Radiation Safety and Protection Plan

• Site conducted

  Select

• Nominee

• Possession Licensee

• Possession licence number

• Radiation practice(s)

• Date(s) of audit

  Date

• Prepared by

• Location
  Address

• Note to the Radiation Safety Officer (RSO)
  This checklist is used to record whether the radiation practice is complying with some of the basic requirements of the Radiation Safety Act 1999 and the practice's approved Radiation Safety and Protection Plan(RSPP).
  Items are to be marked as Yes, No or N/A (not applicable). Some items will have a clear answer; others require a judgment based on the extent of compliance. A mark of Yes is one that indicates compliance with the Act or a satisfactory level of radiation safety.

1.1 Declaration

• Radiation Safety Officer is to complete this section when the audit is complete

• Name and Signature of Radiation Safety Officer

  Sign

• Date

  Date

• Possession Licensee I Nominee is to complete this section upon receipt of this checklist

• Signature

  Sign

• Date

  Date

• An answer of No to any of the items in this checklist normally indicates a possible breach of the Radiation Safety Act 1999 or non-compliance with your approved Radiation Safety and Protection Plan. It is likely that you will need to take action to remedy this. Check the RSO report on the last page for recommendations for action

1.2 Licensing and authorized used of radiation sources

Possession Licence

• • Is the possession licence current?

  Yes

  No

  N/A

• What is the expiry date?

  Date

• • Do the authorities listed on the possession licence cover all the radiation practices conducted?

  Yes

  No

  N/A

• • if there are conditions on the licence, have all these conditions been complied with?

  Yes

  No

  N/A

Radiation Safety Officer

• The RSO must either hold a relevant RSO certificate, or be in one of the categories of person mentioned in Section 27 of the Radiation Safety Regulation.

• For each RSO who holds a certificate:

• • Is the RSO certificate current?

  Yes

  No

  N/A

• What is the expiry date?

  Date

• Do the authorities listed on the certificate cover the radiation practices conducted?

  Yes

  No

  N/A

Authorised Persons

• Requests for a radiation procedure can only be made by an Authorised Person (see Rags Schedule 3A). Alternatively an Authorised Person may have a written protocol allowing a referral from a non-authorised person to be considered a request.

• • Are all radiation procedures requested by an Authorised Person (either directly or via protocol)?

  Yes

  No

  N/A

• • Are all request forms completed as described in the RSPP?

  Yes

  No

  N/A

Use Licence

• Are all persons using a radiation source appropriately licensed or otherwise under the Act?<br><br>These persons must either - <br>- hold a current and appropriate use licence, or<br>- be exempt under the Act. Also check for any conditions attached to use licenses

  Yes

  No

  N/A

Authorised use of radiation sources

• • Are all persons using a radiation source authorised by the possession licensee to use the source?

  Yes

  No

  N/A

• Check the RSPP for details about authorised use of radiation sources.

• • Is access to, or use of, radiation sources adequately controlled?

  Yes

  No

  N/A

1.3 Training

• • Has the RSO provided the training described in the RSPP?

  Yes

  No

  N/A

• • Have all the persons who are required to participate In the training, done so?

  Yes

  No

  N/A

1.4 Radiation sources and premises

• Were Approvals to Acquire obtained for each radiation source purchased in the past

• • Is the radiation source inventory correct?

  Yes

  No

  N/A

• • Does each radiation source in use have a current and appropriate certificate of compliance?

  Yes

  No

  N/A

• • Does each premises in use have a current and appropriate certificate of compliance?

  Yes

  No

  N/A

• • Were Approvals to Relocate obtained for each radiation source permanently relocated outside of Queensland in the past year?

  Yes

  No

  N/A

• • If radiation sources have been disposed of, are there records of the disposal?

  Yes

  No

  N/A

1.5 Radiation safety and protection plan (RSPP)

• • Can the approved RSPP be located?

  Yes

  No

  N/A

• • Is the approved RSPP available to all persons using radiation sources?

  Yes

  No

  N/A

• • Has the RSPP been reviewed within the past year or as described In the RSPP?

  Yes

  No

  N/A

• • Have the results of any review been reported to the possession licensee?

  Yes

  No

  N/A

1.6 Radiation Monitoring

• This section is only relevant if the RSPP requires require personal monitoring devices to be provided

• • Are personal monitoring devices provided to all persons who need to be monitored as described in the RSPP?

  Yes

  No

  N/A

• • Are all monitored persons advised of the results of the dose assessment?

  Yes

  No

  N/A

• • Is the personal monitoring record for each monitored person up-to-date?

  Yes

  No

  N/A

• • Are personal alarm dosemeters supplied, checked, and used as described in the RSPP?

  Yes

  No

  N/A

1.7 Safety devices, personal protective equipment and radiation monitoring equipment

• • Are safety devices supplied, checked, and used as described in the RSPP?

  Yes

  No

  N/A

• • Is personal protective equipment supplied, checked, and used as described in the RSPP?

  Yes

  No

  N/A

• • Is radiation monitoring equipment supplied, checked (or calibrated), and used as described in the RSPP?

  Yes

  No

  N/A

1.8 Making an exposure

• • Is the exposure register completed as described in the RSPP?

  Yes

  No

  N/A

• • Are radiographs marked with the information described in the RSPP?

  Yes

  No

  N/A

• • Are the QC tests as described in the RSPP being performed?

  Yes

  No

  N/A

1.9 Radiation Incidents (Act s45)

• • Are dangerous events reported to Radiation Health? • Are radiation Incidents managed as described In the RSPP?

  Yes

  No

  N/A

• • Are radiation Incidents managed as described in the RSPP?

  Yes

  No

  N/A

1.10 RSO report to Possession Licensee

• Record here any items that need to be reported such as: • action that the Possession Licensee must take to remedy a breach of the Radiation Safety Act 1999 results of any review of the RSPP • areas of non-compliance with the RSPP • recommendations arising from the audit

Report

• Details

Sign Off

• Prepared by

  Sign