Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location

Inspection Details

  • Facility Manager

  • Email

  • Date of Last Aegis Internal Audit

General Requirements

  • % of Staff Mandatory Training Completed - ie: Manual handlind and Fire ( annual ) chemical safety ( 2 yearly )

  • Details of Training not completed:

  • Do you have a Senior Cleaner in place?

  • Name

Communication

  • Evidence of Facility Staff Meeting Minutes - Qtr

  • Date of Last Meeting

  • Evidence of Facility Resident Meeting Minutes - Qtr.

  • Date of Last Meeting

  • Memo system in place to communicate important information to staff?

  • Evidence of Resident Satisfaction Survey - annually

  • Date of Last Survey

  • % above Satisfactory

Supplier Records

  • Evidence of Fire Protection Certificate of Compliance

  • Select Certificate Type;

  • Expiry Date of Certificate

  • Select Certificate Type;

  • Expiry Date of Certificate

Records

  • Weekly Cleaning Schedule Records are Completed

  • Weekly Cleaning Audits are completed

  • Vacant Room Clean Records are completed

  • Maintenance logbook jobs are completed in a timely manner?

  • Record details

  • Electrical tagging of items are within date code?

  • Record details

  • Fire Service Equipment tagged and within date code?

  • Record details

  • MSDS records are in place; SharePoint, Main nurses station & Main Chemical Storage Room

  • All up to date?

Admin / Reception / Foyer

  • Admin Staff are wearing an Aegis uniform with name badge?

  • Signage is displayed as per Aegis Signage policy?

  • Reception area is neat and welcoming? <br>Sign in book, Aegis brochures and Department of Health and Ageing brochures are displayed?

  • Are floors clean in general? (daily clean)

  • Is the area free from stains, or long term dirt/marks, with evidence of regular scrubbing/extraction cleaning?

  • Is the front door glass and windows clean with no visible marks ?

  • Curtains/blinds are clean, dust free and in good repaired?

  • Picture frames, window ledges, shelving etc. are dust free and clean?

  • Walls are clean and unmarked?

  • Chairs are clean, vacuumed and stain free?

  • Area is odour free?

  • Maintenance requirements or any Additional information

  • General comments.

Common Areas / Corridors

  • Common Area / Corridor

  • Common Area / Corridor
  • Wing name and location

  • Floor coverings are clean in general? (daily clean)

  • Is the area free from stains, or long term dirt/marks, with evidence of regular scrubbing/extraction cleaning?

  • Area is odour free?

  • Wall surfaces / skirting boards are clean and unmarked?

  • Curtains/blinds are clean, dust free and in good repair?

  • Picture frames, window ledges, shelving, light fittings and air vents are dust free and clean?

  • Furniture is clean, vacuumed and stain free?

  • Hand basin is clean with hand wash and paper towels? Bin is clean and lined?

  • Water coolers are clean and bottles are emptied?

  • Signage is displayed as per Aegis Signage policy?

  • Maintenance requirements or any Additional information

  • General comments.

Dining Rooms

    Dining Room
  • Dining room name and location

  • Is the area free from stains, or long term dirt/marks, with evidence of regular scrubbing/extraction cleaning?

  • Area is odour free?

  • Wall surfaces / skirting boards are clean and unmarked?

  • Curtains/blinds are clean, dust free and in good repaire?

  • Picture frames, window ledges, shelving, light fittings and air vents are dust free and clean?

  • Furniture is clean and stain free?

  • Signage is displayed as per Aegis Signage policy?

  • Maintenance requirements or any Additional information

  • General comments.

Lounge Areas

  • Lounge Area

  • Lounge Room
  • Lounge Wing and Location

  • General comment on Housekeeping

  • Is the area free from stains, or long term dirt/marks, with evidence of regular scrubbing/extraction cleaning?

  • Area is odour free?

  • Wall surfaces / skirting boards are clean and unmarked?

  • Picture frames, window ledges, shelving, light fittings and air vents are dust free and clean?

  • Furniture is clean, vacuumed and stain free?

  • Curtains/blinds are clean, dust free and in good repaired?

  • Signage is displayed as per Aegis Signage Policy; template, font, logo, created date, laminated, no visible fixings?

  • Maintenance requirements or any Additional information

  • General comments.

Resident Room

    Resident Room
  • Wing and Room No

  • Floor coverings (Flotex, Carpet, Vinyl, Tiles) clean and stain free?

  • Room is odour free?

  • Wall surfaces / skirting boards are clean and unmarked?

  • Curtains/blinds are clean, dust free and in good repair?

  • Picture frames and light fittings are dust free and clean?

  • Furniture is clean, stain/dust free and in good condition and placed in orderly manner?

  • Shelving, ledges and window frames are dust free?

  • Resident fridge is clean inside/outside and food items are within date code?

  • Internal windows are clean?

  • Bins are clean, not over flowing and garbage bag lined?

  • Maintenance requirements or any Additional information

  • General comments.

  • Bathroom Type

  • Bathroom no or Location

  • Bathroom floor is clean and stain free?

  • Bathroom walls, doors & skirting boards are clean and unmarked?

  • Air vents are clean and dust free?

  • Toilet is clean and stain free?

  • Behind the toilet, toilet base and tank is clean ?

  • Bathroom basin is clean, hand soap is available and paper towels are available?

  • Shower tiles are clean and stain free including the grout?

  • Shower head is clean and in good condition?

  • Shower curtains are clean and in good condition ?

  • No leaking tapware?

  • General good housekeeping practices observed? (No visible OSH risk items)

  • Maintenance requirements or any Additional information

  • General comments.

Common Bathroom / Toilet

    Common Bathroom / Toilet
  • Name of the wing and Location

  • Floor Tiles clean and stain free?

  • Room is odour free?

  • Wall surfaces / skirting boards are clean and unmarked?

  • Shelving, ledges and window frames are dust free?

  • Internal windows are clean?

  • Bins are clean, not over flowing and garbage bag lined?

  • Light fittings are dust free, clean and in working order?

  • Air vents are dust free and clean?

  • Bathroom basin is clean, hand soap is available and paper towels are available?

  • Toilet is clean and stain free?

  • Shower tiles are clean and stain free including the grout?

  • Shower head is clean and in good condition?

  • No leaking tapware?

  • General good housekeeping practices observed? (No visible OSH risk items)

  • Signage is displayed as per Aegis Signage Policy; template, font, logo, created date, laminated, no visible fixings?

  • Maintenance requirements or any Additional information

  • General comments.

Staff Room

  • Floor coverings (Vinyl, Tiles) clean and stain free?

  • Fridge is clean inside and out, frost free and food safe?

  • Sink is clean with hand wash and paper towels?

  • Bins are clean, not over flowing and garbage bag lined?

  • Dining tables and chairs are clean, stain/dust free and in good condition?

  • Picture frames, light fittings and air vents are dust free and clean?

  • Shelving, ledges and window frames are dust free?

  • Wall surfaces / skirting boards are clean and unmarked?

  • Internal windows are clean?

  • Curtains/blinds are clean, dust free and in good repair?

  • General good housekeeping practices observed?

  • Maintenance requirements or any Additional information

  • General comments.

Cleaners Room and Equipment

  • Cleaners Trolley

  • Trolley
  • Name of the cleaner

  • Name of Wing

  • The staff is wearing an Aegis uniform with name badge?

  • Is the facility Microfibre based ?

  • Cleaning trolley is set up correctly for Microfibre cleaning?

  • Only clean water, Crew, Creme R7 & PerDiem are stored in the trolley ?

  • Microfibre mops are stored correctly on trolley with cross contamination in mind? (RED up, BLUE down)

  • Correct colour coded mops and cloths are used for correct areas?

  • No chemicals left on top of trolley unattended?

  • Is chemical compartment locked when unattended? (without key in lock)

  • Cleaning Schedule record is on the trolley and filled out during shift?

  • Do Cleaning staff know they have access to Aegis SharePoint?

  • Details of System for Access;

  • Do cleaning staff have their own Cleaners Handbook?

  • Has cleaner had sufficient training on all equipment?

  • Who provided training?

  • Does cleaner know nearest emergency exit and muster point?

  • Maintenance requirements or any Additional information

  • Cleaner's Room
  • Wing

  • Cleaner

  • Cleaning equipment are cleaned and in good condition?

  • Equipment electrical cords are in good condition and tagged?

  • Room is clean, neat and hazard free?

  • Minimal chemicals only are stored within cleaners room?

  • Chemicals are all labelled?

  • Only Aegis approved chemicals are used?

  • Cleaners room is locked when not attended?

  • Maintenance requirements or any additional information

Laundry

  • Laundry Room

  • Laundry
  • Area is odour free?

  • Laundry room layout has a clean and dirty area?

  • Room is clean, neat and hazard free?

  • Dirty linen bags are stored correctly on trolleys?

  • Chemicals are placed within the locked compartment or the room is lockable?

  • Chemicals are all labelled?

  • Laundry equipment is clean?

  • Cleaning equipment are in good condition?

  • Electrical cords are in good condition and tagged?

  • How often are curtains to be washed?

  • Ask curtain care instructions and answer is correct.

  • Dryer filters are lint free and cleaned daily?

  • Laundry Cleaning Schedule Records are completed

  • Resident Lost Clothing system in place and organised?

  • Is the Lost Property Form completed correctly and feedback is given to the residents or family member?

  • Maintenance requirements or any Additional information

Health and Hygiene

  • The facility has warm running water to wash hands through single spout, single use towels (or air dryer) and soap ?

  • Ask the cleaning staff when do they wash their hands and the answer they say is correct ?

  • Cleaning and Laundry staff should wash hands before commencing/recommencing work and after using the toilet, coughing, sneezing, smoking, handling cleaning equipment, after/before tasks etc.

  • Cleaning and Laundry staff understand the risk of Viral Gastro-enteritis within the workplace (vomiting, gastro); facility has system in place for staff to report illness ?

  • Does the staff member know what they should do if feeling ill with gastro and/or vomiting before work and/or at work?

  • Ask a cleaning staff member how they would carry out their duties within an Outbreak and if they understand the risk of outbreak fully ?

Chemical Storage Room

  • General design and construction of premises appropriate

  • Premise has adequate storage facilities for storage of chemicals

  • Premises has sufficient lighting

  • Floors are able to be effectively cleaned

  • Walls and ceilings are able to be effectively cleaned

  • Adequate ventilation provided within the room

  • MSDS Register is available within the room and is it up to date ?

  • PPE kit available in the room?

  • Chemical room is lockable and locked when not attended?

  • Fire extinguisher is located close by and serviced in date?

  • Maintenance requirements or any Additional information

Maintenance Room

  • Room has adequate storage facilities for items?

  • Room has sufficient lighting?

  • Floors are able to be effectively cleaned?

  • Adequate ventilation provided within the room?

  • Room is clean, neat and hazard free?

  • PPE kit available in the room?

  • MSDS Register is available within the room?

  • Maintenance Schedule completed?

  • Maintenance room is locked when not attended?

  • Maintenance requirements or any Additional information

Waste Management

  • Waste area has adequate storage facilities for number of bins?

  • Floors are able to be effectively cleaned?

  • Adequate ventilation provided within the room?

  • Room is clean, neat and hazard free?

  • Have waste bins been kept clean by regular washing?

  • Area is odour free?

  • Waste bins are numbered?

  • Waste bins are filled before another is used?

  • Correct bins are used for appropriate waste?

  • Cardboard boxes are flattened before placing in bin?

  • Maintenance requirements or any Additional information

Animal and Pests

  • Practical measures to eradicate and prevent harbourage of pests used (eg good housekeeping, no stock stored on floors, not over stocked, pest controller)

  • No signs of insect infestation or rodent activity in premises

  • Additional information

Additional Information

  • Photos of other items

  • Additional Notes/Comments

  • Re-inspection Required

  • Time before next inspection

  • DECLARATION: I have read this report and understand the contents

  • Facility Manager signature

  • Central Office signature

  • NOTE: assessment report contains findings from date/time of inspection only

Contact Details

  • Aegis Aged Care Group

  • Address: 90 Goodwood Pde Burswood Perth WA 6103

  • Telephone: (08) 6254 8200

  • Fax: (08) 6254 8299

  • Email: operations@aegiscare.com.au

  • Web: www.aegiscare.com.au


    www.aegiscare.com.au

  • ABN: 97 377 986 723

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