Information

  • Audit Title

  • Conducted on

  • Prepared by

  • Inspection Result

Business details

  • Trading name

  • ABN

  • Proprietor/owner

  • Phone

  • Email

  • Person interviewed

  • Inspection type

  • Procedures conducted

Premise

Hand wash basin

  • Hand wash basin is installed at bench height and is easily accessible

  • Select date

  • Hand wash basin is clearly designated for hand washing only

  • Select date

  • Hand wash basin is supplied with liquid soap and single use paper towels

  • Hand wash basin is provided with a supply of warm water mixed from a hot and cold water supply through a single outlet

  • Select date

  • Select date

Equipment cleaning sink

  • Premise equipped with a separate cleaning sink of an adequate size and capacity

  • Select date

  • Equipment cleaning sink is provided with a supply of warm water mixed from a hot and cold water supply through a single outlet

  • Select date

Premise/fixtures/fittings/furniture

  • Fixtures, fittings and furniture are in a good state of repair, smooth, impervious to moisture and capable of being easily and effectively cleaned

  • Select date

  • A clean, dust free environment is provided for clean equipment

  • Select date

  • Soiled and clean equipment are stored separately

  • Select date

  • Chemicals are stored and handled in accordance with SDS

  • Select date

  • Chemical containers are appropriately labelled

  • Select date

  • Add media

  • Appropriate ventilation is installed in the premises

  • Select date

Waste

  • Waste bin provided in each treatment room

  • Select date

  • Sharps bin provided in each treatment room that complies with AS/NZS 4261:1994 or AS/NZS 4031:1992

  • Select date

  • A licensed waste transporter is used for the collection and disposal of sharps waste

  • Select date

Hygiene

  • Premise, fixtures, fittings and equipment kept clean, free from dust and other visible matter

  • Select date

  • Operator washes hands before and after each treatment and when treatment is interrupted

  • Select date

  • Single use gloves are worn during all skin penetration procedures and are promptly discarded after each treatment

  • Select date

  • Skin undergoing treatment with suitable antiseptic prior to commencement of treatment

  • Select date

  • Single use items are disposed of after each use

  • Select date

  • Liquids/gels are decanted into a clean dish/container for each client. Anything unused is disposed of immediately after use

  • Select date

  • Soiled and clean equipment are processed separately to avoid cross contamination

  • Select date

  • Linen is changed after each client

  • Select date

  • Sharps are disposed into a sharps container immediately after use<br>

  • Select date

  • Evidence of smoking, eating or drinking in the treatment rooms

  • Select date

  • An equipped first aid kit is available on site

  • Select date

Equipment processing

  • Reusable equipment cleaned in warm soapy water, disinfected and dried prior to reuse

  • Select date

  • All equipment penetrating the skin are sterile

  • Select date

Servicing and record keeping

  • SDS for all hazardous substances used are provided onsite

  • Autoclaves are tested, serviced regularly and calibrated at least once per year by a qualified service technician

  • Select date

  • Records of sterilisation including date, time, number of items processed, duration, maximum temperature, maximum pressure and faults with cycle are kept onsite

  • Select date

Inspection results

  • Comments

  • Forms to be submitted to Council

  • Inspection rating

Council details

  • Name of officer

  • Phone: (02) 9748 9999 Fax: (02) 9764 1034 Email: council@strathfield.nsw.gov.au

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.