• Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Premises details

  • Trading name

  • Licence number

  • Address

  • Proprietor

  • Person interviewed

  • Inspection type

  • Inspection time & date

  • Business details notified [PHA31(1)]

  • Inspection Invoice to be issued?


  • Waxing

  • Nail services

  • Ear piercing

  • Body piercing

  • Tattooing

  • Microdermabrasion

  • Skin needling

  • Electrolysis

  • Cosmetic enhancement

  • Semi-permanent makeup

  • Colonic lavage

  • Other

  • Photo



  • Photo

  • Premises is clean and hygienic [PHR23(1)a]

  • Premises is structurally suitable [LGR11(1)]

  • Adequate washing, drainage, ventilation and lighting facilities provided [LGR13(1)]

  • Suitable floor coverings, shelves, fittings and furniture [LGR13(3)]

  • Shelves fittings and furniture are durable, smooth, impervious to moisture and capable of being easily cleaned [LGR13(4b)]

  • Hand wash basin provided [PHR23(1c)]

  • In each treatment room

  • Hand wash basin is provided with clean, potable, warm water through a common spout [PHR23(1c) & LGR13(4a)]

  • Hand basin situated against a wall with a durable, smooth, impervious to moisture and capable of being easily clean [LGR11(2)]

  • Liquid soap provided [PHR23(1e)(i)]

  • Hand sanitiser provided in each room/treatment area

  • Single use towels or other suitable hand drying equipment provided [PHR23(1e)(ii)]

  • Separate sink for the cleaning of equipment [PHR23(1d)]

  • Cleaning sink provided with clean, warm water [PHR23(d)]

  • Adequate toilet facilities provided (colonic lavage) [PHR24(a)&(b)]


  • Photo

  • General

  • Equipment is in good working order [PHR23(2)]

  • Equipment is stored in a clean and dry environment [PHR23(2)]

  • Clean linen available [PHR23(e)(iii)]

  • Clean and dirty linen stored in separate receptacles

  • All articles used to penetrate the skin (including both reusable articles and single use items) are clean and sterile [PHR27(5)]

  • Sterile packaging is opened in front of client

  • Tattooing

  • Tattoo spray bottles protected from contamination

  • Electrical hand piece is wiped with antiseptic after each client

  • Adequate supply of sterile disposable needles available [PHR25(2)]

  • Single use items i.e. needles, razors, stencils not re-used [PHR27(1)]


  • Photo

  • Waste disposal bin provided [PHR23(b)]

  • Compliant yellow sharps container provided [PHR25(1)&(3)]

  • Sharps container appropriately disposed of by a licensed contractor [POEO]

  • Sharps / needles disposed into a sharps container immediately after use [PHR27(2)&(4)]

  • Single use items are appropriately disposed of immediately after use [PHR27(3)&28(1b)]

  • Clinical waste bin provided


  • General

  • Clients records kept

  • Adequate procedures in place to assess clients and prevent disease transmissions

  • Hands washed prior to and after conducting procedure

  • Clean gowns or aprons available and worn during skin pen procedure [PHR23(e)(iii)&28(2)&(3)]

  • Single use disposable gloves are provided and worn during skin penetration procedures [PHR23(e)(iii)&28(1a)]

  • Waxing

  • Skin prepared with suitable antiseptic (pre-wax solution)

  • The spatula used to apply the wax is thrown out after use - no double dipping [PHR30]

  • Wax not reused and thrown out after use [PHR30]

  • Roll on wax: canister / applicator not reused [PHR30]

  • Tattooing

  • The ink, pigment or other liquid decanted into single use container [PHR29(1)]

  • Single use needles used

  • Single use container / applicators not reused [PHR29(1)]

  • Single use applicator used [PHR29(1)]

  • Benches/ chairs protected with single use coverings

  • After care information provided


  • Photo

  • All equipment is cleaned and dried after use [PHR23(2)]

  • Hospital grade disinfectant is being used

  • Foot spas are cleaned and disinfected

  • Cleaned and disinfected after each client

  • Components removed and cleaned daily

  • Soaked overnight once a week [PHR23(2)]


  • All reusable articles used to penetrate the skin are cleaned and sterilised using a bench top autoclave [PHR26(1)&(2)(a)]

  • All sterilised articles kept in a sterilised environment .i.e. Dry and protected from contamination (PHR27(5)]

  • Operator is adequately trained in the operation of the autoclave (onsite sterilisation) [PHR26(2b)]

  • Articles prepared and packed appropriately. Autoclave operated correctly [PHR26(c)]

  • Records kept for autoclave sterilisation (onsite) including time, date, length of time, temperature and pressure levels of the autoclave OR Records kept for sterilisation (offsite) including the date when the articles were sent off for sterilisation and the name and address details of the person who sterilises the articles [PHR26(3)&(4)]

  • Records of sterilisation kept at the premises for minimum of 12 months [PHR26(3)&(4)]

  • Autoclave is serviced and calibrated annually [PHR26(2c)]

  • Photo

  • Inspection result

  • Action

  • Reinspection required

  • Date of reinspection

  • I have read and understood the contents of this inspection report and will forward the report,mid applicable, onto the proprietor / owner or applicable person.

  • Time inspection completed


Inspection results

  • Satisfactory - All aspects of the premises comply with relevant legislative requirements.

  • Unsatisfactory - one or more relevant legislative requirements have not been met and have resulted in unsatisfactory workplace practices. A re-inspection will be required and legal action may be considered should the matter not be rectified prior to the reinspection.

General information

  • The Factsheets published by NSW Health outline the industries best practice standards. Council advises all premises to comply with the relevant documents for best practice purposes.

  • NSW Health advises that cuticle cutters are a skin penetration item that is required to be sterilised. Sterilisation can only be undertaken using an autoclave or dry heat steriliser. The sterilisation unit must comply with Australian Standard AS 2182 - Sterilisers - steam - benchtop" and be registered with the Therapeutic Goods Administration.

  • Fact sheets on procedures carried out by skin penetration premises can be found on the NSW Health website Fact sheets are available in English, Vietnamese, Chinese, Arabic and other languages.

  • Information on submission requirements for Development Applications, registration forms and fact sheets may be found on Council's website.

Council's Contact Details

  • Ballina Shire Council Telephone: (02) 6686 1210 Email:

  • 40 Cherry St Fax (02) 6681 1375. Web:

  • BALLINA NSW 2478

  • PO Box 450 Ballina NSW 2478

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.