skirting boards are clean and unmarked?

Internal windows are clean?

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

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

General good housekeeping practices observed?

Note any Maintenance requirements:

Cleaners Room and Equipment

Cleaner's Room

Cleaner

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

Chemicals are placed within the locked compartment?

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

Equipment is clean?

Take photo of equipment.

Cleaning equipment are in good condition?

Equipment electrical cords are in good condition and tagged?

Room is clean, neat and hazard free?

Minimal chemicals only are stored within cleaners room?

Chemicals are all labelled?

Only Aegis approved chemicals are used?

Cleaners room is locked when not attended?

Note any Maintenance requirements:

Laundry

Laundry Room

Laundry

Area is odour free?

Laundry room layout has a clean and dirty area?

Room is clean, neat and hazard free?

Dirty linen bags are stored correctly on trolleys?

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

Chemicals are all labelled?

Only Aegis approved chemicals are used?

Equipment is clean?

Take photo of equipment.

Cleaning equipment are in good condition?

Equipment electrical cords are in good condition and tagged?

Dryer filters are lint free and cleaned daily?

Note any Maintenance requirements:

Chemical Storage Room

General design and construction of premises appropriate

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:

Maintenance Room

Room has adequate storage facilities for items?

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?

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:

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)

No signs of insect infestation or rodent activity in premises

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

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.

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

Cleaning and Laundry staff have clean waterproof coverings on bandages

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.

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?

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

Additional Information

Additional Notes/Comments

Action Required

Re-inspection Required

Time before next inspection

DECLARATION: I have read this report and understand the contents

Facility Manager signature
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

Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.