UHSC Health Premises Inspection Report

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Business details

• Trading name

• Business Address

• Postal Address (if different)

• Owners name

• Person Interviewed

• Email address

• Phone number

• Date

  Date

Activities undertaken at the site

• Hairdressing / Barber

  Yes

  No

  N/A

• Beauty / Waxing

  Yes

  No

  N/A

• Manicure / Pedicure

  Yes

  No

  N/A

• Skin Penetration / Tattooing / Piercing

  Yes

  No

  N/A

• Add media

  Media

• Other

  Yes

  No

  N/A

Cleanliness of Premises

• Floors, walls and ceiling are suitably constructed and maintained in a clean / hygienic condition

  Yes

  No

  N/A

• Shelves, cupboards and benches are suitably constructed and maintained in a clean condition

  Yes

  No

  N/A

• Equipment is clean, dry and in good working order

  Yes

  No

  N/A

Hand washing and cleaning facilities

• Adequate hand washing facilities provided

  Yes

  No

  N/A

• Hand washing facilities provided with liquid soap and single use towels

  Yes

  No

  N/A

• Adequate facilities provided for cleaning / disinfection / sterilisation of equipment

  Yes

  No

  N/A

• Hospital grade disinfectant used

  Yes

  No

  N/A

Waste disposal

• Suitable waste bins provided

  Yes

  No

  N/A

• Sharps bin provided and emptied regularly

  Yes

  No

  N/A

• Commercial waste contractor

  Yes

  No

  N/A

Skin Penetration

• Articles used to penetrate the skin are sterile

  Yes

  No

  N/A

• Sterile equipment discarded or reprocessed if package is damaged

  Yes

  No

  N/A

• Single use items disposed of after use

  Yes

  No

  N/A

• Records for each sterilisation cycle provided - date, time held, temp and pressure held, faults, etc

  Yes

  No

  N/A

• Appropriate PPE provided and worn - eg gloves / apron,

  Yes

  No

  N/A

Hairdressing / barbers

• Scissors / brushes / combs / clippers are clean

  Yes

  No

  N/A

• Brush and roller trays are clean

  Yes

  No

  N/A

• Single use items (including razors) disposed of after use

  Yes

  No

  N/A

Beauty salons

• Single use equipment for use of wax / liquids / gels

  Yes

  No

  N/A

• Equipment and contact surfaces cleaned and disinfected between uses

  Yes

  No

  N/A

General

• Clean linen / towels provided

  Yes

  No

  N/A

• Smoking observed with the premises

  Yes

  No

  N/A

• Evidence of pest activity observed

  Yes

  No

  N/A

• Construction and fit out of premises is suitable for the use activities undertaken at the premises - smooth impervious and easily cleanable

  Yes

  No

  N/A

Comments

• Additional information / comments

• Re-inspection required

  Yes

  No

  N/A

• Re-inspection Due on or after

  Date

• Add media

  Media