Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location

Inspection Details

  • Facility Manager

  • Date of Last Aegis Internal Audit

General Requirements

  • % of Staff Mandatory Training Completed - ie: Manual handlind and Fire ( annual ) chemical safety ( 2 yearly )

  • Details of Training not completed:

Communication

  • How does the facility communicate the meeting minutes to cleaning and laundry staff ?

  • Does the facility have Staff , Resident, Infection Control , OSH , Quality meeting minutes and are they all up to date ?

  • Do cleaning and Laundry staff know they have access to Aegis Share Point and Aegis Cleaning / Laundry Handbook ?

Records

  • Weekly Cleaning Schedule Records are Completed with appropriate information and kept neat

  • Weekly Cleaning Audits are Completed

  • Vacant Room Clean Records are completed

  • Maintenance Log Book system in place?

  • Maintenance jobs are completed in a timely manner?

  • Record details

  • Electrical tagging of items are within date code?

  • Record details

  • Fire Service Equipment tagged and within date code?

  • Record details

  • MSDS records are in place; Main nurses station / First aid room & Main Chemical Storage Room

  • Record details

Admin / Reception / Foyer

  • Floors are clean and stain free?

  • Admin Staff are wearing an Aegis uniform with name badge?

  • Signage is displayed as per Aegis Signage Policy; signage template, font, logo, created date, laminated, no visible fixings?

  • Reception counter is neat, signing book displayed, Aegis brochures are on displayed and neat, Department of Health and Ageing brochures are displayed?

  • Is the front door glasses and windows clean with no visible marks ?

  • Curtains/blinds are clean, dust free and in good repaired?

  • Picture frames and light fittings are dust free and clean?

  • Wall and furniture surfaces are clean and unmarked?

  • This is to be done by

  • Area is odour free?

  • Archive room is organised and hazard free?

  • Maintenance requirements or any Additional information

Common Areas / Corridors

  • Common Area / Corridor

  • Common Area / Corridor
  • wing name and location

  • Floor coverings (Flotex, Carpet, Vinyl, Tiles) clean and stain free?

  • Area is odour free?

  • Wall and furniture surfaces are clean and unmarked?

  • This is to be done by

  • Curtains/blinds are clean, dust free and in good repaired?

  • Picture frames, light fittings and air vents are dust free and clean?

  • Furniture is clean, stain/dust free and in good condition?

  • Shelving, ledges and window frames are dust free?

  • Internal windows are clean?

  • Hand basin is clean with hand wash and paper towels?

  • Bins are clean, not over flowing and garbage bag lined?

  • General good housekeeping practices observed?

  • Signage is displayed as per Aegis Signage Policy; signage template, font, logo, created date, laminated, no visible fixings?

  • Maintenance requirements or any Additional information

Dining Rooms

    Dining Room
  • Dining room name and location

  • Floor coverings (Flotex, Carpet, Vinyl, Tiles) clean and stain free?

  • Area is odour free?

  • Wall and furniture surfaces are clean and unmarked?

  • This is to be done by

  • Curtains/blinds are clean, dust free and in good repaired?

  • Picture frames, light fittings and air vents are dust free and clean?

  • Furniture is clean, stain/dust free and in good condition?

  • Shelving, ledges and window frames are dust free?

  • Internal windows are clean?

  • General good housekeeping practices observed?

  • Signage is displayed as per Aegis Signage Policy; signage template, font, logo, created date, laminated, no visible fixings?

  • Maintenance requirements or any Additional information

Lounge Areas

  • Lounge Area

  • Lounge Room
  • Lounge name and Location

  • Floor coverings (Flotex, Carpet, Vinyl, Tiles) clean and stain free?

  • Area is odour free?

  • Wall and furniture surfaces are clean and unmarked?

  • This is to be done by

  • Curtains/blinds are clean, dust free and in good repaired?

  • Picture frames, light fittings and air vents are dust free and clean?

  • Furniture is clean, stain/dust free and in good condition?

  • Furniture is placed in an orderly manner?

  • Shelving, ledges and window frames are dust free?

  • Internal windows are clean?

  • General good housekeeping practices observed?

  • Signage is displayed as per Aegis Signage Policy; signage template, font, logo, created date, laminated, no visible fixings?

  • Maintenance requirements or any Additional information

Resident Room

    Resident Room
  • Wing Name and Room No

  • Floor coverings (Flotex, Carpet, Vinyl, Tiles) clean and stain free?

  • Room is odour free?

  • Wall and furniture surfaces are clean and unmarked?

  • This is to be done by

  • Curtains/blinds are clean, dust free and in good repaired?

  • Picture frames and light fittings are dust free and clean?

  • Furniture is clean, stain/dust free and in good condition?

  • Furniture is placed in an orderly manner?

  • Shelving, ledges and window frames are dust free?

  • Resident fridge is clean inside/outside and food items are within date code?

  • Internal windows are clean?

  • Bins are clean, not over flowing and garbage bag lined?

  • Maintenance requirements or any Additional information

  • Bathroom Type

  • Bathroom no or Location

  • Bathroom floor is clean and stain free?

  • Wall and furniture surfaces are clean and unmarked?

  • This is to be done by

  • Air vents are clean?

  • Toilet is clean and stain free?

  • Behind the toilet , toilet base and tank is clean ?

  • Bathroom basin is clean, hand soap is available and paper towels are available?

  • Shower tiles are clean and stain free including the grout?

  • Shower head is clean and in good condition?

  • Shower curtains are clean and in good condition ?

  • Are tap ware and cisterns in good working condition ?

  • General good housekeeping practices observed? (No visible OSH risk items)

  • Maintenance requirements or any Additional information

Common Bathroom / Toilet

    Common Bathroom / Toilet
  • Name of the wing and Location

  • Floor Tiles clean and stain free?

  • Room is odour free?

  • Wall and furniture surfaces are clean and unmarked?

  • This is to be done by

  • Shelving, ledges and window frames are dust free?

  • Internal windows are clean?

  • Bins are clean, not over flowing and garbage bag lined?

  • Light fittings are dust free, clean and in working order?

  • Air vents are dust free and clean?

  • Bathroom basin is clean, hand soap is available and paper towels are available?

  • Toilet is clean and stain free?

  • Shower tiles are clean and stain free including the grout?

  • Shower head is clean and in good condition?

  • Are tap ware and cisterns in good working condition ?

  • Signage is displayed as per Aegis Signage Policy; signage template, font, logo, created date, laminated, no visible fixings?

  • Maintenance requirements or any Additional information

Staff Room

  • Name of cleaner responsible for area:

  • Floor coverings (Vinyl, Tiles) clean and stain free?

  • Fridge is clean inside and out, frost free and food safe?

  • The notice board informations are current and displayed orderly

  • Sink is clean with hand wash and paper towels?

  • Bins are clean, not over flowing and garbage bag lined?

  • Dining tables and chairs are clean, stain/dust free and in good condition?

  • Picture frames, light fittings and air vents are dust free and clean?

  • Shelving, ledges and window frames are dust free?

  • Wall and furniture surfaces are clean and unmarked?

  • This is to be done by

  • Internal windows are clean?

  • Curtains/blinds are clean, dust free and in good repaired?

  • General good housekeeping practices observed?

  • Maintenance requirements or any Additional information

Cleaners Room and Equipment

  • Cleaners Trolley

  • Trolley
  • Name of the cleaner

  • Name of Wing

  • The staff is wearing an Aegis uniform with name badge?

  • Is the wing or facility Microfibre based ?

  • Cleaning trolley is set up correctly as suitable for Microfibre cleaning method ?

  • Only spray bottle with clean water , Crew or Go getter , R7 or Diversol Cx , Perdium or CCS spotter are stored in the trolley ?

  • Microfiber cleaning clothes are stored correctly and the cleaners know the correct way of using the microfiber ?

  • Correct colour coded mops and clothes are used for correct areas ?

  • Only minimal and correct chemicals are placed within the locked compartment?

  • Cleaning Schedule record is on a clip board on the trolley?

  • Does the staff member have their own handbook within easy access ?

  • Maintenance requirements or any Additional information

  • Cleaner's Room

  • Room
  • Wing

  • Cleaner

  • Cleaning equipment are in good condition?

  • Equipment electrical cords are in good condition and tagged?

  • Room is clean, neat and hazard free?

  • Minimal chemicals only are stored within cleaners room?

  • Chemicals are all labelled?

  • Only Aegis approved chemicals are used?

  • Cleaners room is locked when not attended?

  • Maintenance requirements or any Additional information

Laundry

  • Laundry Room

  • Laundry
  • Area is odour free?

  • Laundry room layout has a clean and dirty area?

  • Room is clean, neat and hazard free?

  • Dirty linen bags are stored correctly on trolleys?

  • Chemicals are placed within the locked compartment or the room is lockable?

  • Chemicals are all labelled?

  • Laundry Equipment is clean?

  • Cleaning equipment are in good condition?

  • Equipment electrical cords are in good condition and tagged?

  • Dryer filters are lint free and cleaned daily?

  • Laundry Cleaning Schedule Records are completed

  • Resident Lost Clothing system in place

  • Is the lost property form filled correctly and required feed back is given to the residents or family member about the lost item ?

  • Maintenance requirements or any Additional information

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 and is it up to date ?

  • PPE kit available in the room?

  • Chemical room is lockable and locked when not attended?

  • Fire extinguisher is located close by and in date?

  • Maintenance requirements or any Additional information

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?

  • PPE kit available in the room?

  • MSDS Register is available within the room ?

  • Maintenance cleaning schedule completed ?

  • Maintenance room is locked when not attended?

  • Maintenance requirements or any Additional information

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?

  • Correct bins are used for appropriate waste?

  • Cardboard boxes are flatten before placing in bin?

  • Maintenance requirements or any Additional information

Animal and Pests

  • Practical measures to eradicate and prevent harbourage of pests used (eg good housekeeping, no stock stored on floors, not over stocked, pest controller)

  • No signs of insect infestation or rodent activity in premises

  • Additional information

Health and Hygiene

    Cleaner
  • Name of the Cleaner

  • Ask the cleaning staff when do they wash their hands and the answer they say is correct ?

  • Cleaning and Laundry staff should wash hands before commencing/recommencing work and after using the toilet, coughing, sneezing, smoking, handling cleaning equipment, after/before tasks etc.

  • Cleaning and Laundry staff understand the risk of Viral Gastro-enteritis within the workplace (vomiting, gastro); facility has system in place for staff to report illness ?

  • Does the staff member know what they should do if feeling ill with gastro and/or vomiting before work and/or at work?

  • Ask a cleaning staff member how they would carry out their duties within an Outbreak and if they understand the risk of outbreak fully ?

Additional Information

  • Photos of other items

  • Additional Notes/Comments

  • Re-inspection Required

  • Time before next inspection

  • DECLARATION: I have read this report and understand the contents

  • 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

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.