Information

  • Audit Title

  • Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

GENERAL INFORMATION

  • Date and Time audit began

  • Name of business

  • Address of premises

  • Phone number

  • Name of proprietor or staff in attendance

  • ASC reference number

  • Name of inspector

  • Activities conducted

PREMISES DESIGN & WORKFLOW

  • Workflow and designated zones<br><br><br>

  • Hand wash facilities

  • Equipment sink

  • Suitability/ maintenance floors/walls/ceiling

  • Fittings/fixtures/equipment

  • Lighting & ventilation

CLEANING AND DISINFECTION

  • Collection containers for soiled instruments

  • Manual cleaning procedures

  • Disinfection processes:- Bleach/Thermal/Chemical

  • Equipment for manual cleaning

  • Process for accidental contamination of instruments/needles

  • Cleanliness of premises

  • Work surfaces

STORAGE & HANDLING OF EQUIPMENT & MATERIALS

  • Clean/sterile instruments and stock

  • Dispensing of bulk cream

  • Staff personal items

OPERATOR HYGIENE

  • Appropriate hand washing practices

  • Use of gloves

  • Personal hygiene

LINEN

  • Storage of soiled linen

  • Laundering of soiled linen

  • Storage of clean linen

OCCUPATION HEALTH & SAFETY

  • Immunisation

  • Training

  • Procedure for dealing with accidental bleeding

  • Procedure relating to occupational exposure

  • Personal protective equipment

  • Chemicals:- use and storage

WASTE

  • Contaminated instruments/ needles

  • Clinical and related waste

  • Handling and Disposal of Sharps

  • Other waste

WAXING

  • Application of skin disinfectant

  • Waxing procedures/ reuse of wax

  • After care advice

ELECTROLYSIS/ COSMETIC TATTOOING

  • Per-sterile/single use disposable needles

  • Application of skin disinfectant

MANICURE, PEDICURE AND NAIL TREATMENTS

  • Nail fungus and infections

  • Chemicals- minimising exposure

BODY / EAR PIERCING

  • Application of skin disinfectants

  • Use sterilised and appropriate jewellery

  • No equipment sharing

  • Use of aseptic techniques

TATTOOING

  • Application of skin disinfectants and lubricants

  • Use of single use inks, water for rinsing and stencils on each client

  • No equipment techniques

  • Use of aseptic techniques

  • Use of wipes/ paper towels

COLONIC IRRIGATION

  • Equipment to have ARTG number

  • Temperature of water 34'C-40'C

  • Single-use lubricant, gloves and wipes provided

  • Clean gowns, robes, towels provided

  • Adequate toilet and shower facilities

  • Use of single-use and sterile catheters

  • Use of single-use tubing

  • Equipment not connected directly to potable water

  • Equipment does not allow backflow of faecal matter into clean water

  • Water system filters

CLIENT CONSENT/ AFTER CARE (Piercing and tattoo only)

  • Client consent obtained

  • Transmission of disease

  • After care advice

ULTRASONIC CLEANERS

  • Preparation/Operation/Maintenance

OFF-SITE STERILISATION Reg. 24(b)(ii)

  • Off-site sterilisation - cleaning and transport

STERILISATION- PACKAGING & LOADING

  • Materials- suitable packaging and sufficient stock

  • Labelling - packaging labeled appropriately

  • Sealing - packaging correctly sealed

  • Loading - correct loading of steriliser

STERILISATION PROCESS

  • Monitoring of sterilisation process

  • Unloading

  • Validation of steriliser loads

  • Maintenance of steriliser

BEST PRACTICE RECORDS

  • Guidelines on-site

  • Cleaning schedule

  • Incident Record

  • Chemical Disinfection Record

  • Staff Training and Qualifications

  • Staff Immunisations

  • Client Procedure Record

  • Wax Temperature Record (reusable hard wax only)<br>

  • Documentation of off-site sterilisation

  • Sterilisation Monitoring Record

  • Ultrasonic Cleaner Test Record

  • Heat Sealer Test Record

  • Equipment Maintenance Record

  • Validation of Steriliser/ Load Record

FURTHER ACTION

  • Further Action?

REINSPECTION DATE

  • Select date

SIGNATURES

  • Signature of Proprietor/Staff

  • Signature of Officer

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.