QSP Condition Based Survey

• Site conducted

  Select

• Conducted on

  Date

• Prepared by

• Area/Building

• Physical Condition Rating System

• Excellent - as new condition

• Good - Acceptable for its age and can be maintained with normal maintenance

• Average - Needs some attention. Not urgent.

• Poor - Requires replacement or major refurbishment

• Extremely Poor - Failed item or represents WH&S hazard - replace immediately

External Elements

• Concrete areas/walkways (record any areas with cracks >2mm in width as poor)

  Select Excellent Good Average Poor Extremely Poor N/A

  • Excellent
  • Good
  • Average
  • Poor
  • Extremely Poor
  • N/A

• Windows

  Select Excellent Good Average Poor Extremely Poor N/A

  • Excellent
  • Good
  • Average
  • Poor
  • Extremely Poor
  • N/A

• Step Treads/Tactiles/Nosing

  Select Excellent Good Average Poor Extremely Poor N/A

  • Excellent
  • Good
  • Average
  • Poor
  • Extremely Poor
  • N/A

• External Walls (including painting)

  Select Excellent Good Average Poor Extremely Poor N/A

  • Excellent
  • Good
  • Average
  • Poor
  • Extremely Poor
  • N/A

• Doors (including painting)

  Select Excellent Good Average Poor Extremely Poor N/A

  • Excellent
  • Good
  • Average
  • Poor
  • Extremely Poor
  • N/A

• External screens/sun shades

  Select Excellent Good Average Poor Extremely Poor N/A

  • Excellent
  • Good
  • Average
  • Poor
  • Extremely Poor
  • N/A

• Signage

  Select Excellent Good Average Poor Extremely Poor N/A

  • Excellent
  • Good
  • Average
  • Poor
  • Extremely Poor
  • N/A

• Roof Plumbing (gutters, downpipes etc)

  Select Excellent Good Average Poor Extremely Poor N/A

  • Excellent
  • Good
  • Average
  • Poor
  • Extremely Poor
  • N/A

• Roofing (sheets, eaves, soffitts, flashing etc)

  Select Excellent Good Average Poor Extremely Poor N/A

  • Excellent
  • Good
  • Average
  • Poor
  • Extremely Poor
  • N/A

• Joinery/Furniture items (bag-racks, seating etc)

  Select Excellent Good Average Poor Extremely Poor N/A

  • Excellent
  • Good
  • Average
  • Poor
  • Extremely Poor
  • N/A

• Handrails/Balustrades

  Select Excellent Good Average Poor Extremely Poor N/A

  • Excellent
  • Good
  • Average
  • Poor
  • Extremely Poor
  • N/A

• Fences/gates

  Select Excellent Good Average Poor Extremely Poor N/A

  • Excellent
  • Good
  • Average
  • Poor
  • Extremely Poor
  • N/A

• Electrical infrastructure (powerpoints, switchboards etc)

  Select Excellent Good Average Poor Extremely Poor N/A

  • Excellent
  • Good
  • Average
  • Poor
  • Extremely Poor
  • N/A

• Plumbing fixtures (taps, bubblers, sinks, valves, RPZ etc)

  Select Excellent Good Average Poor Extremely Poor N/A

  • Excellent
  • Good
  • Average
  • Poor
  • Extremely Poor
  • N/A

• Wet Fire Equipment (hydrants, hose reels etc)

  Select Excellent Good Average Poor Extremely Poor N/A

  • Excellent
  • Good
  • Average
  • Poor
  • Extremely Poor
  • N/A

• Dry fire equipment (FIP's, EWIS speakers etc)

  Select Excellent Good Average Poor Extremely Poor N/A

  • Excellent
  • Good
  • Average
  • Poor
  • Extremely Poor
  • N/A

• Lighting fixtures

  Select Excellent Good Average Poor Extremely Poor N/A

  • Excellent
  • Good
  • Average
  • Poor
  • Extremely Poor
  • N/A

• Emergency/exit lighting

  Select Excellent Good Average Poor Extremely Poor N/A

  • Excellent
  • Good
  • Average
  • Poor
  • Extremely Poor
  • N/A

• AC Units/ventilation (external components, Plenary-owned units only)

  Select Excellent Good Average Poor Extremely Poor N/A

  • Excellent
  • Good
  • Average
  • Poor
  • Extremely Poor
  • N/A

• Grilles/vents

  Select Excellent Good Average Poor Extremely Poor N/A

  • Excellent
  • Good
  • Average
  • Poor
  • Extremely Poor
  • N/A

• Water storage (tanks, hot water systems)

  Select Excellent Good Average Poor Extremely Poor N/A

  • Excellent
  • Good
  • Average
  • Poor
  • Extremely Poor
  • N/A

• Pumps

  Select Excellent Good Average Poor Extremely Poor N/A

  • Excellent
  • Good
  • Average
  • Poor
  • Extremely Poor
  • N/A

• Playground equipment

  Select Excellent Good Average Poor Extremely Poor N/A

  • Excellent
  • Good
  • Average
  • Poor
  • Extremely Poor
  • N/A

• Softfall areas

  Select Excellent Good Average Poor Extremely Poor N/A

  • Excellent
  • Good
  • Average
  • Poor
  • Extremely Poor
  • N/A

• Linemarking (courts, carparks etc)

  Select Excellent Good Average Poor Extremely Poor N/A

  • Excellent
  • Good
  • Average
  • Poor
  • Extremely Poor
  • N/A

• Lifts

  Select Excellent Good Average Poor Extremely Poor N/A

  • Excellent
  • Good
  • Average
  • Poor
  • Extremely Poor
  • N/A

• Storage Areas/Sheds (including roller doors)

  Select Excellent Good Average Poor Extremely Poor N/A

  • Excellent
  • Good
  • Average
  • Poor
  • Extremely Poor
  • N/A

• Other items (please specify in notes)

  Select Excellent Good Average Poor Extremely Poor N/A

  • Excellent
  • Good
  • Average
  • Poor
  • Extremely Poor
  • N/A

Internal Elements

• Windows

  Select Excellent Good Average Poor Extremely Poor N/A

  • Excellent
  • Good
  • Average
  • Poor
  • Extremely Poor
  • N/A

• Doors

  Select Excellent Good Average Poor Extremely Poor N/A

  • Excellent
  • Good
  • Average
  • Poor
  • Extremely Poor
  • N/A

• Blinds & curtains

  Select Excellent Good Average Poor Extremely Poor N/A

  • Excellent
  • Good
  • Average
  • Poor
  • Extremely Poor
  • N/A

• Floor coverings (carpet, vinyl, timber, sports floors etc)

  Select Excellent Good Average Poor Extremely Poor N/A

  • Excellent
  • Good
  • Average
  • Poor
  • Extremely Poor
  • N/A

• Internal walls

  Select Excellent Good Average Poor Extremely Poor N/A

  • Excellent
  • Good
  • Average
  • Poor
  • Extremely Poor
  • N/A

• Internal painting

  Select Excellent Good Average Poor Extremely Poor N/A

  • Excellent
  • Good
  • Average
  • Poor
  • Extremely Poor
  • N/A

• Ceiling areas (ceiling tiles etc)

  Select Excellent Good Average Poor Extremely Poor N/A

  • Excellent
  • Good
  • Average
  • Poor
  • Extremely Poor
  • N/A

• Lighting fixtures

  Select Excellent Good Average Poor Extremely Poor N/A

  • Excellent
  • Good
  • Average
  • Poor
  • Extremely Poor
  • N/A

• Emergency/exit lighting

  Select Excellent Good Average Poor Extremely Poor N/A

  • Excellent
  • Good
  • Average
  • Poor
  • Extremely Poor
  • N/A

• Fire equipment

  Select Excellent Good Average Poor Extremely Poor N/A

  • Excellent
  • Good
  • Average
  • Poor
  • Extremely Poor
  • N/A

• AC equipment (internal elements, Plenary owned items only)

  Select Excellent Good Average Poor Extremely Poor N/A

  • Excellent
  • Good
  • Average
  • Poor
  • Extremely Poor
  • N/A

• Fans (ceiling, wall and exhaust fans)

  Select Excellent Good Average Poor Extremely Poor N/A

  • Excellent
  • Good
  • Average
  • Poor
  • Extremely Poor
  • N/A

• Plumbing fixtures (taps, sinks, eyewash stations)

  Select Excellent Good Average Poor Extremely Poor N/A

  • Excellent
  • Good
  • Average
  • Poor
  • Extremely Poor
  • N/A

• Toilet fixtures (cisterns, pans, seats etc)

  Select Excellent Good Average Poor Extremely Poor N/A

  • Excellent
  • Good
  • Average
  • Poor
  • Extremely Poor
  • N/A

• Dispensers (toilet paper, paper towel, soap)

  Select Excellent Good Average Poor Extremely Poor N/A

  • Excellent
  • Good
  • Average
  • Poor
  • Extremely Poor
  • N/A

• Electrical fixtures (powerpoints, data points, switches, etc)

  Select Excellent Good Average Poor Extremely Poor N/A

  • Excellent
  • Good
  • Average
  • Poor
  • Extremely Poor
  • N/A

• Electrical distribution (switchboards, RCDs etc)

  Select Excellent Good Average Poor Extremely Poor N/A

  • Excellent
  • Good
  • Average
  • Poor
  • Extremely Poor
  • N/A

• AV equipment (projectorss, speakers etc)

  Select Excellent Good Average Poor Extremely Poor N/A

  • Excellent
  • Good
  • Average
  • Poor
  • Extremely Poor
  • N/A

• Hot & boiling water units

  Select Excellent Good Average Poor Extremely Poor N/A

  • Excellent
  • Good
  • Average
  • Poor
  • Extremely Poor
  • N/A

• Joinery (whiteboards, pinboards, benches, cupboards, shelving etc)

  Select Excellent Good Average Poor Extremely Poor N/A

  • Excellent
  • Good
  • Average
  • Poor
  • Extremely Poor
  • N/A

• Loose Furniture - chairs/seats/stools/lounges etc

  Select Excellent Good Average Poor Extremely Poor N/A

  • Excellent
  • Good
  • Average
  • Poor
  • Extremely Poor
  • N/A

• Loose Furniture - tables/desks

  Select Excellent Good Average Poor Extremely Poor N/A

  • Excellent
  • Good
  • Average
  • Poor
  • Extremely Poor
  • N/A

• Loose Furniture - other

  Select Excellent Good Average Poor Extremely Poor N/A

  • Excellent
  • Good
  • Average
  • Poor
  • Extremely Poor
  • N/A

• Whitegoods & Appliances (fridges, dishwashers, ovens, stoves etc)

  Select Excellent Good Average Poor Extremely Poor N/A

  • Excellent
  • Good
  • Average
  • Poor
  • Extremely Poor
  • N/A

• Signage

  Select Excellent Good Average Poor Extremely Poor N/A

  • Excellent
  • Good
  • Average
  • Poor
  • Extremely Poor
  • N/A

• Special Equipment (ITD/Manual Arts, Hospitality/Cooking, Sporting etc)

  Select Excellent Good Average Poor Extremely Poor N/A

  • Excellent
  • Good
  • Average
  • Poor
  • Extremely Poor
  • N/A

• Toilet Partitions/doors

  Select Excellent Good Average Poor Extremely Poor N/A

  • Excellent
  • Good
  • Average
  • Poor
  • Extremely Poor
  • N/A

• Operable Walls

  Select Excellent Good Average Poor Extremely Poor N/A

  • Excellent
  • Good
  • Average
  • Poor
  • Extremely Poor
  • N/A

• Security equipment

  Select Excellent Good Average Poor Extremely Poor N/A

  • Excellent
  • Good
  • Average
  • Poor
  • Extremely Poor
  • N/A

• EWIS equipment (speakers, detectors, sensors)

  Select Excellent Good Average Poor Extremely Poor N/A

  • Excellent
  • Good
  • Average
  • Poor
  • Extremely Poor
  • N/A

• Coldrooms

  Select Excellent Good Average Poor Extremely Poor N/A

  • Excellent
  • Good
  • Average
  • Poor
  • Extremely Poor
  • N/A

• Other (please specify)

  Select Excellent Good Average Poor Extremely Poor N/A

  • Excellent
  • Good
  • Average
  • Poor
  • Extremely Poor
  • N/A

Other Elements

• Garden areas

  Select Excellent Good Average Poor Extremely Poor N/A

  • Excellent
  • Good
  • Average
  • Poor
  • Extremely Poor
  • N/A

• Grassed areas

  Select Excellent Good Average Poor Extremely Poor N/A

  • Excellent
  • Good
  • Average
  • Poor
  • Extremely Poor
  • N/A

• Bio-Basin areas

  Select Excellent Good Average Poor Extremely Poor N/A

  • Excellent
  • Good
  • Average
  • Poor
  • Extremely Poor
  • N/A

• Carparks/internal roadways

  Select Excellent Good Average Poor Extremely Poor N/A

  • Excellent
  • Good
  • Average
  • Poor
  • Extremely Poor
  • N/A

• Stormwater swales/culverts etc

  Select Excellent Good Average Poor Extremely Poor N/A

  • Excellent
  • Good
  • Average
  • Poor
  • Extremely Poor
  • N/A

• Perimeter fencing & Gates

  Select Excellent Good Average Poor Extremely Poor N/A

  • Excellent
  • Good
  • Average
  • Poor
  • Extremely Poor
  • N/A

• Other - please specify

  Select Excellent Good Average Poor Extremely Poor N/A

  • Excellent
  • Good
  • Average
  • Poor
  • Extremely Poor
  • N/A

Comments

• Comments