Information

  • Reference No.

  • Trading Name

  • Company Name

  • Conducted on

  • Prepared by

  • Location
  • Personnel

A MORTUARY PREMISES DETAILS:

  • Prop/Director:

  • Email Address:

  • Council Approval Identification Details:

  • Contact Number

  • ABN/ACN

  • Person Interviewed

  • Health Registration Number:

  • Registration Details Complete?

  • Registration details match with Council approval?

B AUDIT DETAILS

  • 1. Premises generally (Clause 5)

  • Only approved mortuary being used for body preparation? (1)

  • Only approved mortuary being used for body storage? (2)

  • Bodies not stored in a vehicle? (3)

  • Holding room being used for body storage only? (4)

  • Bodies not stored as a hospital? (5)

  • 2. Facilities for Body Preparation Rooms (Clause 6)

  • Vehicle reception area adjacent to body preparation room? (1)(a)

  • Vehicle reception area screen from public view? (1)(a)

  • Hand wash basin with adequate hot and cold water and hands free operation? (1)(b)

  • Sufficient slabs, tables and fittings?

  • Slabs, tables and fittings impervious and drained for cleaning? (1)(c)

  • Refrigerated body storage facilities for at least two adults? (1)(d)

  • Temperature:

  • Less than 5 C?

  • Impervious containers with lids; hands free operation for solid wastes? (1)(e)

  • Only bodies stored in body refrigerator?

  • 3. Waste Disposal (Clause 7)

  • Solid wastes disposed as contaminated (clinical) waste?

  • Waste observed in container:

  • Name of clinical waste contractor:

  • 4. Vehicles (Clause 8)

  • Hearse: Make, Model and Registration (1)(a):

  • Collection vehicle: Make, model and registration (1)(b):

  • Mortuary transport service or freight carrier? (2)

  • Bodies placed only in vehicle body area? (3)

  • Vehicle body area not used for other purposes? (4)

  • Vehicle clean of exudates? (5)

  • Un-embalmed bodies transported less than 8 hours? (7)

  • Body bags supplied in vehicle? (CI 13)

  • Protective clothing in vehicle? (CI 14)

  • 5. Mortuary Register of Body Preparation (Clause 18)

  • Register Sighted? (1)

  • Entries complete for disposed bodies? (3)

  • Entries reconciled with each body prepared? (2 & 3)

  • 6. Retention of Bodies (Clause 10)

  • All bodies held in mortuary or holding room? (1)

  • All bodies kept under refrigeration? (2)

  • Reason for any body not in refrigeration? (3)

  • All un-embalmed bodies kept less than 7 working days after certificate? (4)

  • 7. Embalming of bodies (Clause 11 & 12)

  • Any un-embalmed bodies on premises? (*)

  • Name and qualification of embalmer? (11,1)

  • Qualification approved?

  • Any body with List B disease embalmed? (11,2)

  • Any body with List A disease pierced by unqualified person? (12)

  • 8. Body Bags (Clause 13)

  • All bodies in body bags and identified? (1)

C RECOMMENDATIONS

  • Recommendation;

D ACTION TAKEN

  • Action;

  • (*) = Not a legislative requirement

  • NB:

  • Prop/Director Signature:

  • EHO/Officer Signature:

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.