Title Page

  • Site conducted

  • Conducted on

  • Prepared by

  • Location
  • Follow on work required

System Information

  • System manufacturer

  • System type

  • Site phone number

  • Rack software version

  • Speech unit software version

  • Main rack location

  • Dwelling count

  • Dect phone make / model

  • Printer tested

  • Mangers display fitted

  • Picture of rack (internal)

Equipment checks

  • All batteries on system retain 70% of their capacity

  • Rack in good condition

  • Mains fault monitor tested

  • System clock correct

  • System logged checked

  • Telephone line fault monitored tested

  • Auto offsite - Total duration to Ealing Careline in seconds

  • Dual com tested

  • Signal to Ealing Careline tested in all modes *on site *off site*remote

  • Visually inspect mains surge device

  • Visually inspect BT surge device

  • UPS for managers handset tested

  • Visually inspect trunking , cabling, modules are damage free

System checks

  • Speech quality to Ealing Careline

  • Radio pedant tested in communal area, zonal receiver tested

  • Managers handset tested

  • Mains failure system switch over to standby battery

  • Mains restore

Battery & system voltage checks

  • System voltage

  • Rack battery Charging voltage

  • Rack battery on load voltage

  • Rack battery size V & AH

  • Rack battery Installation date

  • PA battery charging voltage

  • PA battery on load voltage

  • PA battery size V & AH

  • PA battery installation date

  • Managers panel battery charging voltage

  • Managers panel battery on load voltage

  • Managers panel battery size V & AH

  • Mangers panel installation date

  • Battery tester meter number

Communal area handset inspection( test all functions, system ID in comment box)

  • Lift

  • WC

  • Common room

  • Office

  • Laundry room

  • Guest room

  • Communal kitchen

  • Key safe

  • Fire panel

  • Managers button 1

  • Managers. Button 2

  • Other

  • Dwellings tested
  • Flat number

  • All pull cords tested

  • Pull cord type

  • Pendant tested

  • Number of pull cords switches installed

  • Handset tested

  • Smoke alarms tested ( incl heat detector, locator switch) (provide expairy date in comment box)

  • Co detector tested ( provide expairy date in comment box)

  • All signals confirmed received at Ealing Careline

  • Deaf kit installed - tested ( strobe, vibrating pillow, interconnection to detection)

  • Deaf kit permanently connected to mains supply or precautions in place to stop equipment being unplugged

  • Comments

  • Number of FA detectors installed

System condition statement

  • System fully functional no faults present

  • System has minor faults which will not effect the correct operation of system

  • System has major faults which effect the correct operation system

  • Name

  • Signature

  • Date

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.