Service Manager Visit Report

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

MAINTENANCE

MAIN TEST CERTIFICATES

• Kitchen Gas Safety

  In Date

  Overdue

  N/A

• THIS CERTIFICATE IS OVERDUE FOR RENEWAL. THIS INSPECTION MUST BE ARRANGED AS A MATTER OF URGENCY

• CONTRACTOR and DATE OF ISSUE

• Boiler Gas Safety

  In Date

  Overdue

  N/A

• THIS CERTIFICATE IS OVERDUE FOR RENEWAL. THIS INSPECTION MUST BE ARRANGED AS A MATTER OF URGENCY

• CONTRACTOR and DATE OF ISSUE

• Laundry Gas Safety

  In Date

  Overdue

  N/A

• THIS CERTIFICATE IS OVERDUE FOR RENEWAL. THIS INSPECTION MUST BE ARRANGED AS A MATTER OF URGENCY

• CONTRACTOR and DATE OF ISSUE

• 5 Year Periodic Electrical Examination

  In Date

  Overdue

  N/A

• THIS CERTIFICATE IS OVERDUE FOR RENEWAL. THIS INSPECTION MUST BE ARRANGED AS A MATTER OF URGENCY

• CONTRACTOR and DATE OF ISSUE

• Emergency Lighting

  In Date

  Overdue

  N/A

• THIS CERTIFICATE IS OVERDUE FOR RENEWAL. THIS INSPECTION MUST BE ARRANGED AS A MATTER OF URGENCY

• CONTRACTOR and DATE OF ISSUE

• Fire Alarm

  In Date

  Overdue

  N/A

• THIS CERTIFICATE IS OVERDUE FOR RENEWAL. THIS INSPECTION MUST BE ARRANGED AS A MATTER OF URGENCY

• CONTRACTOR and DATE OF ISSUE

• Nurse call System

  In Date

  Overdue

  N/A

• THIS CERTIFICATE IS OVERDUE FOR RENEWAL. THIS INSPECTION MUST BE ARRANGED AS A MATTER OF URGENCY

• CONTRACTOR and DATE OF ISSUE

• PAT Testing

  In Date

  Overdue

  N/A

• THIS CERTIFICATE IS OVERDUE FOR RENEWAL. THIS INSPECTION MUST BE ARRANGED AS A MATTER OF URGENCY

• CONTRACTOR and DATE OF ISSUE

• Fire Extinguishers

  In Date

  Overdue

  N/A

• THIS CERTIFICATE IS OVERDUE FOR RENEWAL. THIS INSPECTION MUST BE ARRANGED AS A MATTER OF URGENCY

• CONTRACTOR and DATE OF ISSUE

• Baths and Patient Hoists

  In Date

  Overdue

  N/A

• THIS CERTIFICATE IS OVERDUE FOR RENEWAL. THIS INSPECTION MUST BE ARRANGED AS A MATTER OF URGENCY

• CONTRACTOR and DATE OF ISSUE

• Passenger Lifts

  In Date

  Overdue

  N/A

• THIS CERTIFICATE IS OVERDUE FOR RENEWAL. THIS INSPECTION MUST BE ARRANGED AS A MATTER OF URGENCY

• CONTRACTOR and DATE OF ISSUE

• Water Chlorination

  In Date

  Overdue

  N/A

• THIS CERTIFICATE IS OVERDUE FOR RENEWAL. THIS INSPECTION MUST BE ARRANGED AS A MATTER OF URGENCY

• CONTRACTOR and DATE OF ISSUE

WEEKLY / MONTHLY IN HOUSE CHECKS

• ARE THE FOLLOWING INSPECTIONS UP TO DATE AND RECORDED

• DORGARD INSPECTION

• NOTE

• EMERGENCY LIGHT TESTS

• NOTE

• FIRE ALARM TESTS

• NOTE

• NURSE CALL INSPECTION

• NOTE

• WATER TEMPERATURE RECORDING

• NOTE

• CO LEVEL MONITORING

• NOTE

• BED RAILS and BED BRAKE INSPECTIONS

• NOTE

• WINDOW RESTRICTOR INSPECTIONS

• NOTE

• WHEELCHAIR INSPECTIONS

• NOTE

• HAS A FIRE DRILL BEEN CARRIED OUT IN THE LAST 3 MONTHS FOR DAY STAFF AND 6 MONTHS FOR NIGHT STAFF ?

  Yes

  No

  N/A

• HOME IS TO CARRY OUT FIRE DRILLS AND UPDATE THE REGISTER ASAP

KITCHEN

• Are the Kitchen COSHH sheets in place and up-to date ?

  Yes

  No

  N/A

• TO BE RESOLVED ASAP

• Are the COSHH Risk Assessments in place ?

  Yes

  No

  N/A

• TO BE RESOLVED ASAP

• Are Hygiene Schedules in place and in opration ?

  Yes

  No

  N/A

• TO BE RESOLVED ASAP

• Are SAFER FOOD BETTER BUSINESS Records and schedules in place and in use ?

  Yes

  No

  N/A

• TO BE RESOLVED ASAP

• Is recording of Freezer and Fridge temperatures up to date ?

  Yes

  No

  N/A

• TO BE RESOLVED ASAP

• Are both the Kitchen and Storage areas clean and tidy ?

  Yes

  No

  N/A

• TO BE RESOLVED ASAP

DOMESTICS

• Are the COSHH sheets in place and up-to date ?

  Yes

  No

  N/A

• TO BE RESOLVED ASAP

• Are the COSHH Risk Assessments in place ?

  Yes

  No

  N/A

• TO BE RESOLVED ASAP

• Are cleaning schedules in place and up-to date ?

  Yes

  No

  N/A

• TO BE RESOLVED ASAP

• Are chemicals stored away safely ?

  Yes

  No

  N/A

• TO BE RESOLVED ASAP

• Does the home look and smell clean ?

  Yes

  No

  N/A

• TO BE RESOLVED ASAP

• Is a DEEP CLEAN regime in place for all areas in the home ?

  Yes

  No

  N/A

• TO BE PUT IN PLACE ASAP

FIRE ESCAPE ROUTES

• Are Fire Escape routes clear of obstruction ?

  Yes

  No

  N/A

• TO BE RESOLVED IMMEDIATELY

• Are corridors free of obstructions

  Yes

  No

  N/A

• TO BE RESOLVED IMMEDIATELY

• Are Fire Extinguishers signed correctly ?

  Yes

  No

  N/A

• TO BE RESOLVED IMMEDIATELY

• Are Fire Notices correctly filled out and displayed ?

  Yes

  No

  N/A

• TO BE RESOLVED IMMEDIATELY

• Are Fire Extinguishers signed correctly ?

  Yes

  No

  N/A

• TO BE RESOLVED IMMEDIATELY

EXTERNALLY

• Are garden areas neat, tidy and free of litter.

  Yes

  No

  N/A

• Note areas that need attention

• Are car park areas neat, tidy and free of litter.

  Yes

  No

  N/A

• Note areas that need attention

• Are there any other issues to note in or around the building ?

  Yes

  No

• Note areas that need attention