Information
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Full Name of Approval Holder:
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Health licence #
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Business Name:
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Location
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Postal Address:
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Manager on site
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Contact number
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Preferred Method of Service
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Conducted on
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Prepared by
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Inspection Type
- per registration
- final
- transfer
- routine
- revisit
- complaint
- other
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Accommodation Type
- caravan park
- backpackers
- budget accommodation
- farm stay
- bed and breakfast
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Guest Register available?
- Yes
- No
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Site plans available that identify the number of rooms and number of beds in each room?
- Yes
- No
Rooms/Cabins
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Structure/Cleanliness - Is the premises maintained in a clean and hygienic condition?
- Yes
- No
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Directions
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Timeframe for Compliance
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Ventilation/Dampness - Is there a policy implemented in the event that a room becomes affected by dampness to ensure the comfort and health of occupants?
- Yes
- No
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Directions
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Timeframes for Compliance
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Have the number of beds per room and/or the number of occupants per room changed to that certified/approved by Queensland Fire and Emergency Services and Council’s Building Department?<br><br>Please note: An increase in the number of beds per room and/or the number of occupants may require assessment and re-certification from Queensland Fire and Emergency Services.<br>
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Directions
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Timeframe for Compliance
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Where bedding is provided, is it structurally sound and kept in a clean and sanitary condition free of pests and vermin?
- Yes
- No
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Directions
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Timeframes for Compliance
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Where personal linen is provided, is it changed and replaced as required and whenever there is a change of occupation?
- Yes
- No
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Directions
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Timeframes for Compliance
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Sufficient lighting - Is adequate lighting provided?
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Directions
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Timeframes for Compliance
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Is a laundering service used?
- Yes
- No
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What is the name of the service provider?
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Does the service provider have a Bed Bug Management Policy and suitable processes to prevent soiled items being stored near clean items?
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Advice for Service Provider
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Appliances (where applicable) - Have applicable electrical equipment been inspected and tagged at the required frequency?
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Timeframes for Compliance
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Numbered Rooms/Cabins - Are rooms easily identified (i.e. numbering system)?
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Directions
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Timeframes for Compliance
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Is privacy assured for occupants in all sleeping rooms?
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Directions
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Timeframes for Compliance
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Are all common use rooms/areas able to be accessed without passing thorough sleeping rooms or other rooms not for common use?
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Directions
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Timeframes for Compliance
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Is an adequate supply of water provided to the premises that complies with the minimum standards for drinking water?
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Directions
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Timeframes for Compliance
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Is waste adequately managed and disposed of?
- Yes
- No
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Directions
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Timeframes for Compliance
Kitchen/Common Area
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Is a kitchen provided for use by guests?
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Is a Food Business Licence required for the activities being conducted?
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Directions
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Timeframes for Compliance
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Are suitable facilities provided to ensure food safety?
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Directions
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Timeframes for Compliance
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Is an adequate and continuous supply of potable hot and cold water provided to kitchen sinks and hand washing facilities?
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Directions
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Timeframes for Compliance
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Where refrigerators and freezers are provided for use by guests, are regular temperature checks undertaken to ensure food stored therein is being stored at a safe temperature?
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Directions
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Timeframes for Compliance
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Is the food stored in a safe and suitable manner?
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Directions
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Timeframes for Compliance
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Where food handling equipment is provided, is it stored in a suitable manner?
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Directions
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Timeframes for Compliance
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Are the kitchen facilities maintained in a reasonable state of repair?
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Directions
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Timeframes for Compliance
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Are the kitchen facilities maintained in a clean and hygienic condition?
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Directions
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Timeframes for Compliance
Amenities
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Are amenities located so that each person has convenient access to one bath or shower, one water closet and one hand washing facility without passing through any other sleeping room or room not for communal use?
- Yes
- No
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Directions
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Timeframes for Compliance
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Is the minimum number of amenities provided for the number of persons being accommodated?<br><br>Please note: A minimum of one bath or shower and one water closet must be provided for every ten persons accommodated.
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Directions
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Timeframes for Compliance
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Is there an adequate and continuous supply of potable hot and cold water provided to all showers, baths and hand basins?
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Directions
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Timeframes for Compliance
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Is privacy assured for users?
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Directions
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Timeframes for Compliance
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Are amenities maintained in a reasonable state of repair?
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Directions
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Timeframes for Compliance
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Are amenities maintained in a clean and hygienic condition?
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Directions
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Timeframes for Compliance
Pest Control
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Pests/Vermin - Is pest control treatment for insects and vermin being undertaken by a licensed pest control technician at least once every 12 months and more often if required?
- Yes
- No
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Directions
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Timeframes for Compliance
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Does the operator have an effective Bed Bug Management Policy in place?
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Directions
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Timeframes for Compliance
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Treatment Method
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Number of days from date of inspection
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Monitoring
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Number of days from date of inspection
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Evidence of Pests
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Number of days from date of inspection
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Support Program:
- Staff Sighting
- Treatment Record
- Monitoring
Results
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Time Inspection Completed
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General Comments
Sign Off
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I acknowledge the findings and outcomes of this Inspection have been explained to me in detail.
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Name of approval holder/representative
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Position
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Signature
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Date
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Name of Authorised Person
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Signature
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Date