Information
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
Inspection Details
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Facility Manager
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Email
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Date of Last Aegis Internal Audit
General Requirements
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Details of Training not completed:
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Do you have a Senior Cleaner in place?
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Name
Communication
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Evidence of Facility Staff Meeting Minutes - Qtr
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Date of Last Meeting
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Evidence of Facility Resident Meeting Minutes - Qtr.
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Date of Last Meeting
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Memo system in place to communicate important information to staff?
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Evidence of Resident Satisfaction Survey - annually
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Date of Last Survey
Supplier Records
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Evidence of Fire Protection Certificate of Compliance
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Select Certificate Type;
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Expiry Date of Certificate
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Select Certificate Type;
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Expiry Date of Certificate
Records
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Weekly Cleaning Schedule Records are Completed
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Weekly Cleaning Audits are completed
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Vacant Room Clean Records are completed
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Maintenance logbook jobs are completed in a timely manner?
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Record details
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Electrical tagging of items are within date code?
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Record details
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Fire Service Equipment tagged and within date code?
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Record details
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MSDS records are in place; SharePoint, Main nurses station & Main Chemical Storage Room
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All up to date?
Admin / Reception / Foyer
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Admin Staff are wearing an Aegis uniform with name badge?
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Signage is displayed as per Aegis Signage policy?
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Reception area is neat and welcoming? <br>Sign in book, Aegis brochures and Department of Health and Ageing brochures are displayed?
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Are floors clean in general? (daily clean)
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Is the area free from stains, or long term dirt/marks, with evidence of regular scrubbing/extraction cleaning?
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Is the front door glass and windows clean with no visible marks ?
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Curtains/blinds are clean, dust free and in good repaired?
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Picture frames, window ledges, shelving etc. are dust free and clean?
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Walls are clean and unmarked?
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Chairs are clean, vacuumed and stain free?
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Area is odour free?
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Maintenance requirements or any Additional information
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General comments.
Common Areas / Corridors
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Common Area / Corridor
Common Area / Corridor
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Wing name and location
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Floor coverings are clean in general? (daily clean)
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Is the area free from stains, or long term dirt/marks, with evidence of regular scrubbing/extraction cleaning?
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Area is odour free?
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Wall surfaces / skirting boards are clean and unmarked?
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Curtains/blinds are clean, dust free and in good repair?
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Picture frames, window ledges, shelving, light fittings and air vents are dust free and clean?
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Furniture is clean, vacuumed and stain free?
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Hand basin is clean with hand wash and paper towels? Bin is clean and lined?
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Water coolers are clean and bottles are emptied?
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Signage is displayed as per Aegis Signage policy?
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Maintenance requirements or any Additional information
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General comments.
Dining Rooms
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Dining Room
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Dining room name and location
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Is the area free from stains, or long term dirt/marks, with evidence of regular scrubbing/extraction cleaning?
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Area is odour free?
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Wall surfaces / skirting boards are clean and unmarked?
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Curtains/blinds are clean, dust free and in good repaire?
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Picture frames, window ledges, shelving, light fittings and air vents are dust free and clean?
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Furniture is clean and stain free?
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Signage is displayed as per Aegis Signage policy?
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Maintenance requirements or any Additional information
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General comments.
Lounge Areas
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Lounge Area
Lounge Room
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Lounge Wing and Location
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General comment on Housekeeping
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Is the area free from stains, or long term dirt/marks, with evidence of regular scrubbing/extraction cleaning?
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Area is odour free?
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Wall surfaces / skirting boards are clean and unmarked?
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Picture frames, window ledges, shelving, light fittings and air vents are dust free and clean?
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Furniture is clean, vacuumed and stain free?
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Curtains/blinds are clean, dust free and in good repaired?
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Signage is displayed as per Aegis Signage Policy; template, font, logo, created date, laminated, no visible fixings?
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Maintenance requirements or any Additional information
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General comments.
Resident Room
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Resident Room
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Wing and Room No
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Floor coverings (Flotex, Carpet, Vinyl, Tiles) clean and stain free?
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Room is odour free?
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Wall surfaces / skirting boards are clean and unmarked?
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Curtains/blinds are clean, dust free and in good repair?
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Picture frames and light fittings are dust free and clean?
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Furniture is clean, stain/dust free and in good condition and placed in orderly manner?
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Shelving, ledges and window frames are dust free?
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Resident fridge is clean inside/outside and food items are within date code?
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Internal windows are clean?
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Bins are clean, not over flowing and garbage bag lined?
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Maintenance requirements or any Additional information
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General comments.
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Bathroom Type
- En suite
- Common Bathroom
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Bathroom no or Location
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Bathroom floor is clean and stain free?
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Bathroom walls, doors & skirting boards are clean and unmarked?
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Air vents are clean and dust free?
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Toilet is clean and stain free?
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Behind the toilet, toilet base and tank is clean ?
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Bathroom basin is clean, hand soap is available and paper towels are available?
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Shower tiles are clean and stain free including the grout?
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Shower head is clean and in good condition?
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Shower curtains are clean and in good condition ?
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No leaking tapware?
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General good housekeeping practices observed? (No visible OSH risk items)
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Maintenance requirements or any Additional information
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General comments.
Common Bathroom / Toilet
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Common Bathroom / Toilet
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Name of the wing and Location
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Floor Tiles clean and stain free?
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Room is odour free?
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Wall surfaces / skirting boards are clean and unmarked?
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Shelving, ledges and window frames are dust free?
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Internal windows are clean?
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Bins are clean, not over flowing and garbage bag lined?
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Light fittings are dust free, clean and in working order?
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Air vents are dust free and clean?
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Bathroom basin is clean, hand soap is available and paper towels are available?
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Toilet is clean and stain free?
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Shower tiles are clean and stain free including the grout?
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Shower head is clean and in good condition?
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No leaking tapware?
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General good housekeeping practices observed? (No visible OSH risk items)
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Signage is displayed as per Aegis Signage Policy; template, font, logo, created date, laminated, no visible fixings?
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Maintenance requirements or any Additional information
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General comments.
Staff Room
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Floor coverings (Vinyl, Tiles) clean and stain free?
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Fridge is clean inside and out, frost free and food safe?
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Sink is clean with hand wash and paper towels?
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Bins are clean, not over flowing and garbage bag lined?
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Dining tables and chairs are clean, stain/dust free and in good condition?
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Picture frames, light fittings and air vents are dust free and clean?
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Shelving, ledges and window frames are dust free?
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Wall surfaces / skirting boards are clean and unmarked?
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Internal windows are clean?
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Curtains/blinds are clean, dust free and in good repair?
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General good housekeeping practices observed?
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Maintenance requirements or any Additional information
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General comments.
Cleaners Room and Equipment
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Cleaners Trolley
Trolley
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Name of the cleaner
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Name of Wing
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The staff is wearing an Aegis uniform with name badge?
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Is the facility Microfibre based ?
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Cleaning trolley is set up correctly for Microfibre cleaning?
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Only clean water, Crew, Creme R7 & PerDiem are stored in the trolley ?
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Microfibre mops are stored correctly on trolley with cross contamination in mind? (RED up, BLUE down)
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Correct colour coded mops and cloths are used for correct areas?
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No chemicals left on top of trolley unattended?
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Is chemical compartment locked when unattended? (without key in lock)
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Cleaning Schedule record is on the trolley and filled out during shift?
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Do Cleaning staff know they have access to Aegis SharePoint?
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Details of System for Access;
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Do cleaning staff have their own Cleaners Handbook?
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Has cleaner had sufficient training on all equipment?
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Who provided training?
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Does cleaner know nearest emergency exit and muster point?
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Maintenance requirements or any Additional information
Cleaner's Room
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Wing
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Cleaner
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Cleaning equipment are cleaned and in good condition?
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Equipment electrical cords are in good condition and tagged?
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Room is clean, neat and hazard free?
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Minimal chemicals only are stored within cleaners room?
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Chemicals are all labelled?
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Only Aegis approved chemicals are used?
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Cleaners room is locked when not attended?
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Maintenance requirements or any additional information
Laundry
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Laundry Room
Laundry
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Area is odour free?
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Laundry room layout has a clean and dirty area?
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Room is clean, neat and hazard free?
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Dirty linen bags are stored correctly on trolleys?
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Chemicals are placed within the locked compartment or the room is lockable?
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Chemicals are all labelled?
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Laundry equipment is clean?
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Cleaning equipment are in good condition?
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Electrical cords are in good condition and tagged?
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How often are curtains to be washed?
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Ask curtain care instructions and answer is correct.
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Dryer filters are lint free and cleaned daily?
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Laundry Cleaning Schedule Records are completed
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Resident Lost Clothing system in place and organised?
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Is the Lost Property Form completed correctly and feedback is given to the residents or family member?
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Maintenance requirements or any Additional information
Health and Hygiene
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The facility has warm running water to wash hands through single spout, single use towels (or air dryer) and soap ?
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Ask the cleaning staff when do they wash their hands and the answer they say is correct ?
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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.
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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 ?
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Does the staff member know what they should do if feeling ill with gastro and/or vomiting before work and/or at work?
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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
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General design and construction of premises appropriate
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Premise has adequate storage facilities for storage of chemicals
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Premises has sufficient lighting
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Floors are able to be effectively cleaned
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Walls and ceilings are able to be effectively cleaned
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Adequate ventilation provided within the room
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MSDS Register is available within the room and is it up to date ?
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PPE kit available in the room?
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Chemical room is lockable and locked when not attended?
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Fire extinguisher is located close by and serviced in date?
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Maintenance requirements or any Additional information
Maintenance Room
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Room has adequate storage facilities for items?
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Room has sufficient lighting?
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Floors are able to be effectively cleaned?
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Adequate ventilation provided within the room?
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Room is clean, neat and hazard free?
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PPE kit available in the room?
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MSDS Register is available within the room?
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Maintenance Schedule completed?
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Maintenance room is locked when not attended?
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Maintenance requirements or any Additional information
Waste Management
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Waste area has adequate storage facilities for number of bins?
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Floors are able to be effectively cleaned?
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Adequate ventilation provided within the room?
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Room is clean, neat and hazard free?
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Have waste bins been kept clean by regular washing?
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Area is odour free?
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Waste bins are numbered?
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Waste bins are filled before another is used?
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Correct bins are used for appropriate waste?
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Cardboard boxes are flattened before placing in bin?
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Maintenance requirements or any Additional information
Animal and Pests
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Practical measures to eradicate and prevent harbourage of pests used (eg good housekeeping, no stock stored on floors, not over stocked, pest controller)
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No signs of insect infestation or rodent activity in premises
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Additional information
Additional Information
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Photos of other items
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Additional Notes/Comments
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Re-inspection Required
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Time before next inspection
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DECLARATION: I have read this report and understand the contents
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Facility Manager signature
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Central Office signature
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NOTE: assessment report contains findings from date/time of inspection only
Contact Details
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Aegis Aged Care Group
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Address: 90 Goodwood Pde Burswood Perth WA 6103
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Telephone: (08) 6254 8200
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Fax: (08) 6254 8299
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Email: operations@aegiscare.com.au
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Web: www.aegiscare.com.au
www.aegiscare.com.au -
ABN: 97 377 986 723