Title Page

  • Site conducted

  • Conducted on

  • Prepared by

  • Location


  • Is an Infection Control Manual or Policy available?

  • Is an Infection Control Management Plan (ICMP) available? (QLD only)

  • Is a Radiation Safety Management Plan (RSPP) available? (QLD & VIC only)

  • Are there relevant policies & procedures available? select those that apply

  • Are Safety Data Sheets available for products used in practice?

  • Are copies of the two Australian Standards available in either printed or digital format?

  • Is the Federal Governments National Health & Medical Research Council (NHRMC) Australian Guidelines on Infection Prevention Available in either printed or digital format?

  • Confirm with clinicians that in line with AHPRA & National Law a blood test has been undertaken within the last 36 months to confirm antibody status for HBV, HCV, and HIV.

  • Does the practice have any of the follow registers (printed or digital)

  • Is yearly Infection Control training undertaken and documented?

Personal Protective Equipment

  • Are all masks being treated as single use?

  • Are Level 2 and N95 Masks available?

  • Have team members been fit tested for N95 masks?

  • Is correct eye protection being worn that includes side eye protection?

  • Are heavy-duty utility gloves available and being worn in the sterilisation room when reprocessing instruments?

  • Are aprons being worn in the sterilisation room when reprossing instruments?

  • Are scrubs/aprons removed when in non-clinical areas?

  • Is enclosed footwear being worn in clinical areas?

Hand Hygiene

  • Is handwash and ABHR being used at the correct opportunities?

  • Is moisturiser available and used when appropriate?

  • Are hands being dried with disposable paper towel?

  • Has all hand and wrist jewelry been removed prior to working in clinical areas? *Note a plain wedding band is permissible provided appropriate hand hygiene is completed

Sharps Management

  • Do sharps containers conform to Australian Standards (AS4301 and AS4261) by having the following; a lid, an appropriate mouth with plastic fingers, a full line mark, a bio-hazard symbol and disposal instructions?

  • Confirm all sharps containers are not filled beyond the full line mark?

  • Are sharps containers wall mounted or is a safety-engineered device used such as a Sharpsmart container?

  • Are any full sharps containers stored safety when awaiting collection?

  • Are needles being disposed of by clinicians?

  • Are team members aware of what to do in the event of a sharps injury?

  • Is a risk assessment completed for any sharps injuries?

Infection Control - Treatment rooms

  • Is the environment clean and are work surfaces conducive for effective cleaning?

  • Are floor coverings impervious with sealed joins and in good repair?

  • Are dental chairs in good repair allowing for effective cleaning?

  • Observe team members clean treatment rooms between patients. What tasks have been completed?

  • Are all handpieces sterilised between patients? (even if not used)

  • Are suction units cleaned daily?

  • Is there a process for the collection of amalgam & scrap metal?

  • Is a detergent and a disinfectant product available for cleaning?

  • Are any barriers used? ie curing light, intra-oral camera's or x-ray holders

  • Are instruments stored to ensure no damage to the pack?

  • Check a selection of instruments to ensure they are clean and sterile. Were any issues identified?

  • Is instrument sterility checked chairside by the clinician?

  • Is the water being used in the dental chair being treated?

  • Have the dental unit waterlines been tested for water quality in the past 12 months and was the result below 200 CFU?

  • If impressions are taken, are they cleaned and disinfected?

Infection Control - Sterilisation room

  • Is daily validation occuring on the Ultrasonic bath?

  • Is the Ultrasonic bath solution prepared in line with instructions?

  • Is daily validation occurring on the Autoclave/s?

  • Is the sterilisation room cleary demarcated into clean and dirty zones?

  • Were any instances of cross contamination identified

  • When reprocessing instruments is correct PPE being worn?

  • Are there dedicated brushes for manual cleaning?

  • If Rotary NiTi files are used and reprocessed, are they being reprocessed according to ADA guidelines?

  • Are handpieces cleaned and lubricated prior to sterilisation?

  • Are low-lint or lint-free cloths being used for the drying of instruments?

  • Review processed and/or sterilised instruments for cleanliness. Were any issues identified

  • Review instrument tracking (from recording to the patient file). Is this being completed inline with guidelines?

  • Is there a process for identifying and disposing of damaged instruments?

  • What instruments are being bagged and tracked?


  • Is there a record of the Ultrasonic passing daily validation? Record any issues identified

  • Is there record of the autoclaves passing daily validation? Record any issues identified

Review autoclave log sheets for the below content

  • Autoclave Identifier

  • Load/Cycle number

  • Completed cycle parameters

  • List of instruments/contents

  • Number of instruments/bags

  • Person who loaded and unloaded autoclave

  • Chemical indicator (class 4 or 6)

  • Can team members identify a correct and incorrect colour change on chemical indicators

  • Is the autoclave loaded as per manufacturer's guidelines

  • Can the most recent autoclave validation certificates be provided

  • Was a spore test/biological test completed in the last validation

  • Was cold spot identification completed in the last validation

Health & Safety

  • Is there a current evacuation diagram?

  • Does the evacuation diagram contain all the required information

  • Has an evacuation been practiced and recorded in the past 12 months

  • Are emergency exits clearly signed

  • Are fire extinguishers serviced every 6 months?

  • Is there a medical emergency/first aid kit?

  • Is emergency oxygen available

  • Is there an AED

  • Has medical emergency/first aid training occurred in the past 12 months

  • Is nitrous oxide used?

  • Are x-rays being taken by licensed individuals

  • Is there a process for recording incidents

  • Is there a process for recording incidents that occur to patients

  • Are there any hazards identifed?

  • Are there any unlabelled/unidentified chemicals?

  • Is there an Asbestos clearance certificate or Asbestos Register/Management Plan available?

  • Has electrical testing and tagging been completed within the past 12 months?

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.