Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Chair

  • Top surface and base of chair

  • Behind headrest and adjustment knob

  • Side panels

  • Under arm rest

Bracket table

  • Under tray and rim

  • Side handles

  • Top surface

Switch panel

  • Below switch panel and buttons

  • Bottom surface

  • Top surface

Hand piece Bracket

  • Outer surface

  • Hand piece cradle, buttons, and groves around buttons

  • Hand piece tubing and inner coupling grooves

Light

  • Arm

  • Light cover and switch

  • Handles

Bench Tops

  • Clean area

  • Contaminated area

  • Clerical area

Suction Bracket

  • Outer surfaces

  • Underneath

  • Hand piece cradle, buttons, and inner rim of buttons

  • Hand piece tubing - wiping the entire tube

Cuspidor

  • Inner bowl & upper ridge includes water- activator buttons

  • Spittoon filter and inner rim

X-ray Unit

  • Cone

  • Head

  • Arm

  • Outer trigger button and inner control pad

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