Information

  • Site conducted

  • Facility Name:

  • Assessment Number:

  • Conducted on

  • Prepared by

  • Attendees:

Condition (Quality) Assessment

Building Envelope/Structure

  • What is the general condition of the building form?

  • Notes:

  • Photo's:

Building Fitout

  • What is the general condition of the ceilings and internal walls?

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  • What is the general condition of the kitchen facilities?

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  • What is the general condition of the toilet facilities?

  • Notes:

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Electrical Services

  • What is the general condition of the lighting system(s)?

  • Notes:

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  • What is the general condition of the electrical boards (ie switchboards, sub boards, main boards etc)?

  • Notes:

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Fire Services

  • What is the general condition of the fire service elements (ie smoke detectors, fire panels, sprinkers etc)?

  • Notes:

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Hydraulic Services

  • What is the general condition of the hydraulic service elements?

  • Notes:

  • Photo/s:

Mechanical Services

  • What is the general condition of heating, cooling and/or ventilation system(s)?

  • Notes:

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Flooring

  • What is the general condition of the floor structure (ie subfloor etc)

  • Notes:

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  • What is the general condition of the floor coverings?

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Roof

  • What is the general condition of the roof structure?

  • Notes:

  • Photo/s:

Fit for Purpose Assessment

Functionality

  • Does the facility have adequate space/area for the services associated?

  • Can the facility be adapted to suit other services/purposes?

Configuration

  • Are the facility spaces/areas effectively connected and positioned?

Amenity

  • Is the facility modern and attractive?

  • Is the facility compatible with its surrounds?

  • Does the facility have complementary peripheral infrastructure?

Environmental Sustainability

  • Does the facility have appropriate ESD elements incorporated?

Services

  • Does the facility have adequate amenities (ie kitchen, toilets etc)?

  • Does the facility have adequate heating/cooling/ventilation?

  • Does the facility have an adequate internal and external lighting?

  • Does the facility have an adequate security system?

Location and Accessibility Assessment

Site Topography

  • Is the site suitable (ie taking account of levels or other constraints) for the services associated with the facility?

Geography

  • Is the facility located within the precinct or vicinity of its target user group(s)?

  • Is the facility close to necessary amenities for which its users may require (ie shops, schools etc)

Public Transport

  • Is the facility accessible via public transport?

Carparking

  • Does the facility have adequate carparking?

  • Is the facility carparking within close proximity?

Crime Prevention Through Environmental Design (CPTED)

  • Is there appropriate natural access control associated with the facility?

  • Does the facility have appropriate natural surveillance?

  • Is there appropriate territorial reinforcement (ie demarcation of spaces)?

Utilisation/Capacity Assessment

User Numbers

  • Is the facility's utilisation (ie based on numbers) similar to its capaciy?

User Diversity

  • Is the facility utilised by a range of groups?

Frequency of Use

  • Is the facility utilised for the majority of the day and/or night?

Service Criticality

  • Are the risks associated with the non-delivery of services from the facility high?

Legislative/Compliance Assessment

Access and Egress

  • Are disabled toilets provided?

  • Are disabled parking bays provided?

  • Is there compliant access and egress? (Including ramps, exit signs, door hardware etc)

Fire Resistance

  • Does the facility have an effective fire evacuation plan on display?

Health and Amenity

  • Does the kitchen comply with the community health department's regualations?

General Compliance

  • Are the essential safety measures maintained and measured as per the regulations?

  • Is there appropriate roof access hardware?

Works Required

Works Required

  • Work Order #1

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  • Work Order #2

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  • Work Order #3

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  • Work Order #5

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  • Work Order #6

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  • Work Order #7

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  • Work Order #8

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  • Work Order #9

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  • Work Order #10

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  • Work Order #11

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  • Work Order #12

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  • Work Order #13

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  • Work Order #14

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  • Work Order #15

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  • Work Order #16

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  • Work Order #17

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  • Work Order #18

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  • Work Order #19

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  • Work Order #20

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  • Work Order #21

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  • Work Order #22

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  • Work Order #23

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  • Work Order #24

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  • Work Order #25

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Additional Notes

Additional Notes:

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  • Note #5

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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.