Facility Inspection - MPS

• Facility

  Select
• Location
  Address

• Date & Time

  Date

• Prepared by

• Previous Inspection Date?

  Date

• Has the previous inspection been reviewed?

  Yes

  No

  N/A

• Why has the last inspection not been reviewed?

• Are there any outstanding actions?

  Yes

  No

  N/A

• Reason for uncompleted actions?

Outdoor areas

• Is the area surrounding the facility safe, free from rubbish, obstructions and potential hazards? Walk around the outside of the whole facility.

  Yes

  No

  N/A

• What is the concern?

• Can this be rectified now?

  Yes

  No

  N/A

• Does this need to be reported as an action?

  Yes

  No

  N/A

• Is the building safe, clean and free from and potential hazards? Walk around the outside of the whole facility.

  Yes

  No

  N/A

• What is the concern?

• Can this be rectified now?

  Yes

  No

  N/A

• Does this need to be reported as an action?

  Yes

  No

  N/A

• Is the key lock box and/or keypad in good working order?

  Yes

  No

  N/A

• Are the keys in good working order?

  Yes

  No

  N/A

• Is there an alarm at this facility?

  Yes

  No

  N/A

• Is the alarm in good working order?

  Yes

  No

  N/A

Emergency Management

• Evacuation plan displayed?

  Yes

  No

  N/A

• Extinguishers in place, clearly marked for type of fire?

  Yes

  No

  N/A

• Extinguishers recently serviced? (Check 6 monthly punch mark on tabs.)

  Yes

  No

  N/A

• Extinguishers clear of obstructions?

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Can this be rectified now?

  Yes

  No

  N/A

• Does this need to be reported as an action?

  Yes

  No

  N/A

• Extinguisher no more than 1200 mm max height & base not lower that 100 mm?

  Yes

  No

  N/A

• Can this be rectified now?

  Yes

  No

  N/A

• Does this need to be reported as an action?

  Yes

  No

  N/A

• Extinguisher indicator signs 2.1 m above floor level?

  Yes

  No

  N/A

• Can this be rectified now?

  Yes

  No

  N/A

• Does this need to be reported as an action?

  Yes

  No

  N/A

• Adequate direction notices for fire exits?

  Yes

  No

  N/A

• Can this be rectified now?

  Yes

  No

  N/A

• Does this need to be reported as an action?

  Yes

  No

  N/A

• Exit door easily opened from inside?

  Yes

  No

  N/A

• Can this be rectified now?

  Yes

  No

  N/A

• Does this need to be reported as an action?

  Yes

  No

  N/A

• Exits clear of obstructions?

  Yes

  No

  N/A

• Can this be rectified now?

  Yes

  No

  N/A

• Does this need to be reported as an action?

  Yes

  No

  N/A

• Fire alarm system functioning correctly?

  Yes

  No

  N/A

• Can this be rectified now?

  Yes

  No

  N/A

• Does this need to be reported as an action?

  Yes

  No

  N/A

• Is there a defibrillator located at this facility?

  Yes

  No

  N/A

• Status ready indicator shows unit is ready?

  Yes

  No

  N/A

• Battery is working and not expired?

  Yes

  No

  N/A

• Unit is free of cracks, foreign substances, or other signs of damage?

  Yes

  No

  N/A

• Pads are sealed, unused and not expired?

  Yes

  No

  N/A

• Supporting materials are sealed and unused within expiration - Scissors and gloves?

  Yes

  No

  N/A

General Lighting

• Light fittings clean and in good condition?

  Yes

  No

  N/A

• Emergency exit lighting operable?

  Yes

  No

  N/A

Building General

• Floor surfaces even and uncluttered?

  Yes

  No

  N/A

• Can this be rectified now?

  Yes

  No

  N/A

• Does this need to be reported as an action?

  Yes

  No

  N/A

• Entry and walkways kept clear?

  Yes

  No

  N/A

• Can this be rectified now?

  Yes

  No

  N/A

• Does this need to be reported as an action?

  Yes

  No

  N/A

• Stairs and risers kept clear?

  Yes

  No

  N/A

• Can this be rectified now?

  Yes

  No

  N/A

• Does this need to be reported as an action?

  Yes

  No

  N/A

• Are railings in good condition?

  Yes

  No

  N/A

• Can this be rectified now?

  Yes

  No

  N/A

• Does this need to be reported as an action?

  Yes

  No

  N/A

• Are fall preventive measures in place and used where gaps occur in railings?

  Yes

  No

  N/A

• Can this be rectified now?

  Yes

  No

  N/A

• Does this need to be reported as an action?

  Yes

  No

  N/A

• Are walls, windows, furnishings and ceilings clean and tidy?

  Yes

  No

  N/A

• Can this be rectified now?

  Yes

  No

  N/A

• Does this need to be reported as an action?

  Yes

  No

  N/A

• Are walls, windows, furnishings and ceilings damaged and in need of repair or replacement?

  Yes

  No

  N/A

• Is there any signage not on a noticeboard that does not belong to MPS?

  Yes

  No

  N/A

• Take signage down

• Overall cleanliness of the facility?

  Good

  Fair

  Poor

  N/A

• Reason?

Kitchen

• Is the area clear of rubbish?

  Yes

  No

  N/A

• Please clear rubbish

• All tableware stored neatly and appropriately?

  Yes

  No

  N/A

• Please stack tableware away neat and tidy

• All perishable food items disposed of? Check fridge, freezer and cupboards.

  Yes

  No

  N/A

• Dispose of any perishable food items

• Are floor, surfaces and equipment clean?

  Yes

  No

  N/A

• Does the facility need a clean?

  Yes

  No

  N/A

• Any damage to floor, surfaces, cupboards or equipment?

  Yes

  No

  N/A

• Any sharp edges, obstructions or potential hazards?

  Yes

  No

  N/A

• Is the electrical equipment working and in good order?

  Yes

  No

  N/A

• All electrical equipment test and tagged?

  Yes

  No

  N/A

• Does anything need to be repaired or replaced?

  Yes

  No

  N/A

Bathroom & Toilets

• Is the area clear of rubbish?

  Yes

  No

  N/A

• Please clear rubbish

• Are floor, surfaces and equipment clean?

  Yes

  No

  N/A

• Does the facility need a clean?

  Yes

  No

  N/A

• Any damage to floor, surfaces, cupboards or equipment?

  Yes

  No

  N/A

• Any sharp edges, obstructions or potential hazards?

  Yes

  No

  N/A

• Is the electrical equipment working and in good order?

  Yes

  No

  N/A

• All electrical equipment test and tagged?

  Yes

  No

  N/A

• Does anything need to be repaired or replaced?

  Yes

  No

  N/A

• Is there sufficient consumables? ie: Toilet paper, soap, paper towels

  Yes

  No

  N/A

• What needs to be replaced?

Rubbish

• Waste, recycle and sanitary bins located at suitable points around facility?

  Yes

  No

  N/A

• Can this be rectified now?

  Yes

  No

  N/A

• Reason?

• Do we need to purchase more bins?

  Yes

  No

  N/A

• Which bins and how many?

• Are the bins being emptied regularly enough?

  Yes

  No

  N/A

• Does any rubbish need to removed?

  Yes

  No

  N/A

Storage

• Are furniture and materials stored appropriately?

  Yes

  No

  N/A

• Please store away neat and tidy if safe to do so. Notify if not

• Is the storage room clear of rubbish, obstructions and potential hazards?

  Yes

  No

  N/A

• Please clear area if safe to do so. Notify if not

• Is there storage signage in place? Photos showing how and where to store items.

  Yes

  No

  N/A

• Is there any furniture or materials damaged and need to be repaired or replaced?

  Yes

  No

  N/A

• Number of chairs?

• Number of tables?

Electrical Safety

• Have safety switches been installed?

  Yes

  No

  N/A

• Are they being tested every 6 months?

  Yes

  No

  N/A

• Are double adapters being used?

  Yes

  No

  N/A

• Portable equipment tested and tagged and in good working order?

  Yes

  No

  N/A

• What needs to be test and tagged?

• Stationary equipment test and tagged and in good working order? ie: Heater and air conditioning & remotes

  Yes

  No

  N/A

• What needs to be test and tagged?

• Is there any broken plugs, sockets or switches?

  Yes

  No

  N/A

• Is there any power leads across walkways?

  Yes

  No

  N/A

• Please remove and make area safe

• Are there any strained, frayed or damaged leads?

  Yes

  No

  N/A

• Turn off power at switch and unplug cords and make area safe and report.

• Where required are emergency shut-down procedures in place?

  Yes

  No

  N/A

Chemical Safety

• Hazardous Substance Register complete and available?

  Yes

  No

  N/A

• Material Safety Data Sheets available for all chemicals?

  Yes

  No

  N/A

• Risk assessments completed for hazardous substances?

  Yes

  No

  N/A

• All containers labelled correctly?

  Yes

  No

  N/A

• Place unlabelled container in a safe place and label with hazardous substance and notify management.

• Any known unused substances disposed of safely? Unknown to be labelled hazardous substance and notify management.

• Is adequate ventilation provided?

  Yes

  No

  N/A

Audio Visual Equipment (AV) - PCT / Flinders / Mt Eliza / Dromana

• Is there AV at this location?

  Yes

  No

  N/A

• Is there a system user guide?

  Yes

  No

  N/A

• PROJECTOR in good working order?

  Yes

  No

  N/A

• PROJECTOR SCREEN in good working order?

  Yes

  No

  N/A

• HAND HELD MICROPHONES in good working order?

  Yes

  No

  N/A

• LAPEL MICROPHONES in good working order?

  Yes

  No

  N/A

• MICROPHONE STANDS in good working order?

  Yes

  No

  N/A

• SPEAKERS in good working order?

  Yes

  No

  N/A

• TV and REMOTES in good working order?

  Yes

  No

  N/A

• LECTURN in good working order?

  Yes

  No

  N/A

• CABLES in good working order?

  Yes

  No

  N/A

• SOUND SYSTEM in good working order?

  Yes

  No

  N/A

• PAGING SYSTEM in good working order?

  Yes

  No

  N/A

• TOUCHSCREEN in good working order?

  Yes

  No

  N/A

• Yes

  No

  N/A

Stocktake of Crockery & Cutlery - Flinders

• Is there crockery and cutlery that we provide at this location? - Only PCT & Flinders

  Yes

  No

  N/A

• Number of Dinner plates?

• Number of side plates?

• Number of mugs?

• Number of glasses?

• Number of knives?

• Number of forks?

• Number of spoons?

• Number of teaspoons

Stocktake of Crockery & Cutlery -Flinders

• Is there crockery and cutlery that we provide at this location? - Only PCT & Flinders

  Yes

  No

  N/A

• Number of Dinner plates?

• Number of side plates?

• Number of mugs?

• Number of glasses?

• Number of knives?

• Number of forks?

• Number of spoons?

• Number of teaspoons

• Number of wine glasses?

• Number of champagne flutes?

• Number of pot glasses?

• Number of tea cups?

• Number of saucers?

• Number of glass jugs?

• Number of silver jugs?

• Number of coffee pots?

• Number of coffee warmers?

Sign Off

• Is this facility inspection complete

  Yes

  No

  N/A

• undefined

• Date & Time

  Date

• On site representative

  Sign

• Auditor's signature

  Sign