2019 Equip Safety & Cal Report CFHC Winter Haven

American Bio~Medics Work Order #: 23740

Equipment Data MediMizer™

Control #: 2656 Description: Charger Base, Tympanometer
Manufacturer: Welch Allyn Inc. Model #: 71123
Status: In Service
Serial #: NSN2656
Work Order PO #:

Facility: CFHC Winter Heaven
Department: Laboratory

Location: Winter Haven, FL System:

Floor: 1 Room #: Desk Building:

Risk Priority: 0 Last Seen: 03/01/19 Inspections: Last:03/01/19 Next: 03/01/20 Safety and Performance

Warranty Expires: Parts: / / Labor: / /

Old Control #:

Work Order Data

Work Order Type: Inspection, P.M. or S.P.R. Requested On: 03/01/19 12:00 AM Due: 03/31/19
Person Requesting: Scheduled Phone:
Service Requested: Safety and Performance.

Date WO # Service Requested Past Service Information Service

03/01/19 23740 Safety and Performance. Completed All Scheduled Inspect
03/09/18 21602 Safety and Performance. Completed All Scheduled Inspect
03/10/17 19785 Safety and Performance. Completed All Scheduled Inspect

Date Tech Verb Noun Minutes R Service Entry Area Part # Qty Unit Cost Description

Date Tech Verb Noun Minutes R

Service Information for this Work Order

Emanuel Colon (Employee)

03/01/19 4 minutes Completed All Scheduled Inspections (Quick Entry)

Passed: CHECK INTEGRETY OF CASE AND CONDITION OF CHARGER

Passed: CHECK OVERALL CONDITION OF UNIT FOR DAMAGE

Passed: CHECK HEARING TUBES

Passed: CHECK CONDITION OF LEAD WIRES

Passed: CHECK FOR PROPER OPERATION OF ALL CONTROLS AND INDICATORS

Passed: PERFORM FUNCTION TEST ACCORDING TO MFG INSTRUCTIONS IN TECH MANUAL

Passed: CALIBRATE IF NECESSARY FOLLOWING MFG INSTRUCTIONS

Passed: CHECK THAT ALL ACCESSORIES OPERATE PROPERLY

03/18/19 07:26 PM Page 1

American Bio~Medics Work Order #: 23741

Equipment Data MediMizer™

Control #: 2657 Description: TYMPANOMETER
Manufacturer: Welch Allyn Inc. Model #: 23300
Status: Unit Not Located
Serial #: 201601216
Work Order PO #:

Facility: CFHC Winter Heaven
Department: Laboratory

Location: Winter Haven, FL System:

Floor: 1 Room #: Desk Building:

Risk Priority: 0 Last Seen: 03/09/18 Inspections: Last:03/09/18 Next: 03/01/20 Performance

Warranty Expires: Parts: / / Labor: / /

Old Control #:

Work Order Data

Work Order Type: Inspection, P.M. or S.P.R. Requested On: 03/01/19 12:00 AM Due: 03/31/19
Person Requesting: Scheduled Phone:
Service Requested: Performance.

Notes: Unable to locate.

Date WO # Service Requested Past Service Information Service

03/01/19 23741 Performance. Unit Not Located
03/09/18 21603 Performance. Completed All Scheduled Inspect
03/10/17 19786 Performance. Completed All Scheduled Inspect

Date Tech Verb Noun Minutes R Service Entry Area Part # Qty Unit Cost Description

Date Tech Verb Noun Minutes R

Service Information for this Work Order

Emanuel Colon (Employee)

03/01/19 2 minutes Unit Not Located (Quick Entry)

03/18/19 07:26 PM Page 1

American Bio~Medics Work Order #: 23452

Equipment Data MediMizer™

Control #: 2658 Description: NEBULIZER, ULTRASONIC
Manufacturer: Drive Medical Design and Manufacturing Model #: 18080
Status: In Service
Serial #: 13S150309795
Work Order PO #:

Facility: CFHC Winter Heaven
Department: Adult Triage

Location: Winter Haven, FL System:

Floor: 1 Room #: Desk Building:

Risk Priority: 3 Last Seen: 03/01/19 Inspections: Last:03/01/19 Next: 03/01/20 Safety, Performance and

Warranty Expires: Parts: / / Labor: / /

Old Control #:

Work Order Data

Work Order Type: Inspection, P.M. or S.P.R. Requested On: 03/01/19 12:00 AM Due: 03/31/19
Person Requesting: Scheduled Phone: (813) 413-8600
Service Requested: Safety, Performance and PM.

Notes: Unit has two prong plug.

Date WO # Service Requested Past Service Information Service

03/01/19 23452 Safety, Performance and PM. Completed All Scheduled Inspect
03/09/18 21518 Safety, Performance and PM. Completed All Scheduled Inspect
03/10/17 19782 Safety, Performance and PM. Completed All Scheduled Inspect

Date Tech Verb Noun Minutes R Service Entry Area Part # Qty Unit Cost Description

Date Tech Verb Noun Minutes R

Service Information for this Work Order

Emanuel Colon (Employee)

03/01/19 4 minutes Completed All Scheduled Inspections (Quick Entry)

Passed: Perform Safety according to manual

Passed: CHECK UNIT FOR SIGNS OF DAMAGE

Passed: CHECK AND CLEAN LINT FILTER AND WATER TUBE.

Passed: CHECK FOR WATER LEAKAGE

Passed: VERIFY PROPER OUTPUT PARAMETERS ACCORDING TO MFG SPECS

Passed: CHECK ULTRASONIC OUTPUT FOR SHARP WATER CONE AND MISTING.

Passed: CHECK OPERATION OF LOW-WATER CUT-OFF CIRCUIT.

Passed: CHECK INTERIOR FOR SIGNS OF ELECTRICAL OR WATER DAMAGE.

Passed: TUNE UNIT ACCORDING TO MFG INSTRUCTIONS

Passed: CLEAN INTERIOR AND EXTERIOR OF UNIT

Passed: TIGHTEN ALL HARDWARE

03/18/19 07:26 PM Page 1

American Bio~Medics Work Order #: 23620

Equipment Data MediMizer™

Control #: 2803 Description: Battery Charger, Vaginal Speculum
Manufacturer: Welch Allyn Inc. Model #: 74011
Status: In Service
Serial #: NSN2803
Work Order PO #: Pref. Team: CLINENG
Team Leader:
Facility: CFHC Winter Heaven
Department: Adult Triage

Location: Winter Haven, FL System:

Floor: 1 Room #: Building:

Risk Priority: 4 Last Seen: 03/01/19 Inspections: Last:03/01/19 Next: 03/01/20 Safety, Performance and

Warranty Expires: Parts: / / Labor: / /

Old Control #:

Work Order Data

Work Order Type: Inspection, P.M. or S.P.R. Requested On: 03/01/19 12:00 AM Due: 03/31/19
Person Requesting: Scheduled Phone: (813) 413-8600
Service Requested: Safety, Performance and PM.

Date WO # Service Requested Past Service Information Service

03/01/19 23620 Safety, Performance and PM. Completed All Scheduled Inspect
03/09/18 22390 Safety, Performance and PM. Completed All Scheduled Inspect

Date Tech Verb Noun Minutes R Service Entry Area Part # Qty Unit Cost Description

Date Tech Verb Noun Minutes R

Service Information for this Work Order

Emanuel Colon (Employee)

03/01/19 4 minutes Completed All Scheduled Inspections (Quick Entry)

Passed: CHECK ELECTRICAL SAFETY

Passed: CHECK CONDITION OF POWER CORD AND PLUG

Passed: CHECK OVERAL CONDITION OF HARDWARE ON DEVICE, LATCHES, HOSES AND COVERS.

Passed: CHECK MECHANICAL INTEGRITY OF ALL CONTROLS AND SWITCHES

Passed: CHECK DC OUTPUT OF IN LINE POWER TRANSFORMER: 5vDC 1400mA

Passed: IF APPLICABLE, CHECK BATTERIES CONDITION AND REPLACE ,IF NECESSARY.

Passed: CHECK CHARGER INDICATOR FOR PROPER OPERATION.

Passed: CHECK ACCURACY OF THE CHARGING CURRENT INCLUDING SPECIAL MODES.

Passed: VERIFY OUTPUT OF BATTERY WITH DVM UNDER LOAD AND NO-LOAD CONDITIONS.

Passed: CHECK HIGH AND LOW HEART RATE ALARMS FOR OPERATION. (DATASCOPE 990 UNITS)

Passed: INSPECT BATTERY FOR LEAKAGE AND CORROSION.

Passed: CHECK BATTERY INSTALLATION DATE. REPLACE PER MANUFACTURER'S RECOMENDATION.

03/18/19 07:26 PM Page 1

American Bio~Medics Work Order #: 23621

Equipment Data MediMizer™

Control #: 2804 Description: SCALER, DENTAL
Manufacturer: Dentsply International Model #: GEN-137
Status: In Service
Serial #: G137-07107
Work Order PO #: Pref. Team: CLINENG
Team Leader:
Facility: CFHC Winter Heaven
Department: Adult Triage

Location: Winter Haven, FL System:

Floor: 1 Room #: Building:

Risk Priority: 0 Last Seen: 03/01/19 Inspections: Last:03/01/19 Next: 03/01/20 Safety and Performance

Warranty Expires: Parts: / / Labor: / /

Old Control #:

Work Order Data

Work Order Type: Inspection, P.M. or S.P.R. Requested On: 03/01/19 12:00 AM Due: 03/31/19
Person Requesting: Scheduled Phone: (813) 413-8600
Service Requested: Safety and Performance.

Date WO # Service Requested Past Service Information Service

03/01/19 23621 Safety and Performance. Completed All Scheduled Inspect
03/09/18 22391 Safety and Performance. Completed All Scheduled Inspect

Date Tech Verb Noun Minutes R Service Entry Area Part # Qty Unit Cost Description

Date Tech Verb Noun Minutes R

Service Information for this Work Order

Emanuel Colon (Employee)

03/01/19 5 minutes Completed All Scheduled Inspections (Quick Entry)

Passed: CHECK ELECTRICAL SAFETY

Passed: CHECK GROUND RESISTANCE {pass < .5 OHMS} .11 Ohms

Passed: CHECK ELECTRICAL LEAKAGE {pass < 300 uA} 95.7 uA

Passed: CHECK OVERAL CONDITION OF HARDWARE ON DEVICE, LATCHES, HOSES AND COVERS.

Passed: CHECK MECHANICAL INTEGRITY OF ALL CONTROLS AND SWITCHES

Passed: CHECK CONDITION OF POWER CORD AND PLUG

Passed: CHECK HARDWARE AND CABLES INTEGRITY.

Passed: CHECK OPERATION OF ALL CONTROLS.

Passed: CHECK UNIT FOR SIGNS OF DAMAGE.

03/18/19 07:26 PM Page 1

American Bio~Medics Work Order #: 23742

Equipment Data MediMizer™

Control #: 2946 Description: GLUCOSE ANALYZER
Manufacturer: Hemocue Incorporated Model #: 201
Status: In Service
Serial #: 1813119043
Work Order PO #:

Facility: CFHC Winter Heaven
Department: Laboratory

Location: Lab - CFHC Winter Haven System:

Floor: 1 Room #: Lab Building:

Risk Priority: 0 Last Seen: 03/01/19 Inspections: Last:03/01/19 Next: 03/01/20 Safety, Performance and

Warranty Expires: Parts: / / Labor: / /

Old Control #:

Work Order Data

Work Order Type: Inspection, P.M. or S.P.R. Requested On: 03/01/19 12:00 AM Due: 03/31/19
Person Requesting: Scheduled Phone:
Service Requested: Safety, Performance and PM.

Date WO # Service Requested Past Service Information Service

03/01/19 23742 Safety, Performance and PM. Completed All Scheduled Inspect
09/14/18 22947 New equipment inspection. New Equipment Inspection

Date Tech Verb Noun Minutes R Service Entry Area Part # Qty Unit Cost Description

Date Tech Verb Noun Minutes R

Service Information for this Work Order

Emanuel Colon (Employee)

03/01/19 4 minutes Completed All Scheduled Inspections (Quick Entry)

Passed: CHECK OVERAL CONDITION OF HARDWARE ON DEVICE, LATCHES, HOSES AND COVERS.

Passed: CHECK MECHANICAL INTEGRITY OF ALL CONTROLS AND SWITCHES

Passed: CHECK CONDITION OF POWER CORD AND PLUG, IF APPLICABLE.

Passed: CHECK BATTERY CONDITION.

Passed: VISUALLY INSPECT UNIT FOR DAMAGE OR MISSING PARTS

Passed: CLEAN EXTERIOR WITH DISINFECTANT. CHECK FOR CONTAMINATION.

Passed: CLEAN SENSORS AND CALIBRATION STRIP READER IF APPLICABLE

Passed: CLEAN REAGENT STRIP CHAMBER OR REPLACE IF DAMAGED OR DETERIORATED

Passed: VERIFY TIMER ACCURACY WITH STOPWATCH. CHECK MFR SPECIFICATIONS FOR LIMITS

Passed: MEASURE BATTERY VOLTAGE. SHOULD BE >6.00 VOLTS (REPLACE IF NECESSARY)

Passed: PERFORM REFLECTANCE TEST USING MFR CALIBRATED STRIPS.

Passed: CHECK ALL DISPLAYS AND INDICATORS FOR PROPER OPERATION

Passed: CHECK INTERIOR FOR SIGNS OF ELECTRICAL OR MECHANICAL DAMAGE.

Passed: CLEAN INTERIOR PAYING SPECIAL ATTENTION TO SWITCHES AND CONTROLS.

03/18/19 07:26 PM Page 1

American Bio~Medics Work Order #: 23822

Equipment Data MediMizer™

Control #: 3006 Description: Light, Curing
Manufacturer: Benco Dental Model #: SOLEIL PLUS
Status: In Service
Serial #: C02C060260V4
Work Order PO #: Pref. Team: CLINENG
Team Leader:
Facility: CFHC Winter Heaven
Department: Dental, CFHC Winter Haven

Location: CFHC Winter Haven Dental System:

Floor: 1 Room #: Dental Building:

Risk Priority: 0 Last Seen: 03/16/19 Inspections: Last:03/15/19 Next: 03/01/20 Safety and Performance

Warranty Expires: Parts: / / Labor: / /

Old Control #:

Work Order Data

Work Order Type: Inspection, P.M. or S.P.R. Requested On: 03/01/19 12:00 AM Due: 03/31/19
Person Requesting: Scheduled Phone: (863) 413-8600
Service Requested: Safety and Performance.

Notes: New equipment inspection.

Date WO # Service Requested Past Service Information Service

03/15/19 23822 Safety and Performance. Completed All Scheduled Inspect

Date Tech Verb Noun Minutes R Service Entry Area Part # Qty Unit Cost Description

Date Tech Verb Noun Minutes R

Service Information for this Work Order

Emanuel Colon (Employee)

03/15/19 5 minutes Completed All Scheduled Inspections (Quick Entry)

03/18/19 07:26 PM Page 1

American Bio~Medics Work Order #: 23681

Equipment Data MediMizer™

Control #: CFHCWH1 Description: Curing Light
Manufacturer: Voco America Model #: EC 3
Status: Unit Not Located
Serial #: NSN
Work Order PO #: Pref. Team: CLINENG
Team Leader:
Facility: CFHC Winter Heaven
Department: Dental, CFHC Winter Haven

Location: WHH Dental System:

Floor: 1 Room #: Dental Building:

Risk Priority: 0 Last Seen: 10/05/18 Inspections: Last: / / Next: 03/01/20 Safety and Performance

Warranty Expires: Parts: / / Labor: / /

Old Control #:

Work Order Data

Work Order Type: Inspection, P.M. or S.P.R. Requested On: 03/01/19 12:00 AM Due: 03/31/19
Person Requesting: Scheduled Phone: (863) 413-8600
Service Requested: Safety and Performance.

Notes: Unable to locate.

Date WO # Service Requested Past Service Information Service

03/01/19 23681 Safety and Performance. Unit Not Located
10/05/18 22971 New Equipment Inspection New Equipment Inspection

Date Tech Verb Noun Minutes R Service Entry Area Part # Qty Unit Cost Description

Date Tech Verb Noun Minutes R

Service Information for this Work Order

Emanuel Colon (Employee)

03/01/19 2 minutes Unit Not Located (Quick Entry)

03/18/19 07:26 PM Page 1

American Bio~Medics Work Order #: 23682

Equipment Data MediMizer™

Control #: CFHCWH2 Description: Curing Light
Manufacturer: Voco America Model #: EC 3
Status: Unit Not Located
Serial #: NSN
Work Order PO #: Pref. Team: CLINENG
Team Leader:
Facility: CFHC Winter Heaven
Department: Dental, CFHC Winter Haven

Location: WH Dental System:

Floor: 1 Room #: Dental Building:

Risk Priority: 0 Last Seen: 10/05/18 Inspections: Last: / / Next: 03/01/20 Safety and Performance

Warranty Expires: Parts: / / Labor: / /

Old Control #:

Work Order Data

Work Order Type: Inspection, P.M. or S.P.R. Requested On: 03/01/19 12:00 AM Due: 03/31/19
Person Requesting: Scheduled Phone: (863) 413-8600
Service Requested: Safety and Performance.

Notes: Unable to locate.

Date WO # Service Requested Past Service Information Service

03/01/19 23682 Safety and Performance. Unit Not Located
10/05/18 22970 New Equipment Inspection New Equipment Inspection

Date Tech Verb Noun Minutes R Service Entry Area Part # Qty Unit Cost Description

Date Tech Verb Noun Minutes R

Service Information for this Work Order

Emanuel Colon (Employee)

03/01/19 2 minutes Unit Not Located (Quick Entry)

03/18/19 07:26 PM Page 1

American Bio~Medics Work Order #: 23683

Equipment Data MediMizer™

Control #: CFHCWH3 Description: SCALE,FLOOR,ELECTRONIC
Manufacturer: Health O Meter Incorporated Model #: 500KL
Status: In Service
Serial #: 5000148046
Work Order PO #: Pref. Team: CLINENG
Team Leader:
Facility: CFHC Winter Heaven
Department: Dental, CFHC Winter Haven

Location: CFHC Winter Haven System:

Floor: 1 Room #: Triage Building:

Risk Priority: 3 Last Seen: 03/01/19 Inspections: Last:03/01/19 Next: 03/01/20 Safety, Performance and

Warranty Expires: Parts: / / Labor: / /

Old Control #:

Work Order Data

Work Order Type: Inspection, P.M. or S.P.R. Requested On: 03/01/19 12:00 AM Due: 03/31/19
Person Requesting: Scheduled Phone: (863) 413-8600
Service Requested: Safety, Performance and PM.

Notes: Weight accuracy check: 11.8lbs@11lbs, 30.4lbs@30lbs, 42.4lbs@42lbs, 61.0lbs@60lbs, 73.0lbs@72lbs

Date WO # Service Requested Past Service Information Service

03/01/19 23683 Safety, Performance and PM. Completed All Scheduled Inspect
10/05/18 22969 New Equipment Inspection New Equipment Inspection

Date Tech Verb Noun Minutes R Service Entry Area Part # Qty Unit Cost Description

Date Tech Verb Noun Minutes R

Service Information for this Work Order

Emanuel Colon (Employee)

03/01/19 6 minutes Completed All Scheduled Inspections (Quick Entry)

Passed: CHECK OVERAL CONDITION OF HARDWARE ON DEVICE, LATCHES, HOSES AND COVERS.

Passed: CHECK MECHANICAL INTEGRITY OF ALL CONTROLS AND SWITCHES

Passed: CHECK CONDITION OF POWER CORD AND PLUG, IF APPLICABLE.

Passed: CHECK BATTERY CONDITION.

Passed: CHECK OVERALL CONDITION OF SCALE FOR DAMAGE.

Passed: CHECK THAT ALL DIGITS AND INDICATOR LAMPS FUNCTION PROPERLY

Passed: ZERO SCALE AND PLACE A CALIBRATED WEIGHT ON SCALE AND CHECK FOR ACCURACY

Passed: CHECK ALL MOVING PARTS FOR MECHANICAL INTEGRITY

Passed: CHECK ACCURACY OF UNIT USING A STANDARD SET OF WEIGHTS

Passed: CHECK WEIGHTS THREE SETTINGS

Passed: CHECK BATTERIES AND REPLACE IF NECESSARY.

Passed: CLEAN INTERIOR. CHECK INTERNAL PARTS FOR WEAR. LUBRICATE WHERE NECESSARY.

03/18/19 07:26 PM Page 1

American Bio~Medics Work Order #: 23743

Equipment Data MediMizer™

Control #: CFHCWH4 Description: Centrifuge
Manufacturer: The Drucker Co. Model #: 642E
Status: In Service
Serial #: 180813DM108
Work Order PO #:

Facility: CFHC Winter Heaven
Department: Laboratory

Location: CFHC Winter Haven System:

Floor: 1 Room #: Lab Building:

Risk Priority: 2 Last Seen: 03/01/19 Inspections: Last:03/01/19 Next: 03/01/20 Safety, Performance and

Warranty Expires: Parts: / / Labor: / /

Old Control #:

Work Order Data

Work Order Type: Inspection, P.M. or S.P.R. Requested On: 03/01/19 12:00 AM Due: 03/31/19
Person Requesting: Scheduled Phone:
Service Requested: Safety, Performance and PM.

Date WO # Service Requested Past Service Information Service

03/01/19 23743 Safety, Performance and PM. Completed All Scheduled Inspect
10/05/18 22968 New Equipment Inspection New Equipment Inspection

Date Tech Verb Noun Minutes R Service Entry Area Part # Qty Unit Cost Description

Date Tech Verb Noun Minutes R

Service Information for this Work Order

Emanuel Colon (Employee)

03/01/19 10 minutes Completed All Scheduled Inspections (Quick Entry)

Passed: CHECK ELECTRICAL SAFETY

Passed: CHECK GROUND RESISTANCE {pass < .5 OHMS} .07 Ohms

Passed: CHECK ELECTRICAL LEAKAGE {pass < 300 uA} 10 uA

Passed: CHECK TIMER FOR SMOOTH OPERATION. CHECK OPERATION OF BRAKING.

Passed: CHECK OPERATION OF TACHOMETER IF APPLICABLE.

Passed: CHECK FOR VIBRATIONS AND EXCESS NOISE. CHECK HEAD BALANCE.

Passed: MEASURE ROTOR SPEED USING PHOTOTACHOMETER. RECORD MEASUREMENT BELOW.

Passed: SETTING #1 : 3299 RPM INDICATED ------- RPM ACTUAL 3321 RPM

Passed: ALL READINGS ARE TAKEN WITH ROTOR FULLY LOADED.

Passed: CHECK TIMER ACCURACY USING STOPWATCH. RECORD MEASUREMENT BELOW.

Passed: SET TIMER AT 5 MINUTES: ACTUAL__________

Passed: CHECK OPERATION OF REFRIGERATION AND THERMOSTAT IF APPLICABLE.

Passed: CHECK INTERIOR FOR SIGNS OF ELECTRICAL OR MECHANICAL DAMAGE.

Passed: CHECK INTERIOR FOR SIGNS OF PHYSICAL OR ELECTRICAL DAMAGE.

Passed: CLEAN INTERIOR PAYING SPECIAL ATTENTION TO SWITCHES AND CONNECTORS.

Passed: CHECK MOTOR BRUSHES. CHECK ARMATURE FOR WEAR. CLEAN-OUT CARBON BUILD-UP.

Passed: LUBRICATE MOTOR AND MECHANICAL PARTS WHERE APPLICABLE.

Passed: REPLACE BRUSHES IF NECESSARY

03/18/19 07:26 PM Page 1