Title Page
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
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COMMISSIONING INSPECTION REPORT FOR CARDIAC-PROTECTED ELECTRICAL AREAS
CVSG ASSET SERVICES PTY LTD
ABN 62 128 821 698
Conducted in accordance with:
AS/NZS 3003:2011 ELECTRICAL INSTALLATIONS - PATIENT AREAS -
Select date
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NAME OF PERSON UNDERTAKING TESTS
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NAME OF FACILITY?
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ENTER FACILITY ADDRESS
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LOCATION OF TEST - ROOM NUMBER
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ASSET BARCODE AVAILABLE?
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ENTER BARCODE
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GENERAL REQUIREMENTS FOR BODY-PROTECTED AND CARDIAC-PROTECTED ELECTRICAL AREAS
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2.1 Body-protected or cardiac-protected electrical areas shall not occur in the same room?
CLASSIFICATION OF PATIENT AREAS
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2.2.2.1 Compliance: Check by inspection; verify boundaries of <br>protected electrical areas.
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2.2.2.2 Compliance: Verify no remote equipment with conductive or <br>applied parts in protected electrical area; verify boundaries <br>of protected electrical areas.
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2.2.3 Compliance: Check by inspection; verify boundaries of <br>protected electrical areas.
SUPPLY OF ELECTRICITY TO PATIENT AREAS LOW-VOLTAGE A.C. SUPPLIES
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2.4.1 Compliance: Verify that body-protected or cardiac-protected <br>electrical final sub-circuits are unique to respective rooms in <br>body-protected electrical areas and to individual patient <br>locations in cardiac-protected electrical areas.
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Compliance: Verify that cleaning outlets are on a separate <br>electrical sub-circuit to other socket-outlets in the room.
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2.4.2 Compliance: Obtain written statement of compliance with <br>AS/NZS 3000 from the electrical contractor or the electrician <br>who did the work.
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2.4.3.2(a) Compliance: Verify by inspection and testing that all socket-outlets<br>are protected by LPD:
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Socket-outlets in patient areas.
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Socket-outlets within specified distance of entrance to <br>patient areas.
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Socket-outlets in another room for medical electrical <br>equipment with conductive parts accessible within patient <br>environment or area.
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2.4.3.2(b) Verify all types of sockets in areas protected by LPD.
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2.4.3.3 Compliance: For permanently wired medical electrical <br>equipment with Type B applied parts, verify if it is being used <br>or is going to be used in area and test the LPD.
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Compliance: For other permanently wired medical electrical <br>equipment, obtain written statement of compliance with <br>AS/NZS 3000 from the electrical contractor or the electrician <br>who did the work.
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2.4.4 (a) Compliance: Verify by inspection and confirmation of use.
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2.4.4 (b) Compliance: Verify by inspection and confirmation of use.
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2.4.4 (c) Compliance: Verify by inspection and confirmation of use.
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2.4.4 (d) Compliance: Verify by inspection, confirmation of use and <br>marking.
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2.4.5.1(a) Compliance: Verify by inspection and testing.
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2.4.5.1(b) Compliance: Verify by inspection and testing.
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2.4.5.2 Compliance: Verify by inspection and operation.
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2.4.5.1(c) Compliance: Verify by inspection and testing.
LOW-VOLTAGE D.C. SUPPLIES
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2.5 Compliance: Verify by inspection and current measurement. <br>Include and check the surgical lights battery back-up system.
ACCESS TO CONTROLS AND INDICATORS
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2.6(a) Compliance: Verify by inspection.
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2.6(b) Compliance: Verify by inspection and measurement.
LOW-VOLTAGE SOCKET-OUTLETS
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2.7.1 Compliance: Using the health care facility’s <br>brief/specification/instruction, verify socket-outlet quantity <br>and number on a circuit.
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2.7.2 Compliance: Verify by inspection.
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2.7.3.1 Compliance: Verify label and exact wording used; verify <br>location and distance measurement.
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2.7.3.2 Compliance: Verify by inspection and testing.
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2.7.4.1 Compliance: Verify by inspection that labelling is consistent <br>and identifies respective RCD.
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2.7.4.2 Verify ‘ON’ indication.
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2.7.4.5 Compliance: Verify by inspection and exact wording used.
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2.7.4.4 Compliance: Verify indicator colour and operation; verify <br>exact wording used.
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2.7.4.3 Compliance: Verify electricity supply source to AS/NZS 3009 <br>and associated socket-outlet colouring.
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2.7.5.1 Compliance: Verify by testing—All socket-outlets must be <br>double-poled.
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2.7.5.2 Compliance: Verify by inspection and testing.
RESIDUAL CURRENT DEVICES (RCDS)
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2.8.1 Compliance: RCDs; Verify Type I RCDs in use.
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Verify RCD sensitivity using tests in this Standard (and <br>record results).
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Verify RCD maximum tripping time using tests in this <br>Standard (and record results).
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2.8.4(a) Compliance: Verify by inspection and testing (and record <br>results).
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2.8.2 Compliance: Verify by inspections and testing of upstream <br>protection and discrimination.
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2.8.3 Compliance: Verify by testing that all RCDs double poled.
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2.8.4(b) Compliance: Verify by inspection and testing (and record <br>results).
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2.8.5 Compliance: Verify indicator colour and operation.
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2.8.4(c) Compliance: Verify by inspection and testing (and record <br>results).
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2.8.7 Compliance: Verify by inspection and testing.
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2.8.6 Compliance: Verify by inspection that labelling is consistent <br>and identifies respective circuit and RCD.
LOW-VOLTAGE ISOLATED SUPPLIES
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2.9.1 Compliance: Verify by inspection and testing. Obtain written <br>statement of compliance with AS/NZS 4510 from the <br>electrical contractor or the electrician who did the work.
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2.9.2 Compliance: Verify ventilation and line of sight operation.
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2.9.7(a) Compliance: Verify by inspection.
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2.9.3 Compliance: Verify by inspection and testing using tests in <br>this Standard (and record results).
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2.9.4 Compliance: LIMs <br>Verify LIM prospective hazard current display and current <br>alarm using tests in this Standard (and record results).
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Verify by inspection that labelling is consistent and identifies <br>circuit and LIM.
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2.9.5 Compliance: Verify size of MCB by inspection in conjunction <br>with isolating transformer specifications. Confirm MCB rating <br>is less than or equal to the primary current rating of <br>transformer and is not less than the set point of the overload <br>alarm.
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2.9.6 Compliance: Verify each transformer-isolated supply is <br>below the prospective hazard current of the supply using <br>tests in this Standard (and record results).
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2.9.7(b) Compliance: Verify by inspection.
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2.9.8 Compliance: Verify by inspection.
ISOLATION SWITCHES
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2.10 Compliance: Verify by inspection for accessibility and testing <br>that isolation switch is double-poled; verify correct labelling.
MARKING
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2.11.1 Compliance: Verify by inspection and measurement (where <br>required).
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2.11.2 Compliance: Verify patient area signage installed in correct <br>location and appropriate labels attached and signed.
TESTING AND COMMISSIONING OF ELECTRICAL WORK
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2.12 Compliance: Obtain written statement of compliance with <br>AS/NZS 3000 from the electrical contractor or the electrician <br>who did the work.
CERTIFICATION
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2.13 Certification tests undertaken by a licensed inspector, <br>qualified medical physicist, qualified biomedical engineer or <br>person(s) acceptable to the health care facility.
ADDITIONAL REQUIREMENTS FOR CARDIAC-PROTECTED ELECTRICAL AREAS EXTRA-LOW-VOLTAGE SUPPLIES
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4.2.2 Compliance: Obtain written statement of compliance with <br>extra low-voltage Section of AS/NZS 3000 from the electrical <br>contractor or the electrician who did the work.
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4.2.3 Compliance: Verify by measurement.
DISPOSITION OF ELECTRICAL POINTS CONTROLLED BY RCDS
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4.3 Compliance: Verify by tripping all RCDs in a particular <br>patient location, to confirm that socket-outlets in any other <br>patient location(s) are not protected.
EARTHING AND EQUIPOTENTIAL BONDING
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4.4.1 Compliance: Sight written statement of compliance with <br>AS/NZS 3000 from the electrical contractor or the electrician <br>who did the work.
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Compliance: Verify by measuring the voltage between the <br>EP junction and a representative number of nominated <br>points using a measuring instrument complying with <br>Appendix D.
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4.4.2.2 Compliance: Verify by inspection.
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4.4.2.3 Compliance: Equipotential earthing system; Verify by inspection that only one EP junction is in use.
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Where separate nodes in use: Measure resistance to EP <br>junction and verify label wording.
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Imaging system: Measure resistance to EP junction.
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4.4.2.4 Compliance: Verify by inspection and testing that each <br>socket-outlet is connected to the EP Junction:
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Compliance: Verify resistance of earthing conductor between <br>socket-outlet and EP junction ≤0.1 Ω.Compliance: Verify resistance of earthing conductor between socket-outlet and EP junction ≤0.1 Ω.
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Socket-outlets within cardiac-protected electrical area.
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Socket-outlets within specified distance of entrance to <br>cardiac-protected electrical area.
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Socket-outlets in another room for medical electrical <br>equipment with conductive parts accessible within cardiac-protected<br>electrical area.
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Compliance: Verify protective earthing conductors are <br>insulated and segregated from other conductive items.
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4.4.2.5 Compliance: Verify by inspection and measurement that <br>each item of permanently installed electrical equipment <br>connected to the EP junction has a resistance ≤0.1 Ω.
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Compliance: Verify protective earthing conductors are <br>insulated and segregated from other conductive items.
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Compliance: Verify by inspection that each item of <br>permanently installed electrical equipment inaccessible in <br>the patient environment is earthed to the distribution board <br>or to the EP Junction using an earthing conductor.
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4.4.2.6 Compliance: Verify by inspection and measurement that <br>each item of permanently installed non-electrical equipment <br>or fittings in contact with structural metal in the patient <br>environment is connected to the EP Junction and has a <br>resistance ≤0.1Ω.
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Compliance: Measure resistance of each point not connected to the EP junction.
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Compliance: Verify earthing conductors are insulated and <br>segregated from other conductive items.
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4.4.2.7 Compliance: Verify earthing connections by inspection.
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4.4.2.9 Compliance: Verify EP test facility location and labelling by <br>inspection.
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4.4.2.8 Compliance: Verify EP junction location and labelling by <br>inspection.
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4.4.3 Compliance: Sight written statement of compliance with <br>AS/NZS 3000 from the electrical contractor or the electrician <br>who did the work.
SPECIAL PATIENT AREAS - HOME CARE INSTALLATION
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5.2.1 Compliance: Verify by inspection and testing.
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5.2.2.1 Compliance: Confirm equipment classification.
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5.2.2.2 Compliance: Verify by inspection and testing.
INSTALLATION FOR SELF-HARM PATIENTS
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5.3.1 Compliance: Exception noted for areas specified.
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5.3.2 Compliance: Verify by inspection.
ALTERATIONS, ADDITIONS AND REPAIRS TO ELECTRICAL INSTALLATIONS IN PATIENT AREAS - ALTERATIONS AND ADDITIONS
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6.2.2 Compliance: Verify if not existing CPA or BPA, then full <br>compliance with this Standard required.
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6.2.5 Compliance: Verify EP wiring system.
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6.2.3 Compliance: Verify inspection within last 12 months.
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6.2.4 Compliance: Verify % increase in socket-outlets. If 10% or <br>more increase, then all in patient area to comply with colour <br>requirements.
REPAIRS
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6.3 Compliance: Verify by inspection.
MAGNETIC FIELDS
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7.2 Compliance: Test in nominated areas.
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7.3 Compliance: Verify readings below levels nominated in <br>Standard.
MARKING OF PATIENT AREAS
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8.1, 8.2, <br>8.3 <br>Compliance: Verify that sign is correct size, affixed in correct <br>location, correctly completed, dated and signed and the <br>tester clearly identified.
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End of Audit.
