Alpine Shire Prescribed Accommodation Inspection

• Premises Name

• Proprietor (company operating business?)

• Email

• Address of business
  Address

• Person in charge

• Conducted on

  Date

OVERCROWDING

• Max number of people per room for more than 31 days=<br>Less than 12 m2= 1<br>More than 12m2= 2<br>+ 1 Additional person for every 4m2<br><br>* Rooms cannot be used as a bedroom if the floor area is less then 7.5m2.<br><br><br>

  Yes

  No

  N/A

• Number of rooms

• Number of guests

• Max number of people per room for less than 31 days=<br>Less than 10 m2= 2<br>More than 10m2= 3<br>+ 1 Additional person for every 2m2<br><br>* Rooms cannot be used as a bedroom if the floor area is less then 7.5m2.<br>

  Yes

  No

  N/A

• Number if rooms

• Number of guests

• One toilet, one bath/shower and one hand wash basin with hot and cold water is to be accessible for every 10 persons.<br>

  Yes

  No

  N/A

CLEANING AND MAINTENANCE

• Rooms in a clean, sanitary, hygienic condition and good state of repair?

  Yes

  No

  N/A

• Are toilet and shower facilities in a clean, sanitary, hygienic condition and good working order?

  Yes

  No

  N/A

• Are living rooms and kitchens in a clean, sanitary, hygienic condition and good repair?

  Yes

  No

  N/A

• Is soiled linen laundered in hot water, changed between occupants and suitable storage provided?

  Yes

  No

  N/A

• Is premise maintained in clean condition and appropriate cleaning equipment and products used?

  Yes

  No

  N/A

PEST CONTROL

• Evidence of pest harbourage?<br>

  Yes

  No

  N/A

WASTE DISPOSAL

• Is there sufficient waste collection and disposal practices, including wastewater?

  Yes

  No

  N/A

WATER SUPPLY

• Drinking water potable and safe?

  Yes

  No

  N/A

• Continuous and adequate supply of water and or hot water to toilets, bathroom, drinking, kitchens?

  Yes

  No

  N/A

REGISTER

• Register kept of all names, addresses, contacts, arrival and departure dates of guests?

  Yes

  No

  N/A

FURTHER ACTIONS

• Action required

  Select Yes No N/A

  • Yes
  • No
  • N/A

REINSPECTION DATE

• Select date

  Date

SIGNATURES

• Signature of Proprietor/Staff

  Sign

• Signature of Officer

  Sign

• Alpine Shire Council Great Alpine Road, Bright Post: PO Box 139, Bright, VIC, 3741 Ph: 03 5755 0555 Email: health@alpineshire.vic.gov.au Web: www.alpineshire.vic.gov.au