Audit

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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NAME OF PERSON UNDERTAKING TESTS

NAME OF FACILITY?

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LOCATION OF TEST - ROOM NO.?

ASSET BARCODE AVAILABLE?

UNINTERRUPTIBLE POWER SUPPLIES (UPS)

Confirm that UPS status indicator performance is routinely verified.

INSPECTION

All electrical equipment & fittings in good condition?

LABELLING

Circuit identification visible and intact on each?

Relevant electrical points labelled to identify associated RCDs?

Circuit identification visible and intact on each LIM?

Relevant electrical points labelled to identify associated LIMs?

Overload monitors labelled with alarm setting?

Socket-outlets protected by RCD labelled ‘RCD PROTECTED’?

Socket-outlets protected by Isolating transformers labelled ‘ISOLATING TRANSFORMER PROTECTED’?

Socket-outlets intended for cleaning purposes labelled ‘CLEANING PURPOSES ONLY’?

Body-protected electrical area sign:
Still visible.
Labelled with current inspection date.
Labelled with identity of authorized person.
Labelled with next test date.

SOCKET OUTLETS

Socket-outlets coloured according to type of supply

If RCD protected, power-available indicator operational?

Number of socket-outlets and permanently wired electrical equipment protected by RCD does not exceed 12?

On/off luminous indicators operational, if applicable?

Socket-outlets double-poled if protected by a transformer-isolated supply?

All socket-outlets below 2.3 m protected by LPD?

Confirm each socket-outlet trips the RCD when fault applied?

Confirm each socket-outlet causes a response on LIM when a fault is applied?

Confirm that RCDs do not protect socket-outlets in another patient location?

EARTHING

Confirm that the earth pin of all socket-outlets below 2.3 m are earthed to less that 0.1 Ω?

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

Confirm that the potential difference does not exceed 50 mV between EP junction and—

Earthing pins of at least 2 socket-outlets in each patient location.

Reticulated plumbing pipework services

Accessible conductive parts of permanently wired electrical equipment that are accessible in patient environment:
Surgical luminaires and patient examination lights.
Pendants.
Imaging systems.
Equipment mounting rails.

RCD SENSITIVITY (AUS)

Confirm that the RCD trips at a value greater than 4.5 mA and less than 10.5mA

RCD TRIPPING TIMES (AUS)

Confirm this by repeating the test at least 2 times.

Record the worst case (mA)

RCD SUPPLY AVAILABLE INDICATOR LIGHTS

If applicable, confirm that they are operational.

AUDIO VISUAL RCD TRIP INDICATORS

If applicable, confirm that they are operational.

PROSPECTIVE HAZARD CURRENT OF INSUALTION

Ensure PHC is less than 2 mA when no appliance is plugged in.

Record hazard current (mA)

LIM PROSPECTIVE HAZARD CURRENT ALARM

Confirm that the LIM alarms between 17 and 19 mA. Record alarm current (mA)

OVERLOAD MONITORS

Confirm that a load of 110–120% of transformer rated current causes the alarm to activate in 3–5 s

INSPECTION COMPLETE

INSTALLATION COMPLIANT WITH AS/NZS 3003:2011?

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Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.