Name of Premise
Premises structurally suitable for purpose?
Premises clean and in good repair?
Adequate hygienic facilities to store appliances / utensils?
Adequate light and ventilation?
Adequate washing and drainage facilities?
Washing facilities have hot and cold supply mixed to single outlet?
Wash basin surrounds to be water proof / easily cleaned?
Suitable shelving, fittings and furniture / waterproofing / easily cleaned?
Equipment is clean, dry and in good working order?
Hand basin supplied with warm running potable water?
Hand basin supplied with single use soap and towel?
Separate sink supplied with warm running potable water?
Waste disposal bin?
Needles not reused?
Single use articles and wax appropriately disposed of immediately after completion of procedure?
Skin penetration articles for re-use to be sterilised and kept clean?
Non skin penetration articles for re-use to be cleaned and kept clean?
Autoclave date, time, duration, temperature, pressure records kept?
Single use gloves worn and appropriately disposed of for each skin penetration procedure?
Clean gown or apron worn (impermeable material for colonic lavage)
Ear piercing gun not used for another purpose?
Body piercing equipment not used for any other purpose?
If no action has been taken by the re-inspection, fines will apply in accordance with the Local Government (General) Regulation 2005 made under LocalGovernment Act 1993.
This report relates only to a sample of issues observed in regards to the legislation stated above. It does not imply compliance or non compliance with any other legislation or regulation (e.g. Building Code of Australia)
Environmental Health Officer