Title Page
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Station Name
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Audited on:
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Auditor Name
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Location
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Staff Present - Names
Exterior/Paths/Grounds/Lighting/General
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Is the Traffic Lights IPC Zone system implemented and evident from entry point?
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Is the ground surface smooth with no slip trip hazards?
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Salt available to treat frosty ground?
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No bushes / hedges / weeds overhanging?
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Is their sufficient External Lighting?
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Is there safe separation of pedestrians and vehicles (walkways, bollards etc)?
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Access Control Functional - All staff have cards?
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Are all windows and doors secure?
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CCTV Notice in place? All CCTV Functional?
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Are Stairs and corridors clear, No inappropriate storage?
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STF/STAIRS or any other safety signs all in place. Click No to list signs required.
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A3 Poster - Employers/Employees Obligations present?
Kitchen Area
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Floors, Walls, Ceilings, sound? Lighting safety caged?
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Is there liquid mosituriser, and signage/instructions available for hand hygiene?
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Is there disposable towels and a dispenser ?
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Potable / Filtered water available?
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Worktops, cooker, kettle, microwave, tables, chairs, foot operated bin etc in safe condition?
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Is there a fridge clean notice for out of date foods?
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Fridge/Freezer free of Ice build up?
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Is all food, bread etc in suitable safe containers?
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No evidence of infestation or animals?
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No inappropriate items stored in kitchen?
Crew/Duty Room
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Floors, Walls, Ceiling, Sound? Lighting Safety Caged?
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Floor covering safe / clean / not worn?
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Chairs / Furniture cleanable no penetration in fabric which alter flammability and in good order?
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Tidy, uncluttered, no extension leads?
Female Facilities
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Floors, Walls, Ceilings, sound? Lighting Safety Caged?Seating Present?
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Sanitary Bins maintained and on contract?
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No Clothing or other equipment stored in toilet area?
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Toliets & sinks clean, all fittings and fixtures safe? No wooden parts?
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Shower cubicles clean & safe, no shared towels or washgear?
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Shower head & Sink legionella process in place?
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Opaque Glass / blinds on windows, locks, lights etc functional?
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Handwash signage, Mositurising soap, and disposable towels/dispensers in place?
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If lockers present - clear uncluttered, sufficient in number, named & no items stored overhead?
Male Facilities
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Floors, Walls, Ceilings, sound? Lighting safety caged?Seating present?
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No Clothing or other equipment stored in toilet area
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Toilets, Urinals & sinks clean, all fittings and fixtures safe? No wooden parts?
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Shower cubicles clean & safe, no shared towels or wash gear?
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Showerhead & Sink legionella process in place?
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Opaque glass / blinds on windows, locks, lights etc functional?
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Handwash signage, Mositurising Soap, and disposable towels/dispensers in place?
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If lockers present - clear unclutered, sufficient in number, named & no items stored overhead etc?
Garage / Parking Area.
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Roller doors, Gates etc all serviced and completely functional?
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Floor / Ground clean and in good order, no obstructions?
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Drop out chargers all in good order and service maked.
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Is there safe separation of vehicles & pedestrians?
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Lighting sufficient?
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Ventilation, and prohibition of running engines signs present?
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Clinical and general waste disposal - pedal operated bins?
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Fuel / Oil spill materials and tools present?
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Any equipment stored is clean, undamaged, and safely stored - free of dirt, dust, debris and off the ground?
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No inappropriate storage?
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Oxygen cage on site, correct signage, chains and restraints in use?
Stores Area
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Area is clean, well laid out?
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Safe and sufficient shelving / storage systems?
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No Manual Handling hazards present(too high/too low)?
Wash/Sluice Area
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Area Clean, Dry, Tidy and free from spillages?
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Clinical & General waste bins provided are fit for purpose?
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All equipment, Grimebeat, AdBlue stored safely?
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All relevant PPE present - Goggles, Aprons, Gloves etc?
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Chemicals safely stored, appropriate signage etc in use?
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Disposable mops in use, segragated buckets etc?
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Handwash facilities, signage, paper towels , dispensers and soap in place?
Waste (All Types)
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Are General and recyclable waste separated?
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Clinical bins being used for clinical waste only?
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Waste posters and signage in place and being adhered to?
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All sharps bins correctly marked and disposed of safely per policy?
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Clinical waste bags sealed, tagged and in Big yellow bin at 3/4 full?
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All clinical waste and full sharps bins in large bin?
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Stericycle WTF's available, timely collections?
Vehicles
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Vehicles (CAB & REAR) visibly clean inside and out? Picture & Reg Picture.
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Evidence of VDI use? Daily Walk around Posters Displayed?
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No damage external or internal? Click NO enter Reg Number and damage.
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Footwells clear of debris / dirt? Picture of Reg and debris if not.
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Evidence of Audit using Appendix 7 Cleaning standard
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Medi9, Blue/White towel, spill kits on vehicle?
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Is Sharps bin signed and dated as per policy?
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Disposable Linen in use as per policy and CAO direction ?
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No Excess medical gases on vehicle?
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All manual handling items (belts, banana board etc) present?
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Tax/CVRT/SCA disc in place? Picture if not.
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No Loose equipment in rear saloon? Picture ?
Office / Administration/ Fire Safety
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Physical Office environment - Walls, Storage, Lights, Ceiling's, Floor, Desk & Seating all in order?
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Safety Statement SS & Corporate, RA's, SWPS, SDS, Chemical (including register)/ Biological, all present?
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Safety Statement including RA's sign-off by all staff in past year?
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NIMS/NIRF Forms available to all?
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Staff & Supervsior can explain AINM/NIMS reporting process?
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All NAS Policies present and up to date - pick 3 random ?
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Lone Workers aware of and compliant with policies?
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Fleetwave, RTW Interviews, Leave Cards, Rosters all available and in use?
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DSE - HSEland E-Learning complete. Any relevant assessments done and actions implemented?
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Mandatory Training Complete - MAPA, MH, Children first?
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Station cleaning contract / schedule?
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Fire Safety Register in use?
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Fire Alarm and Emergency Lighting test in date? Check book for reports?
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Fire Detectors, Emergency Lighting, Illuminated exit Signs in place?
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All fire doors functional, including door closures and mag locks?
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Assembly points & fire orders in place?
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Fire Exits in order?