RCF Monthly Inspection MHH

• Facility

• Conducted on

  Date

• Prepared by

• Location
  Address

• For each item identified below, assess the current condition or status of the item and determine the course of action required, if any.
  
  Provide detail on a site map if necessary.
  
  Review action list with the Facility Manager, and request work orders to be raised by the site for any action required.
  
  If escalation is required, refer to A&I Helpdesk at aihelpdesk@scrosswa.org.au

OVERALL APPEARANCE of FACILITY

• 1. Overall appearance of the Facility entrance area

  Good

  Fair

  Poor

  N/A

• 2. Overall appearance of the Facility grounds

  Good

  Fair

  Poor

  N/A

• 3. Overall appearance of the Facility buildings & exterior areas

  Good

  Fair

  Poor

  N/A

• 4. Overall appearance of the Facility paths, walkways & driveways

  Good

  Fair

  Poor

  N/A

• 5. Overall appearance of the Facility internal common areas

  Good

  Fair

  Poor

  N/A

• Commercial kitchen and staff areas

  Good

  Fair

  Poor

  N/A

Emilie

• Overall appearance of wing

  Good

  Fair

  Poor

  N/A

• Overall appearance of kitchen

  Good

  Fair

  Poor

  N/A

• Overall appearance of common areas

  Good

  Fair

  Poor

  N/A

• Hazards to report

  Good

  Fair

  Poor

  N/A

Euphrasie

• Overall appearance of wing

  Good

  Fair

  Poor

  N/A

• Overall appearance of kitchen

  Good

  Fair

  Poor

  N/A

• Overall appearance of common areas

  Good

  Fair

  Poor

  N/A

• Hazards to report

  Good

  Fair

  Poor

  N/A

Mackillop

• Overall appearance of wing

  Good

  Fair

  Poor

  N/A

• Overall appearance of kitchen

  Good

  Fair

  Poor

  N/A

• Overall appearance of common areas

  Good

  Fair

  Poor

  N/A

• Hazards to report

  Good

  Fair

  Poor

  N/A

Nagle

• Overall appearance of wing

  Good

  Fair

  Poor

  N/A

• Overall appearance of kitchen

  Good

  Fair

  Poor

  N/A

• Overall appearance of common areas

  Good

  Fair

  Poor

  N/A

• Hazards to report

  Good

  Fair

  Poor

  N/A

SAFETY INSPECTION

• 7. Inspect all paths of travel for trip hazards or skin tear risks; all driveways are clear of obstruction and line of sight hazards

  Good

  Fair

  Poor

  N/A

• 8. Check evacuation paths are clear from obstruction (bins, pots etc)

  Good

  Fair

  Poor

  N/A

• 9. Check fire systems (hydrants, extinguishers etc) are clear from vegetation & obstructions and signage is clear

  Good

  Fair

  Poor

  N/A

• 10. Check for any other potential hazards on site (broken glass, rusted handrails, loose brickwork, pot-holes in driveways, bin lids unable to be lifted, sharp edges to touch points, sprinkler pop ups too high, low hanging branches etc)

  Good

  Fair

  Poor

  N/A

EXTERNAL COMMON AREAS

• 13. Condition of fences, gates and locks

  Good

  Fair

  Poor

  N/A

• 14. Condition of footpaths & walkways

  Good

  Fair

  Poor

  N/A

• 15. Condition of driveways, hardstand areas & car park areas

  Good

  Fair

  Poor

  N/A

• 16. Condition of all garden areas, including trees, lawn & gardens

  Good

  Fair

  Poor

  N/A

• 18. Condition of Roof & Gutters (visual only)

  Good

  Fair

  Poor

  N/A

• 19. Condition of external doors & windows

  Good

  Fair

  Poor

  N/A

INTERNAL COMMON AREAS

• 21. Condition of floor coverings

  Good

  Fair

  Poor

  N/A

• 22. Condition of window coverings

  Good

  Fair

  Poor

  N/A

• 23. Condition of kitchen, bathroom & toilet facilities

  Good

  Fair

  Poor

  N/A

• 24. Condition of common areas

  Good

  Fair

  Poor

  N/A

SIGN OFF

• Maintenance Worker's Name and Signature

  Sign