CVM Site Audit - FM Self Assessment

• Site Name

• Audit Date

  Date

• Audit Number

• Location
  Address

• Auditor

Carpark & Entry

• Is carpark clean and tidy?

  Good

  Fair

  Poor

  N/A

• Are external gardens presented well?

  Good

  Fair

  Poor

  N/A

• Are lawns mown?

  Good

  Fair

  Poor

  N/A

• Is entryway neat and presented well?

  Good

  Fair

  Poor

  N/A

• Is all signage correct and neat?

  Good

  Fair

  Poor

  N/A

• Are all lights working correctly?

  Good

  Fair

  Poor

  N/A

Reception

• Are floors clean and free of any trip hazards?

  Good

  Fair

  Poor

  N/A

• Are fridges clean?

  Good

  Fair

  Poor

  N/A

• Are retail and cafe displays well presented and stocked?

  Good

  Fair

  Poor

  N/A

• Is a managers feedback box displayed?

  Good

  Fair

  Poor

  N/A

• Is a manager on duty sign displayed?

  Good

  Fair

  Poor

  N/A
Office Spaces

• Are all office areas clean and tidy?

  Good

  Fair

  Poor

  N/A

Staff Rooms

• Is staff room neat and tidy?

  Good

  Fair

  Poor

  N/A

• Is FoundU Clock operational?

  Good

  Fair

  Poor

  N/A
Kitchen


• Is kitchen clean?

  Good

  Fair

  Poor

  N/A

• Are all chemicals/food stored correctly?

  Good

  Fair

  Poor

  N/A

• Are all dispensers working correctly and clean?

  Good

  Fair

  Poor

  N/A

• Are there any trip hazards?

  Good

  Fair

  Poor

  N/A
Pools

• Is the deck and surrounds clean and free of hazards?

  Good

  Fair

  Poor

  N/A

• Is the pool basin & water clarity clean?

  Good

  Fair

  Poor

  N/A

• Are scum lines and pool edging clean?

  Good

  Fair

  Poor

  N/A
Plant Rooms

• Is plant room clean?

  Good

  Fair

  Poor

  N/A

• Are plant room logs in place?

  Good

  Fair

  Poor

  N/A

• Plant Room operations are all up to date and correct?

  Good

  Fair

  Poor

  N/A

• Are there any trip hazards?

  Good

  Fair

  Poor

  N/A

• Does plant appear to be running correctly?

  Good

  Fair

  Poor

  N/A

LTS Store Room

• Is room neat and free of hazards?

  Good

  Fair

  Poor

  N/A

• Is equipment neat and in good condition?

  Good

  Fair

  Poor

  N/A

Pool Tests

• Are pool tests up to date & within acceptable ranges?

  Good

  Fair

  Poor

  N/A

• Is saturation Index up to date & within acceptable ranges?

  Good

  Fair

  Poor

  N/A

• Is water readings up to date?

  Good

  Fair

  Poor

  N/A
Bathrooms

• Are bathroom floors clean?

  Good

  Fair

  Poor

  N/A

• Are roof and ceiling fixtures clean and free of lint?

  Good

  Fair

  Poor

  N/A

• Are toilet bowls and surrounds clean?

  Good

  Fair

  Poor

  N/A

• Are hand basins & mirrors clean?

  Good

  Fair

  Poor

  N/A

• Are showers clean?

  Good

  Fair

  Poor

  N/A

• Are all dispensers, taps, shower, bins, and cisterns in good order?

  Good

  Fair

  Poor

  N/A
Cleaning Store Room

• Is room general tidy?

  Good

  Fair

  Poor

  N/A

• Is room locked and not accessible to public?

  Good

  Fair

  Poor

  N/A
Gym Floor

• Is room clean and presented well?

  Good

  Fair

  Poor

  N/A

• Are all windows and mirrors clean?

  Good

  Fair

  Poor

  N/A

• Is all PA equipment neat and in working order?

  Good

  Fair

  Poor

  N/A

• Is all equipment in good condition?

  Good

  Fair

  Poor

  N/A
Group Fitness Room

• Is room clean and presented well?

  Good

  Fair

  Poor

  N/A

• Are all windows and mirrors clean?

  Good

  Fair

  Poor

  N/A

• Is all PA equipment neat and in working order?

  Good

  Fair

  Poor

  N/A
Creche

• Is area neat and tidy?

  Good

  Fair

  Poor

  N/A

• Are all kids toys in good condition?

  Good

  Fair

  Poor

  N/A
Internal Grounds

• Are internal gardens presented well?

  Good

  Fair

  Poor

  N/A

• Are grandstands neat and tidy?

  Good

  Fair

  Poor

  N/A

• Are all lights working correctly?

  Good

  Fair

  Poor

  N/A

Assets

• Are lawn mowers and garden equipment stored well and in good repair?

  Good

  Fair

  Poor

  N/A

• Are pool vacs stored well and in good repair?

  Good

  Fair

  Poor

  N/A

• Are pool steps stored well and in good repair?

  Good

  Fair

  Poor

  N/A

• Are pool blankets stored well and in good repair?

  Good

  Fair

  Poor

  N/A

• Are tool kits stored well and in good repair?

  Good

  Fair

  Poor

  N/A

Signage

• Are all signs/ posters in date and branded correctly?

  Good

  Fair

  Poor

  N/A

• Are all frames displaying a poster?

  Good

  Fair

  Poor

  N/A

• Are all toilet check signs in place?

  Good

  Fair

  Poor

  N/A

• Permanent signage is up to date with current Branding?

  Good

  Fair

  Poor

  N/A

Other Comments

Lifeguarding

• Lifeguards are roving?

  Safe

  At Risk

  N/A

• Lifeguards are in correct uniform?

  Safe

  At Risk

  N/A

• Lifeguard headcount tally board is displayed and up to date?

  Safe

  At Risk

  N/A

• Is Keep Watch Policy Being Enforced? (0-5 have wristbands on)

  Safe

  At Risk

  N/A

Supervision

• Staff is aware of supervision modes?

  Safe

  At Risk

  N/A

• Supervision plans are displayed?

  Safe

  At Risk

  N/A

• Staff is aware of GSPO?

  Safe

  At Risk

  N/A

Incident Reporting

• Is incident report folder available?

  Safe

  At Risk

  N/A

• Does folder have an incident report register with incident report numbers for each?

  Safe

  At Risk

  N/A

• Are incident reports stored and correctly numbered?

  Safe

  At Risk

  N/A

First Aid

• First aid boxes are stocked?

  Safe

  At Risk

  N/A

• Oxygen & Difibrilator are available and maintained?

  Safe

  At Risk

  N/A

Operations

• OP1-7 are up to date and available to staff?

  Safe

  At Risk

  N/A

• Is OP27 (Daily Checklists) in place, up to date & signed?

  Safe

  At Risk

  N/A

• Is OP28 (Manager OPS Tour) in place, up to date & signed?

  Safe

  At Risk

  N/A

• Is Safety Flip Chart up & available to staff?

  Safe

  At Risk

  N/A

Training

• Qualifications for staff are up to date?

  Safe

  At Risk

  N/A

• Training documents have been logged and signed by staff?

  Safe

  At Risk

  N/A

• Is CPO Induction Training completed for staff?

  Safe

  At Risk

  N/A

• Monthly Lifeguard training has been completed?

  Safe

  At Risk

  N/A

• Evacuation has been conducted and trained in the last 6 months?

  Safe

  At Risk

  N/A

Centre Inspection File

• Folder is available?

  Safe

  At Risk

  N/A

• PPE checklist is complete?

  Safe

  At Risk

  N/A

• Eyewash station checklist is complete?

  Safe

  At Risk

  N/A

• First aid boxes checklist is complete?

  Safe

  At Risk

  N/A

• Oxygen equipment checklist is compelte?

  Safe

  At Risk

  N/A

• Fire extinguishers checklist is complete?

  Safe

  At Risk

  N/A

• Inspections are complete for each section?

  Safe

  At Risk

  N/A

Safe Systems of Work

• SSoW folder has all relevant site tasks inside with the correct Index?

  Safe

  At Risk

  N/A

• SSoW are signed by all staff?

  Safe

  At Risk

  N/A

• Risk assessments are kept with SSoW or in an additional RA folder?

  Safe

  At Risk

  N/A

Safety Data Sheets

• SDS folder is available in each section required?

  Safe

  At Risk

  N/A

• SDS Index is correct with correct chemicals?

  Safe

  At Risk

  N/A

• SDS all have risk assessments attached?

  Safe

  At Risk

  N/A

• SDS are all in date?

  Safe

  At Risk

  N/A

• SDS are all signed by staff?

  Safe

  At Risk

  N/A

Hazchem

• Are all chemicals on site stored correctly & safety?

  Safe

  At Risk

  N/A

• Is appropriate Hazchem signage present for the chemicals on-site?

  Safe

  At Risk

  N/A

• Is chemical identification and PPE requirement signage up and correct?

  Safe

  At Risk

  N/A

PPE

• PPE is available in plant rooms & maintained?

  Safe

  At Risk

  N/A

• PPE placards signage is up?

  Safe

  At Risk

  N/A

General

• Any other WH&S Risks noticed while on site?

  Safe

  At Risk

  N/A

• Number of current Mojo Items

• Extra Notes

• Date & Time

  Date

• Signature

  Sign