Title Page

  • Asset Name:

  • Asset ID No:

  • Inspection Report Number

  • Built Date:

  • Building Floor Area M2:

  • State Heritage Listed

  • Location:
  • Inspection Date:

  • Inspecting Officer:

  • Asset Photo:

CAPEX Information

  • Has there been any RENEWAL or NEW renovations completed during the past 3 year?

  • Has there been any Renewal or New CAPEX projects Identified during this Inspection?

  • Have Budget Bids Estimates been completed?<br>List projects below... separate question

  • Total Cost Estimate ?

  • Have Budget Bid Estimates been approved and entered into the LTFP?

Glossary & List of Common Terms

Glossary & List of Common Terms

  • OCI = "Overall Condition Index" Groups all checked building components together into one overall condition rating.

  • Condition = Condition Rating Score of Separated Building Component taken out of overall grouped materials OCI

  • ACM = Asbestos Containing Material

  • Local Heritage Listing = All changes to
    these places require normal development approval by the City of Kalamunda

  • State Heritage Listing = All changes to
    these places require development approval by the City of Kalamunda and
    must be referred to State Heritage Office as part
    of the development application process for overall approval.

OCI Rating Score Examples

  • 1. Very Good - Asset is in near perfect condition. Only regular maintenance is required.

  • 2. Good - Asset has deteriorated slightly but only routine maintenance is required to maintain the rating.

  • 3. Fair - Asset is in satisfactory condition but showing signs of wear and tear. Moderate levels of periodic (programmed) maintenance are required to maintain the asset in this condition.

  • 4. Poor - Asset is in below average condition with significant signs of wear and tear. High levels of periodic maintenance may be required to maintain the rating of this asset. Regular safety inspections are required as part of a risk management strategy. Partial or full replacement may be required to improve the rating of this asset.

  • 5. Very Poor - Asset is in very poor condition and needing full replacement. Access restrictions and/or warning signs may be needed until replacement. Regular safety inspections are required as part of a risk management strategy.

Overall Building Condition Summary:<br>(To be answered after Inspection has been completed)

  • Condition Findings:

  • OCI

SITE SANITARY:

Service - Type & Overall Condition Index

  • Septic Tanks & Leach Drains

  • Deep Sewage

  • ATU (Aerobic Treatment Unit)

  • Grease Trap

  • OCI

SITE UTILITIES:

Water - Connection Type & Overall Condition Index

  • Mains

  • Storage Tank

  • OCI

Electrical - Switchboard Type & Overall Condition Index

  • Main Boards

  • OCI

  • Sub Boards

  • No of Sub Boards

  • OCI

  • Other...

  • OCI

Electrical - Service Type & Overall Condition Index (Including Service poles, pits etc)

  • Overhead

  • Underground

  • Solar

  • Other...

  • OCI

Gas - Connection Type & Overall Condition Index

  • Mains - Natural

  • Bottle - LPG

  • Other...

  • OCI

STORMWATER:

Drainage - Type & Overall Condition Index

  • Pits & Grates

  • Spoon Drains

  • Other...

  • OCI

SITE INFRASTRUCTURE:

Structure - Type & Overall Condition Index

  • Ramps

  • Disabled Access Compliant

  • OCI

  • Steps

  • Disabled Access Compliant

  • OCI

  • Pathways

  • Disabled Access Compliant

  • OCI

  • Paving/Hardstand Area's

  • Disabled Access Compliant

  • OCI

  • Fencing (Attached to Buildings only, Free Standing is Separate Category)

  • OCI

  • Retaining wall/flower boxes (Lower then 1 meter in height)

  • OCI

  • Other...

  • OCI

EXTERNAL<br>ROOFING:

Roof Construction - Type & Overall Condition Index

  • Timber

  • Steel

  • Other...

  • OCI

  • Painted Surfaces

  • OCI

Roof - Cladding Type & Overall Condition Index

  • Sheeting Zinc

  • Sheeting Colorbond

  • Tiles Clay

  • Tiles Concrete

  • Fiberglass / Polycarbonate

  • Other...

  • OCI

  • Painted Surfaces

  • OCI

Separate Component Works Item

  • Component Type

  • Area in m2

  • Condition

Gutters & Downpipes Type & Overall Condition Index

  • Zinc

  • Colorbond

  • PVC

  • Other...

  • OCI

  • Painted Surfaces

  • OCI

Separate Component Works Item

  • Component Type

  • Area in m2

  • Condition

Eave Cladding Type & Overall Condition Index

  • Asbestos

  • Fiber Cement

  • Tin Sheeting Other...

  • Timber

  • Other...

  • OCI

  • Painted Surfaces

  • OCI

EXTERNAL<br>CHIMNEYS / FLUES:

Chimney/Flue Construction Type & Overall Condition Index

  • Brick

  • Steel

  • Asbestos

  • Other...

  • OCI

EXTERNAL<br>WALLS:

Wall Construction Type & Overall Condition Index

  • Brick

  • Rendered Brick

  • Concrete Tilt Up

  • Rammed Earth

  • Timber/Steel Framed

  • Framed Glass

  • Other...

  • OCI

  • Painted Surfaces

  • OCI

Wall Cladding/Material Type & Overall Condition Index

  • Asbestos

  • Fiber Cement

  • Timber Boards

  • Timber Panel

  • Tin Sheeting - Zinc

  • Tin Sheeting - Colorbond

  • Tiles

  • Other...

  • OCI

  • Painted Surfaces

  • OCI

EXTERNAL <br>WINDOWS / SCREENS / DOORS:

Window Construction Type & Overall Condition Index

  • Timber

  • Aluminium

  • Steel

  • Other

  • OCI

  • Painted Surfaces

  • OCI

Security Screens - Type & Overall Condition Index

  • Roller / Panel

  • Steel Mesh

  • Steel Bars

  • Other...

  • OCI

  • Painted Surfaces

  • OCI

Door Construction Type & Overall Condition Index

  • Timber

  • Aluminum

  • Steel

  • Other...

  • OCI

  • Painted Surfaces

  • OCI

EXTERNAL<br>FOUNDATIONS:

Footings/Slab Construction Type & Overall Condition Index

  • Concrete

  • Limestone

  • Brick

  • Other...

  • OCI

INTERNAL <br>CEILINGS:

Ceilings Construction Type & Overall Condition Index

  • Fixed Frame

  • Suspended Frame

  • Concrete Slab

  • Other

  • OCI

Ceiling Cladding Type & Overall Condition Index

  • Gyprock/Plasterglass

  • Asbestos

  • Fiber Cement

  • Mineral fiber Panels

  • Shade Cloth

  • Metal Sheeting

  • Metal Slats

  • Other...

  • OCI

  • Painted Surfaces

  • OCI

INTERNAL<br>WALLS:

Wall Construction Type & Overall Condition Index

  • Face Brick

  • Rendered Brick

  • Painted Brick

  • Concrete Tilt Up

  • Painted Concrete Tilt Up

  • Rammed Earth

  • Painted Rammed Earth

  • Timber/Steel Framed

  • Other...

  • OCI

  • Painted surfaces

  • OCI

Wall Cladding/Material Type & Overall Condition Index

  • Gyprock / Plasterglass

  • Tiles

  • Asbestos

  • Fiber Cement

  • Timber Boards

  • Timber Panel

  • Tin Sheeting - Colorbond

  • Tin Sheeting - Zinc

  • Other...

  • OCI

  • Painted Surfaces

  • OCI

INTERNAL<br>WINDOWS / SCREENS / PARTITIONS / DOORS:

Window Construction Type & Overall Condition Index

  • Timber

  • Aluminium

  • Other...

  • OCI

  • Painted Surfaces

  • OCI

Security Screens - Type & Overall Condition Index

  • Roller / Panel

  • Steel Mesh

  • Steel Bars

  • Other...

  • OCI

  • Painted Surfaces

  • OCI

Partition Construction Type & Overall Condition Index

  • Framed Glass

  • Pin Board

  • Other...

  • OCI

  • Painted Surfaces

  • OCI

Door Type & Overall Condition Index

  • Timber

  • Timber steel cladded

  • Steel

  • Fire Rated

  • Aluminum and Glass

  • Other...

  • OCI

  • Painted Surfaces

  • OCI

INTERNAL <br>FLOORS:

Floor Construction Type & Overall Condition Index

  • Concrete Slab

  • Framing & Stumps

  • Other...

  • OCI

Floor Covering Type & Overall Condition Index

  • Concrete Unpainted

  • Concrete Painted

  • Terrazzo

  • Carpet Tiles

  • Carpet Sheeting

  • Asbestos Lino/Tiles

  • Vinyl Tiles

  • Vinyl Sheeting

  • Vinyl Planks

  • Ceramic Tiles

  • Composite Tiles

  • Timber T&G

  • Timber Panel

  • Timber Laminated

  • Other...

  • OCI

INTERNAL<br>STAIRS / STEPS / RAMPS / LIFTS:

Construction Type & Overall Condition Index Stairs & Steps

  • Timber

  • OCI

  • Concrete

  • OCI

  • Brick

  • OCI

  • Other...

  • OCI

  • Disabled Access Compliant

Ramps

  • Timber

  • OCI

  • Concrete

  • OCI

  • Brick

  • OCI

  • Other...

  • OCI

  • Disabled Access Compliant

Lifts

  • Passenger

  • OCI

  • Platform

  • OCI

  • Other...

  • OCI

  • Disabled Access Compliant

AIR CONDITIONING:

Heating/Cooling Type & Overall Condition Index

  • HVAC (Heating, Ventilation, & Air Conditioning)

  • OCI

  • Split System (Wall Mounted Single)

  • OCI

  • Split System (Wall Mounted Multi Head)

  • OCI

  • Split System (Ceiling Cassette)

  • OCI

  • Window/Wall (Box Unit)

  • OCI

  • Other...

  • OCI

HOT WATER HEATING:

Hot Water type & Overall Condition Index

  • Electric Storage

  • OCI

  • Gas Storage

  • OCI

  • Electric Instantaneous

  • OCI

  • Gas Instantaneous

  • OCI

  • Solar

  • OCI

  • Other...

  • OCI

FIRE & EMERGENCY<br>SERVICES:

Fire Alarm Systems & Overall Condition Index

  • Fire Indicator Panel

  • Alarm Sirens

  • Fire PA (Public Address)

  • Other...

  • OCI

Fire Suppression Systems & Overall Condition Index

  • Sprinklers

  • Hose Reels

  • Extinguishers

  • Blankets

  • Hydrants

  • Water Tanks

  • Generators

  • Other...

  • OCI

Detection Systems & Overall Condition Index

  • Smoke Detectors

  • Thermal Detectors

  • Other...

  • OCI

Lighting Systems & Overall Condition Index

  • Emergency Lighting (Spit Fires)

  • Exit Signage (Exit or Running Man)

  • Other...

  • OCI

Fire Escapes & Overall Condition Index

  • Fire Rated Doors

  • Evacuation Diagram Signage

  • Other...

  • OCI

BATHROOMS / CHANGEROOMS<br>FITOUTS:

  • Does This Building Contain Any Bathrooms or Changerooms? <br>If YES, Continue on with below questions<br>If NO, proceed onto next section (KITCHENS / KITCHENETTES FITOUTS:)

Ceiling Cladding Type & Overall Condition Index

  • Same constructions as main building above

  • Gyprock/Plasterglass

  • Asbestos

  • Fiber Cement

  • Mineral fiber

  • Tin Sheeting Colorbond

  • Tin Sheeting Zinc

  • Metal Slats

  • Other...

  • OCI

  • Painted Surfaces

  • OCI

Wall Cladding/Material Type & Overall Condition Index

  • Same constructions as main building above

  • Asbestos

  • Ceramic Tiles

  • Fiber Cement

  • Timber Boards

  • Timber Panel

  • Tin Sheeting - Zinc

  • Tin Sheeting - Colorbond

  • Gyprock / Plasterglass

  • Other...

  • OCI

  • Painted Surfaces

  • OCI

Floor Covering Type & Overall Condition Index

  • Same constructions as main building above

  • Ceramic Tiles

  • Concrete Unpainted

  • Concrete Painted

  • Terrazzo

  • Carpet Tiles

  • Carpet Sheeting

  • Asbestos Lino/Tiles

  • Vinyl Tiles

  • Vinyl Sheeting

  • Vinyl Planks

  • Composite Tiles

  • Timber T&G

  • Timber Panel

  • Timber Laminated

  • Other...

  • OCI

  • Painted Surfaces

  • OCI

Fit Out

  • Cabinets

  • OCI

  • Basins

  • OCI

  • Toilet Pans & Cistern/s

  • OCI

  • Urinals & Cistern/s

  • OCI

  • Toilet Cubical Doors/Frames

  • OCI

  • Shower Cubicles Doors / Screens

  • OCI

  • Water Heating

  • OCI

  • Mirror's

  • OCI

  • Fixed Seating

  • OCI

  • Extraction Exhaust Fans

  • OCI

  • Lighting

  • OCI

  • Electric Hand Dryers

  • OCI

  • Other

  • OCI

KITCHENS / KITCHENETTES<br>FITOUTS:

  • Does this building have and Kitchens or Kitchenettes? <br>If YES, Continue on with below questions<br>If NO, proceed onto next section (ACCESSIBILITY / DISABLED ACCESS:)

Ceiling Cladding Type & Overall Condition Index

  • Same constructions as main building above

  • Gyprock/Plasterglass

  • Asbestos

  • Fiber Cement

  • Mineral fiber

  • Tin Sheeting Colorbond

  • Tin Sheeting Zinc

  • Metal Slats

  • Other...

  • OCI

  • Painted Surfaces

  • OCI

Wall Cladding/Material Type & Overall Condition Index

  • Same constructions as main building above

  • Gyprock / Plasterglass

  • Asbestos

  • Ceramic Tiles

  • Fiber Cement

  • Timber Boards

  • Timber Panel

  • Tin Sheeting - Zinc

  • Tin Sheeting - Colorbond

  • Ceramic Tiles

  • Other...

  • OCI

  • Painted Surfaces

  • OCI

Floor Covering Type & Overall Condition Index

  • Same constructions as main building above

  • Ceramic Tiles

  • Concrete Unpainted

  • Concrete Painted

  • Terrazzo

  • Carpet Tiles

  • Carpet Sheeting

  • Asbestos Lino/Tiles

  • Vinyl Tiles

  • Vinyl Sheeting

  • Vinyl Planks

  • Composite Tiles

  • Timber T&G

  • Timber Panel

  • Timber Laminated

  • Other...

  • OCI

  • Painted Surfaces

  • OCI

Fit Out

  • Cabinets / Cupboards

  • OCI

  • Fixed Benches

  • OCI

  • Fixed Shelfing

  • OCI

  • Basins / Sinks / Troughs

  • OCI

  • Oven - Commercial

  • OCI

  • Oven - Domestic

  • OCI

  • Stove & Oven Combined - Commercial

  • OCI

  • Stove & Oven Combined - Domestic

  • OCI

  • Dishwasher - Commercial

  • OCI

  • Dishwasher - Domestic

  • OCI

  • Extraction Exhaust Fans

  • OCI

  • Fixed Seating

  • OCI

  • Lighting

  • OCI

  • Electric Hand Dryers

  • OCI

  • Instantaneous Hot Water Units i.e. Zip, Billi

  • OCI

  • Built in Fridges i.e. Bar, Cool Rooms

  • OCI

  • Built in Freezers i.e. Freezer Rooms

  • OCI

  • Other

  • OCI

ACCESSIBILITY / DISABLED <br>ACCESS:

Travel Routes

  • Exterior Compliant<br>(People with disabilities should be able to arrive on site, approach the building, and enter as freely as everyone else. At least one route of travel should be safe and accessible for everyone, including people with disabilities. This route must include Acrod parking, kerb ramps, access ramps with handrails, and automatic door operators as necessary to enter the building. New premises standards commence as from the 1st May 2011in line with changes to the BCA)

  • Independent Disability Access Audit Recommended

  • Interior Compliant<br>(The layout of the building should allow people with disabilities to obtain materials or services and use of the facilities without assistance. This should include access to general purpose and specialized rooms, public assembly spaces (such as libraries, gymnasiums, and auditoriums), first aid rooms, main office, and restroom facilities. Services also include drinking fountains, telephones, and other amenities)

  • Independent Disability Access Audit Recommended

MISCELLANEOUS ITEMS:

  • Add any items missed in report here...

  • OCI

  • Add any items missed in report here...

  • OCI

  • Add any items missed in report here...

  • OCI

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.