Audit Checklist Forms Audit Checklist Compiled form with Activity Resources, Evac Bag, Participant File, PPE & Infection Control and Staff Personnel Files Choose which form to completeActivity Resource AuditEvac Bag AuditParticipant File AuditPPE & Infection Control StockStaff Personnel File AuditActivity Resource Audit ChecklistAudit Frequency: Quarterly Quarter (please choose one)(Required)January - MarchApril - JuneJuly - SeptemberOctober - DecemberLocation/ Program Area(Required)Jean & Thally'sMary's PlaceFloras PlaceAnnies PlaceItems Present(Required) Activity materials available Resources safe and in good condition Sensory resources available Arts / creative materials stocked Outdoor activity equipment available Damaged items removed or replaced Outcome of Audit(Required)Comments / Actions RequiredCompleted By(Required) First Last Signature(Required)Date(Required) Emergency Evacuation Bag Audit ChecklistAudit Frequency: 12 Monthly Quantity: 1Location/ Program Area(Required)Jean & Thally'sMary's PlaceFloras PlaceAnnies PlaceChecked By(Required) First Last Date of Check(Required) Items Present(Required) Evacuation bag present and clearly labelled First aid kit included Disposable gloves available Hand sanitiser available Emergency blankets Torch (working) Spare batteries for torch Whistle or alert device Basic stationery (pen / marker) Bag easily accessible and not obstructed Bag condition good (zip, straps, waterproofing) Non-perishable food Issues Identified(Required)Action Required(Required)Follow-up Required(Required) Yes No Follow-up Date Participant File Audit ChecklistAudit Frequency: Quarterly Sample Size: Minimum 10% of participant files per quarterQuarter (please choose one)(Required)January - MarchApril - JuneJuly - SeptemberOctober - DecemberParticipant Name(Required) First Last Items Present(Required) Participant profile present Risk assessment current Behaviour Support Plan current (if applicable) BSP signed where required Medication documentation completed Medication chart signatures complete Documents filed in correct sections Information consistent with CTARS Outcome of Audit(Required)Comments / Actions RequiredReviewed By(Required) First Last Signature(Required)Date(Required) PPE & Infection Control Stock Audit ChecklistAudit Frequency: Quarterly Quarter (please choose one)(Required)January - MarchApril - JuneJuly - SeptemberOctober - DecemberLocation/ Program Area(Required)Jean & Thally'sMary's PlaceFloras PlaceAnnies PlaceDate of Check(Required) Items Present(Required) Disposable gloves available and stocked Hand sanitiser available Disposable gowns available Safety goggles / eye protection available Vomit bags available Face masks available Cleaning wipes / disinfectant available PPE stored appropriately and accessible No expired PPE or infection control products Outcome of Audit(Required)Comments / Actions RequiredReviewed By(Required) First Last Signature(Required)Date(Required) Staff Personnel File Audit ChecklistSt Anthony’s Family Care – Disability Services Audit Frequency: Quarterly Sample Size: Minimum 10% of staff personnel files per quarter Quarter (please choose one)(Required)January - MarchApril - JuneJuly - SeptemberOctober - DecemberStaff Member Name(Required) First Last Position(Required)Items Present(Required) 100 Point Identification Verification Signed Contract of Employment NDIS Worker Screening Check Verified Working With Children Check (WWCC) Verified Signed Policies and Procedures Acknowledgement NDIS Code of Conduct Signed First Aid Certificate Current CPR Certificate Current Driver’s Licence Current (if applicable) Car Insurance Provided (if applicable) Training Register Record Up to Date Mandatory Training Completed Performance Appraisal Current Outcome of Audit(Required)Comments / Actions RequiredReviewed By(Required) First Last Signature(Required)
