Prescribed Accommodation - Routine Inspection (City Of Monash)

• Proprietor

• Business Name & address

• Proprietor email:

• Council Registration No.

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

BEDROOMS

• Do no. of occupants comply re overcrowding?

  Yes

  No

  N/A

• Are bedrooms clean & in good repair?

  Yes

  No

  N/A

• Are bedrooms (and any attached ensuites) cleaned before re-use?

  Yes

  No

  N/A

• Is bed linen provided?

  Yes

  No

  N/A

• Is the bed linen changed at least weekly and after re-use?

  Yes

  No

  N/A

AMENITIES

Ensuites

• Are ensuites clean & in good repair?

  Yes

  No

  N/A

Bathrooms

• Are toilets & bathrooms clean & in good repair?

  Yes

  No

  N/A

• Are toilet & bathing facilities at the premises adequate?

  Yes

  No

  N/A

Laundry

• Is the laundry clean & in good repair?

  Yes

  No

  N/A

KITCHEN

• Is kitchen clean & in good repair?

  Yes

  No

  N/A

COMMON AREAS

• Are common areas clean & in good repair?

  Yes

  No

  N/A

WATER/WASTEWATER

• Is there adequate hot & cold water facilities?

  Yes

  No

  N/A

• Is there adequate clean drinking water?

  Yes

  No

  N/A

• Is all sewage & waste water discharged to sewer?

  Yes

  No

  N/A

• Are stormwater guttering, down pipes etc in good condition and connected to legal point of discharge?

  Yes

  No

  N/A

REFUSE/WASTE MANAGEMENT

• Are refuse receptacles sufficient & clean?

  Yes

  No

  N/A

• Is refuse disposed of regularily?

  Yes

  No

  N/A

OUTSIDE AREAS

• Are lawns & gardens well maintained?

  Yes

  No

  N/A

• Are there any outbuildings, garages, sheds etc?

  Yes

  No

  Don't know

• Are these structures in good condition?

  Yes

  No

  N/A

• Are any outbuildings being occupied?

  Yes

  No

  Don't know

• Are these outbuildings approved for occupancy?

  Yes

  No

  N/A

ADDITIONAL

• Is there a register of occupants?

  Yes

  No

  N/A

• Other comments

ITEMS REQUIRING ATTENTION

Item

FOLLOW-UP INSPECTION

• Is a follow-up inspection required?

  Yes

  No

• Follow-up inspection scheduled for:

  Date

SIGN OFF

• On site representative

  Sign

• Add drawing

  Drawing

• Officer's signature

  Sign

• Add drawing

  Drawing

• Public Health Unit ph: 9518 3539