Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

  • Conducted on

Inspection Details

  • Facility Manager

  • Email

  • Maintenance Officer

  • 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

  • Any issues raised in regards with Maintenance ?

Supplier Records

  • Evidence of Fire Protection Certificate of Compliance

  • Select Certificate Type;

  • Expiry Date of Certificate

  • Select Certificate Type;

  • Expiry Date of Certificate

  • Tool

Maintenance log book

  • Is the log book in a good serviceable condition?

  • Are the jobs completed in a reasonable time?

  • Are completed jobs signed and dated?

  • Approximately how many jobs are logged daily?

  • Note any Maintenance requirements:

Maintenance shedule/record

  • Is the daily maintenance schedule up to date and signed?

  • Is the weekly maintenance schedule signed and up to date?

  • Is the monthly maintenance signed and up to date?

  • Is the three monthly maintenance signed and up to date?

  • Is the six monthly maintenance up to date?

  • Is the contractor log in register being completed?

  • Is the wheelchair maintenance book up to 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:

Grounds check

  • Have the entry areas been swept?(daily task)

  • Is there any litter?

  • Are the lights and fittings in a good working condition

  • Is the wall paint work clean and in a good condition?

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

  • Are cobwebs present?

  • Note any Maintenance requirements:

Interior check

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

  • Does it need painting?

  • Does it need repairing?

  • Are the walls in a good condition?

  • Does it need painting?

  • Does it need repairing?

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

  • Are the lights and fittings working and in a good condition?

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

  • Note any Maintenance requirements:

Room check

  • Do the door handles work and are in a good condition? (Main door, bathroom door and outside door)

  • Do the lights work correctly? Check switches

  • Do the electrical equipment work correctly? (TV,digital ect)

  • Do all the remotes work?

  • Does the nurse call work?

  • Does the air conditioning work correctly?

  • 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)

  • Does it need painting?

  • Does it need repairing?

  • Are the walls in a good condition?

  • Does it need painting?

  • Does it need repairing?

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

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

  • Note any Maintenance requirements:

Bathroom check

  • Do the door handles work and are in a good condition? (Main door, bathroom door and outside door)

  • Do the lights work correctly? Check switches

  • Does the nurse call work?

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

  • Does it need painting?

  • Does it need repairing?

  • Are the tiles in a good condition?

  • Are the walls in a good condition?

  • Does it need painting?

  • Does it need repairing?

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

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

  • Do the taps work correctly, hot and cold

  • What is the temperature?

  • Does the shower work correctly?

  • What is the temperature?

  • Does the toilet work correctly?

  • Is the toilet in a good condition, not cracked and secure

  • Are the hand rails secure?

  • 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:

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

  • 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

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