Humana Biweekly Inspection - Account Team

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

AUDIT INSTRUCTIONS

• Always use the appropriate PPE. Update all hang tags where present. When completing checklist, a NO means there is an issue or deficiency found and a YES means that there are no issues or deficiencies. If a NO is marked, please try to resolve while on site and make necessary notes. If issue cannot be resolved or needs another vendor, please make note.

  Yes

  No

  N/A

• Check in at front desk upon arrival.

  Yes

  No

  N/A

• Communicate w/ Site Contact regarding identified deficiencies at the end of PM.

  Yes

  No

  N/A

• Follow up work orders not necessary? If no, provide details around what is needed in notes.

  Yes

  No

  N/A

EXTERIOR

• Exterior signage: Is sign turning on per schedule? If no please notify site contact. May need to do a separate drive by if sign is not on during visit.

  Yes

  No

  N/A

• Sidewalk/parking lot condition: Clear of trip hazards? (Y / N) Check conditions of any ramp (ADA) or drop off areas. Make sure the condition is such that no patients are exposed to risk. Sidewalk is clear of mildew or a slipping hazard due to vegetation? Check parking stoppers to ensure they are properly grounded/straight and no re-bars sticking out. If yes please notify site contact.

  Yes

  No

  N/A

• Check exterior door conditions: Handicap Doors Functioning. Weather Stripping in good condition? Transition Strips in good condition? if no please notify site contact.

  Yes

  No

  N/A

• Check Roof Gutters & down spots for functionality- Are they functioning properly?

  Yes

  No

  N/A

• If Generator is located outside, is the enclosure in good condition?

  Yes

  No

  N/A

• Exterior Lighting: Is exterior lighting operating correctly?

  Yes

  No

  N/A

• Landscaping: Is the exterior landscaping in good condition?

  Yes

  No

  N/A

• Check additional structures on property: dumpster enclosures, cages for vehicles. Is there good access?

  Yes

  No

  N/A

FIRE LIFE SAFETY

• Generator- Report low fuel levels for diesel generator tanks ( _25% , 50%, 75%, 100%_ ) If 25% or less notify site contact.

  Yes

  No

  N/A

• Check the monthly log for Dept of Environmental Protection. Is it in compliance?

  Yes

  No

  N/A

• Generator- Is there an exercise schedule? (Y / N) Check the transfer switch log. If no log or schedule, contact CBRE site manager to contact vendor.

  Yes

  No

  N/A

• Fire Extinguishers- Check that all tags are current and in place. All current?

  Yes

  No

  N/A

• Fire Panel – Check certification date and immediately notify site manager if expired. Current?

  Yes

  No

  N/A

• Back Flow Preventors- Check that all tags are current and in place. All current?

  Yes

  No

  N/A

• Hot Water Heaters- Verify Hot Water Heater thermostat setting is at 114*f. Working properly?

  Yes

  No

  N/A

• Hot Water Heaters- Check for water leaks. All in good condition?

  Yes

  No

  N/A

• Hot Water Heaters- Visual inspect for flame rollout on gas fired hot water heaters. Working properly?

  Yes

  No

  N/A

• Electrical Panels- Make sure that panel is secured with all hardware (door latches, hinges, etc.) All secure?

  Yes

  No

  N/A

• Electrical Panels- Confirm that there is 36” clearance in front of each panel. Are panels clear?

  Yes

  No

  N/A

• Electrical Panel- Confirm that lockout/tagout kit is present and in working order. Properly working?

  Yes

  No

  N/A

• Fire Suppression/Safety System- Check that all tags are current and in place. All current?

  Yes

  No

  N/A

• Stored items should be 18 inches from sprinkler heads: All sprinklers clear of blockage?

  Yes

  No

  N/A

• Check exit lights for proper operation. All in working condition?

  Yes

  No

  N/A

• Check panic bars for proper operation (have alarm disabled before opening door). All in working condition?

  Yes

  No

  N/A

SITE INTERIOR

• All ballasts working. As necessary (indicate # and locations in notes)

  Yes

  No

  N/A

• Doors: Confirm that all entrance and ADA doors are working. Note any gaps or openings in door seals. All in working condition?

  Yes

  No

  N/A

• Windows: Note any gaps or openings in window seals and/or caulking for any signs of condensation. All in good condition?

  Yes

  No

  N/A

• Trip hazards on floor: All in good condition? If not, provide quote to repair if ACM not present.

  Yes

  No

  N/A

• Water stained or damaged ceiling tiles: Any missing or stained tiles? All in good condition? If not, replace. Replace if ACM is not present

  Yes

  No

  N/A

• Painting: Inspect & repair walls that need painting. All in good condition? Provide quote for large projects.

  Yes

  No

  N/A

• Water Leaks: Walk entire site - inspect for signs of water leaks (excluding treatment floor): All in good condition?

  Yes

  No

  N/A

• Water Supply Lines: Inspect all water supply lines to coffee pots, ice machines, water filters, and notify Site Manager immediately if issues are found. All in working condition?

  Yes

  No

  N/A

• Visually check plumbing connections on coffee pots, ice machines, and other dispensing equipment for defective fittings and improper installations. All in working condition? Note any issues found.

  Yes

  No

  N/A

• Check HVAC T-stats to make sure they are working properly. Visually inspect and clean diffusers. Verify T-stats are set with the following parameters:<br>Occupied cooling: 73-75F Occupied heating: 70-72F Unoccupied cooling: 85F Unoccupied heating: 62F<br>Schedule set to start occupied mode 1 hour before business hours begin, end occupied mode ½ hour after business hours end. <br>All in working condition?<br>

  Yes

  No

  N/A

• Humidity: Take humidity reading and check for mold issues. List acceptable range and document readings. Expected humidity reading will be between 40%-60%. If you view a reading outside that range, please immediately notify SM and make a note on this checklist. Humidity readings at acceptable ranges?

  Yes

  No

  N/A

• Check that furniture is clear of stains and damages. Furniture in good condition?

  Yes

  No

  N/A

• Check that the facility floor is clear of trash and debris? Floor clear?

  Yes

  No

  N/A

• Check condition of flooring throughout facility. Floor clear of any hazards?

  Yes

  No

  N/A

RESTROOMS

• Check for loose partitions and all hardware for proper operation. All working in proper condition?

  Yes

  No

  N/A

• Inspect faucets, toilets and urinals for proper operation. All working in proper condition?

  Yes

  No

  N/A

• Check sink and floor drains for any leaks. All working in proper condition?

  Yes

  No

  N/A

• Check wall mounted equipment, secured to wall. All working in proper condition?

  Yes

  No

  N/A

• Trip hazards on restroom floor. Floor is clear of cracked or broken tile? Provide quote to repair. Make sure ACM is not present.

  Yes

  No

  N/A

• Check exhaust fan for proper operation. Working properly?

  Yes

  No

  N/A

• ADA hand rails to be checked. All in proper condition?

  Yes

  No

  N/A

• Check wall mounted equipment for product. All equipment has product?

  Yes

  No

  N/A

ROOF

• Proper drainage. All draining properly?

  Yes

  No

  N/A

• Splits. Roof clear of splits?

  Yes

  No

  N/A

• Does roof have any debris and weeds? Roof clear of debris?

  Yes

  No

  N/A

• Do the roof drains need cleaning? All drains clean?

  Yes

  No

  N/A

• Complete roof access log and contact site contact if materials left on roof by other contractors. Roof clear of materials?

  Yes

  No

  N/A

ROOF TOP UNITS

• Overall condition of panel doors, etc. Visual overview. All in proper condition?

  Yes

  No

  N/A

• Coil cleanliness: Any indication of air bypassing filters? All coils in working condition?

  Yes

  No

  N/A

• Hail damage on coils. Always check after stormy weather. All coils in working condition?

  Yes

  No

  N/A

• Damper operation. Are OA dampers stuck open or closed? All dampers in working condition?

  Yes

  No

  N/A

• Install pan tabs as necessary. Pan tabs installed?

  Yes

  No

  N/A

• Inspect Filters & Spacers ( check monthly, replace quarterly ). Note last date changed.

  Yes

  No

  N/A

• Listen for squeaks, squeals, loud knocks indicating belt or bearing issues. All in working condition?

  Yes

  No

  N/A

EXHAUST FANS

• All fans operating as required?

  Yes

  No

  N/A

• Check for air flow. All in proper working condition?

  Yes

  No

  N/A

• All exhaust fan covers in place & secured?

  Yes

  No

  N/A

• Listen for squeaks, squeals, loud knocks indicating belt or bearing issues. All in working condition?

  Yes

  No

  N/A

• Change all belts annually by May 31st. Mark replacement date on equipment hang tag. All belts in working condition?

  Yes

  No

  N/A

• Grease bearings annually by May 31st. Mark replacement date on equipment hang tag. All bearings in working condition?

  Yes

  No

  N/A

• Confirm that all fans are labeled. All fans labeled correctly?

  Yes

  No

  N/A

GENERAL INFORMATION- MISC ITEMS

• All other items in working condition? If no, provide notes.

  Yes

  No

  N/A

• Please Sign - Marking as Complete.

  Sign