CPAP

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Clinical Area

• Chairs in working condition

  Yes

  No

  N/A

• Table in working condition

  Yes

  No

  N/A

• Electrical cables not exposed

  Yes

  No

  N/A

• Filing cabinet secured

  Yes

  No

  N/A

• Power board safe and secure

  Yes

  No

  N/A

• Clinical bed is safe and secure

  Yes

  No

  N/A

• Steps safe and secure

  Yes

  No

  N/A

• Area is clear of used boxes

  Yes

  No

  N/A

• Lighting is adequate

  Yes

  No

  N/A

Service Area

• Clean and free from clutter

  Yes

  No

  N/A

• Chemicals used are stored correctly

  Yes

  No

  N/A

• Safety goggles available

  Yes

  No

  N/A

• Gloves available

  Yes

  No

  N/A

Blue Boxes

• Blue document and machine to be serviced and inserted into blue box.<br>Complete the service documentation.<br>Download the client data and clear the clock.<br>Clean the machine.

  Yes

  No

  N/A

White Boxes

• Service documentation complete with machine ready for return to client inserted into white box

  Yes

  No

  N/A

Red Boxes

• Red document completed with the machine or product inserted into red box

  Yes

  No

  N/A

Documentation

• Service requirements for all clients to the month printed on BLUE paper

  Yes

  No

  N/A

• Service Letters being sent out on the 1st of the month

  Yes

  No

  N/A

• Service reminder letters being sent out on the 15th of the month

  Yes

  No

  N/A

• Data collected and entered into File Maker Pro

  Yes

  No

  N/A

• Information of the serviced flow generator & humidifier serial numbers entered into MYOB

  Yes

  No

  N/A

• Monthly documents all filed together into file cabinet under the current month

  Yes

  No

  N/A

Sterilization Area

• Items being washed prior to sterilization

  Yes

  No

  N/A

• Items inserted into the sterilizer at 100C for 1 minute only

  Yes

  No

  N/A

Trial Flow Generators and Humidifiers

• Cleaned and ready for re issue placed into a plastic bag with a QC sticker as the seal

  Yes

  No

  N/A

• Identify any smoker machines with a smoker sticker

  Yes

  No

  N/A

Client reception area

• Stored correctly and in the same place

  Yes

  No

  N/A

• Client reception area clean

  Yes

  No

  N/A

• Client chairs serviceable

  Yes

  No

  N/A

• Demonstration stock neat and tidy

  Yes

  No

  N/A