Title Page
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Audit Title
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INSPECTION REPORT FOR CARDIAC-PROTECTED ELECTRICAL AREAS
CVSG ASSET SERVICES PTY LTD
ABN 62 128 821 698
Conducted in accordance with:
AS/NZS 3003:2011 ELECTRICAL INSTALLATIONS - PATIENT AREAS
INSPECTION DETAILS
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Select date
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NAME OF FACILITY?
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LOCATION OF TEST - ROOM NO.?
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ASSET BARCODE AVAILABLE?
UNINTERRUPTIBLE POWER SUPPLIES (UPS)
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Confirm that UPS status indicator performance is routinely verified.
INSPECTION
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All electrical equipment & fittings in good condition?
LABELLING
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Circuit identification visible and intact on each?
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Relevant electrical points labelled to identify associated RCDs?
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Circuit identification visible and intact on each LIM?
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Relevant electrical points labelled to identify associated LIMs?
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Overload monitors labelled with alarm setting?
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Socket-outlets protected by RCD labelled ‘RCD PROTECTED’?
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Socket-outlets protected by Isolating transformers labelled ‘ISOLATING TRANSFORMER PROTECTED’?
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Socket-outlets intended for cleaning purposes labelled ‘CLEANING PURPOSES ONLY’?
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Body-protected electrical area sign:<br>Still visible.<br>Labelled with current inspection date.<br>Labelled with identity of authorized person.<br>Labelled with next test date.
SOCKET OUTLETS
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Socket-outlets coloured according to type of supply
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If RCD protected, power-available indicator operational?
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Number of socket-outlets and permanently wired electrical equipment protected by RCD does not exceed 12?
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On/off luminous indicators operational, if applicable?
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Socket-outlets double-poled if protected by a transformer-isolated supply?
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All socket-outlets below 2.3 m protected by LPD?
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Confirm each socket-outlet trips the RCD when fault applied?
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Confirm each socket-outlet causes a response on LIM when a fault is applied?
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Confirm that RCDs do not protect socket-outlets in another patient location?
EARTHING
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Confirm that the earth pin of all socket-outlets below 2.3 m are earthed to less that 0.1 Ω?
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Confirm that all permanently wired appliances with conductive parts below 2.3 m are earthed to less that 0.1 Ω with respect to EP junction node or other appliances.
POTENTIAL DIFFERENCE BETWEEN ACCESSIBLE METAL EQUIPMENT
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Confirm that the potential difference does not exceed 50 mV between EP junction and—
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Earthing pins of at least 2 socket-outlets in each patient location.
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Reticulated plumbing pipework services<br>
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Accessible conductive parts of permanently wired electrical equipment that are accessible in patient environment:<br>Surgical luminaires and patient examination lights.<br>Pendants.<br>Imaging systems.<br>Equipment mounting rails.
RCD SENSITIVITY (AUS)
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Confirm that the RCD trips at a value greater than 4.5 mA and less than 10.5mA
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Record the sensitivity for each RCD (mA)
RCD TRIPPING TIMES (AUS)
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Confirm this by repeating the test at least 2 times.
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Record tripping times for each RCD (ms)
RCD SUPPLY AVAILABLE INDICATOR LIGHTS
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If applicable, confirm that they are operational.
AUDIO VISUAL RCD TRIP INDICATORS
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If applicable, confirm that they are operational.
PROSPECTIVE HAZARD CURRENT
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Ensure PHC is less than 2 mA when no appliance is plugged in.
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Record hazard current (mA)
LIM PROSPECTIVE HAZARD CURRENT ALARM
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Confirm that the LIM alarms between 17 and 19 mA. Record alarm current (mA)
OVERLOAD MONITORS
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Confirm that a load of 110–120% of transformer rated current causes the alarm to activate in 3–5 s
INSPECTION COMPLETE
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INSTALLATION COMPLIANT WITH AS/NZS 3003:2011?
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