American Bio~Medics Work Order #: 23545
Equipment Data MediMizer™
Control #: 1485 Description: SCALE,FLOOR,ELECTRONIC
Manufacturer: Health O Meter Incorporated Model #: 4025
Status: In Service
Serial #: 402500137
Work Order PO #: Pref. Team: CLINENG
Team Leader:
Facility: CFHC Winter Heaven
Department: Adult Triage
Location: Adult Triage System:
Floor: 1 Room #: 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: Weight accuracy check : 11.8lbs@12lbs, 30.0lbs@30lbs, 42.0lbs@42lbs, 60.8lbs@60lbs, 72.8lbs@72lbs
Date WO # Service Requested Past Service Information Service
03/01/19 23545 Safety, Performance and PM. Completed All Scheduled Inspect
10/05/18 22973 Safety and Performance Safety and Performance
03/09/18 21554 Safety, Performance and PM. Completed All Scheduled Inspect
03/10/17 19572 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 6 minutes Completed All Scheduled Inspections (Quick Entry)
Passed: CHECK ELECTRICAL LEAKAGE:<300 MICROAMPS
Passed: CHECK GROUND RESISTANCE:<.5 OHMS
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 #: 23757
Equipment Data MediMizer™
Control #: 1702 Description: REFRIGERATOR
Manufacturer: Electrolux Home Products Model #: LFTR1814LWG
Status: In Service
Serial #: BA33321608
Work Order PO #: Pref. Team: CLINENG
Team Leader:
Facility: CFHC Winter Heaven
Department: Laboratory
Location: CFHC WH Lab System:
Floor: 1 Room #: Lab 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:
Service Requested: Safety, Performance and PM.
Notes: Temperature accuracy check: Freezer -6.9 dF / -21.6 dF --------- Refrigerator -.2 dC / 31.6 dF
Date WO # Service Requested Past Service Information Service
03/01/19 23757 Safety, Performance and PM. Completed All Scheduled Inspect
03/09/18 21606 Safety, Performance and PM. Completed All Scheduled Inspect
03/10/17 19620 Safety, Performance and PM. Completed All Scheduled Inspect
04/11/16 17652 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 8 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} 46 uA
Passed: CHECK DOOR GASKET AND DOOR. CHECK LOCKING MECHANISM AND LATCHES.
Passed: CHECK TEMPERATURE AND REGULATION. CHECK INSIDE LAMP AND DOOR SWITCH.
Passed: CHECK INTERIOR OF BOX FOR LEAKS OR DAMAGE TO TRAYS.
Passed: CHECK AND CLEAN DRAIN HOSES. CLEAN COMPRESSOR, FAN AND CONDENSER.
Passed: CLEAN FAN FILTERS. CHECK COMPRESSOR FOR QUIET OPERATION.
Passed: CHECK COMPRESSOR AREA FOR SIGNS OF MECHANICAL OR ELECTRICAL DAMAGE.
03/18/19 07:26 PM Page 1
American Bio~Medics Work Order #: 23552
Equipment Data MediMizer™
Control #: 1703 Description: LIGHTS, EXAMINATION
Manufacturer: Welch Allyn Inc. Model #: LS-135
Status: Removed From Inventory
Serial #: NSN1703
Work Order PO #: Pref. Team: CLINENG
Team Leader:
Facility: CFHC Winter Heaven
Department: Adult Triage
Location: CFHC Winter Haven System:
Floor: 1 Room #: 105 Building:
Risk Priority: 3 Last Seen: 04/11/16 Inspections: Last:04/11/16 Next:
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.
Notes: Removed from service and equipment inventory.
Date WO # Service Requested Past Service Information Service
03/01/19 23552 Safety and Performance. Removed from Inventory
03/09/18 21555 Safety and Performance. Unit Not Located
03/10/17 19574 Safety and Performance. Unit Not Located
04/11/16 17616 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 2 minutes Removed from Inventory (Quick Entry)
03/18/19 07:26 PM Page 1
American Bio~Medics Work Order #: 23553
Equipment Data MediMizer™
Control #: 1706 Description: AED Defibrillator
Manufacturer: Philips Medical Systems Model #: HEARTSTART HS1
Status: In Service
Serial #: A13F-01721
Work Order PO #: Pref. Team: CLINENG
Team Leader:
Facility: CFHC Winter Heaven
Department: Adult Triage
Location: CFHC WH Nurse's Desk System:
Floor: 1 Room #: ND Building:
Risk Priority: 0 Last Seen: 03/01/19 Inspections: Last:03/01/19 Next: 03/01/20 Performance and Safety
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: Performance and Safety.
Notes: Battery expiration date: 2020-06 Electrode Expiration Date: 2023 / 09
Date WO # Service Requested Past Service Information Service
03/01/19 23553 Performance and Safety. Completed All Scheduled Inspect
03/09/18 21557 Performance and Safety. Completed All Scheduled Inspect
03/10/17 19577 Performance and Safety. Completed All Scheduled Inspect
04/11/16 17619 Performance and Safety. 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 10 minutes Completed All Scheduled Inspections (Quick Entry)
Passed: CHECK ALL CONTROLS FOR PROPER OPERATION
Passed: CHECK UNIT FOR PROPER OPERATION
Passed: CHECK OPERATION OF ANALOG/DIGITAL DISPLAY.
Passed: CHECK ENERGY SELECT SWITCH FOR MECHANICAL INTEGRITY.
Passed: CHECK SYNCHRONIZER OPERATION FOR PROPER FIRE TIME AND FLAG PULSE.
Passed: CHECK DEFIBRILLATOR OUTPUT. RECORD DATA (ALL NUMBERS ARE IN JOULES).
Passed: PERFORM CALIBRATION PROCEDURE PER SERVICE MANUAL, IF NECESSARY.
Passed: CHECK INTERNAL DISCHARGE OF STORED ENERGY.
Passed: CHECK CHARGE IS REMOVED AFTER CHANGING ENERGY SETTING.
Passed: CHECK ALL CONTROLS AND INDICATORS FOR PROPER OPERATION.
Passed: CHECK ECG WAVEFORM HAS NO DISTORTION OR CLIPPING.
Passed: CHECK THE HEART RATE WITH THE INDICATED ECG WAVEFORM RATES.
Passed: SET MONITOR ALARM TO 120 BPM AND VERIFY AUDIO AND VISUAL ALARMS WHEN THE
Passed: RATE IS INCREASED TO 120 BPM. REPEAT AT 30 BPM.
Passed: CHECK FOR 1 PULSE WAVEFORM FOR EACH 25 MM OF DISTANCE @ 25 MM/SEC SETTING.
Passed: CHECK MONITOR's ABILITY TO DETECT VENTRICULAR FIBRILLATION.
Passed: CHECK VISUAL AND AUDIO INDICATORS.
Passed: CHECK CONDITION OF ALL LAMPS AND LED's.
Passed: CLEAN PRINTER HEAD AND ROLLERS.
Passed: CHECK FOR SIGNS OF HIGH VOLTAGE ARCHING.
Passed: CHECK CONDITION OF POWER CORD AND PLUG FOR ANY SIGNS OF DAMAGE.
Passed: CHECK CONDITION OF BATTERY AND REPLACE IF NECESSARY.
Passed: CHECK BATTERY EXPIRATION DATE. EXPIRES ON 2020 / 06.
Passed: CHECK OVERALL CONDITION OF UNIT FOR DAMAGE.
Passed: CLEAN EXTERNAL SURFACES
Passed: RETURN TO MFG FOR CALIBRATION IF NECESSARY
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.
03/18/19 07:26 PM Page 1
American Bio~Medics Work Order #: 23430
Equipment Data MediMizer™
Control #: 1707 Description: Charger Base, Tympanometer
Manufacturer: Welch Allyn Inc. Model #: 71123
Status: In Service
Serial #: NSN1707
Work Order PO #:
Facility: CFHC Winter Heaven
Department: Adult Triage
Location: CFHC WH Nurse's Desk System:
Floor: 1 Room #: ND 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 23430 Safety and Performance. Completed All Scheduled Inspect
03/09/18 21514 Safety and Performance. Completed All Scheduled Inspect
03/10/17 19514 Safety and Performance. Completed All Scheduled Inspect
04/11/16 17554 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 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)
03/18/19 07:26 PM Page 1
American Bio~Medics Work Order #: 23431
Equipment Data MediMizer™
Control #: 1708 Description: TYMPANOMETER
Manufacturer: Welch Allyn Inc. Model #: 23300
Status: In Service
Serial #: 201301738
Work Order PO #:
Facility: CFHC Winter Heaven
Department: Adult Triage
Location: CFHC Nurse's Desk System:
Floor: 1 Room #: ND 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 23431 Safety and Performance. Completed All Scheduled Inspect
03/09/18 21515 Safety and Performance. Completed All Scheduled Inspect
03/10/17 19515 Safety and Performance. Completed All Scheduled Inspect
04/11/16 17555 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 #: 23554
Equipment Data MediMizer™
Control #: 1709 Description: REFRIGERATOR
Manufacturer: Whirlpool Corporation - Roper Model #: ET0MSRXTQ02
Status: In Service
Serial #: VS05074486
Work Order PO #: Pref. Team: CLINENG
Team Leader:
Facility: CFHC Winter Heaven
Department: Adult Triage
Location: CFHC WH Pediatric Nursing Stor System:
Floor: 1 Room #: Pedi 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.
Notes: Food Refrigerator. Temperature accuracy check: Freezer 11.0 dF / -11.8 dC ------------ Refrigerator 10.0
dF / 49.8 dF
Date WO # Service Requested Past Service Information Service
03/01/19 23554 Safety, Performance and PM. Completed All Scheduled Inspect
03/09/18 21558 Safety, Performance and PM. Completed All Scheduled Inspect
03/10/17 19578 Safety, Performance and PM. Completed All Scheduled Inspect
04/11/16 17620 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 6 minutes Completed All Scheduled Inspections (Quick Entry)
Passed: CHECK ELECTRICAL SAFETY
Passed: CHECK GROUND RESISTANCE {pass < .5 OHMS} .24 Ohms
Passed: CHECK ELECTRICAL LEAKAGE {pass < 300 uA} 36 uA
Passed: CHECK DOOR GASKET AND DOOR. CHECK LOCKING MECHANISM AND LATCHES.
Passed: CHECK TEMPERATURE AND REGULATION. CHECK INSIDE LAMP AND DOOR SWITCH.
Passed: CHECK INTERIOR OF BOX FOR LEAKS OR DAMAGE TO TRAYS.
Passed: CHECK AND CLEAN DRAIN HOSES. CLEAN COMPRESSOR, FAN AND CONDENSER.
Passed: CLEAN FAN FILTERS. CHECK COMPRESSOR FOR QUIET OPERATION.
Passed: CHECK COMPRESSOR AREA FOR SIGNS OF MECHANICAL OR ELECTRICAL DAMAGE.
03/18/19 07:26 PM Page 1
American Bio~Medics Work Order #: 23555
Equipment Data MediMizer™
Control #: 1710 Description: REFRIGERATOR
Manufacturer: Whirlpool Corporation - Roper Model #: ET0MSRXTQ02
Status: In Service
Serial #: VS05074505
Work Order PO #: Pref. Team: CLINENG
Team Leader:
Facility: CFHC Winter Heaven
Department: Adult Triage
Location: CFHC WH Adult Storage System:
Floor: 1 Room #: ND 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.
Notes: Temperature accuracy check: Freezer 16.0 dF / -9.0 dF ---------- Refrigerator 35.5 dF / 2.0 dC
Date WO # Service Requested Past Service Information Service
03/01/19 23555 Safety, Performance and PM. Completed All Scheduled Inspect
03/09/18 21559 Safety, Performance and PM. Completed All Scheduled Inspect
03/10/17 19579 Safety, Performance and PM. Completed All Scheduled Inspect
04/11/16 17621 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 7 minutes Completed All Scheduled Inspections (Quick Entry)
03/18/19 07:26 PM Page 1
American Bio~Medics Work Order #: 23434
Equipment Data MediMizer™
Control #: 1884 Description: Refrigerator, Medications
Manufacturer: Sunpentown Intl. Model #: 626-336-2299
Status: In Service
Serial #: NABU143038920043
Work Order PO #:
Facility: CFHC Winter Heaven
Department: Adult Triage
Location: CFHC Winter Haven System:
Floor: 1 Room #: Meds 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: (813) 413-8600
Service Requested: Safety, Performance and PM.
Notes: Temperature accuracy check: -.5 dF / -18.0 dC
Date WO # Service Requested Past Service Information Service
03/01/19 23434 Safety, Performance and PM. Completed All Scheduled Inspect
03/09/18 21516 Safety, Performance and PM. Completed All Scheduled Inspect
03/10/17 19517 Safety, Performance and PM. Completed All Scheduled Inspect
04/11/16 17557 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 8 minutes Completed All Scheduled Inspections (Quick Entry)
Passed: CHECK ELECTRICAL SAFETY
Passed: CHECK GROUND RESISTANCE {pass < .5 OHMS} .08 Ohms
Passed: CHECK ELECTRICAL LEAKAGE {pass < 300 uA} 7 uA
Passed: CHECK DOOR GASKET AND DOOR. CHECK LOCKING MECHANISM AND LATCHES.
Passed: CHECK TEMPERATURE AND REGULATION. CHECK INSIDE LAMP AND DOOR SWITCH.
Passed: CHECK INTERIOR OF BOX FOR LEAKS OR DAMAGE TO TRAYS.
Passed: CHECK DEFROSTER COIL. CHECK TEMPERATURE GUAGE AND ALARM CIRCUTS.
Passed: CHECK AND CLEAN DRAIN HOSES. CLEAN COMPRESSOR, FAN AND CONDENSER.
Passed: CLEAN FAN FILTERS. CHECK COMPRESSOR FOR QUIET OPERATION.
Passed: CHECK COMPRESSOR AREA FOR SIGNS OF MECHANICAL OR ELECTRICAL DAMAGE.
03/18/19 07:26 PM Page 1
American Bio~Medics Work Order #: 23651
Equipment Data MediMizer™
Control #: 1887 Description: Dental X-Ray
Manufacturer: Gendex Dental Systems Model #: 110-0205G1
Status: In Service
Serial #: GO1400600
Work Order PO #:
Facility: CFHC Winter Heaven
Department: Dental, CFHC Winter Haven
Location: Dental, Winter Haven System:
Floor: 1 Room #: 1 Building:
Risk Priority: 0 Last Seen: 03/01/19 Inspections: Last:03/01/19 Next: 03/01/20 Performance and PM
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: Performance and PM.
Notes: Electrical Safety Check: .08 Ohms Leakage: 55uA
Date WO # Service Requested Past Service Information Service
03/01/19 23651 Performance and PM. Completed All Scheduled Inspect
03/09/18 21568 Performance and PM. Completed All Scheduled Inspect
03/10/17 19584 Performance and PM. Completed All Scheduled Inspect
04/11/16 17622 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 5 minutes Completed All Scheduled Inspections (Quick Entry)
Passed: CHECK KVP MA-TIME FOR ACCURACY
Passed: CHECK ELECTRICAL LOCKS FOR PROPER OPERATION.
Passed: CHECK OTHER ELECTRICAL FUNCTIONS FOR PROPER OPERATION.
Passed: CHECK BATTERIES IF APPLICABLE
Passed: CHECK CONDITION OF CABLE AND DRAPES.
Passed: CHECK SPOT FILM DEVICE IF APPLICABLE.
Passed: CHECK STATIONARY AND MOVABLE RAILS FOR PROPER SUPPORT AND TRAVEL
Passed: CHECK TUBE COLUMN FOR FREE MOVEMENT
Passed: CHECK TABLE BUCKY
Passed: CHECK COLLIMATORS (OPERATIONAL WITHIN SPECS.)
Passed: CHECK INTERIOR FOR SIGNS OF ELECTRICAL OR MECHANICAL DAMAGE.
Passed: CLEAN INTERIOR PAYING SPECIAL ATTENTION TO SWITCHES AND CONTROLS.
Passed: CLEAN COOLING FANS AND FILTERS. CHECK HIGH VOLTAGE CONNECTIONS.
Passed: PERFORM CALIBRATION ACCORDING TO MANUFACTURES SPECIFICATIONS.
03/18/19 07:26 PM Page 1
American Bio~Medics Work Order #: 23663
Equipment Data MediMizer™
Control #: 1888 Description: MONITOR, MULTIPARAMETER
Manufacturer: Welch Allyn Inc. Model #: 42N0B
Status: In Service
Serial #: 201416391
Work Order PO #: Pref. Team: CLINENG
Team Leader:
Facility: CFHC Winter Heaven
Department: Dental, CFHC Winter Haven
Location: Dental, Winter Haven System:
Floor: 1 Room #: Hall Building:
Risk Priority: 3 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: (863) 413-8600
Service Requested: Safety and Performance.
Date WO # Service Requested Past Service Information Service
03/01/19 23663 Safety and Performance. Completed All Scheduled Inspect
03/09/18 21580 Safety and Performance. Completed All Scheduled Inspect
03/10/17 19595 Safety and Performance. Completed All Scheduled Inspect
04/11/16 17633 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 10 minutes Completed All Scheduled Inspections (Quick Entry)
Passed: CHECK ELECTRICAL SAFETY
Passed: CHECK OVERALL CONDITION OF UNIT FOR DAMAGE
Passed: CHECK ALL CONTROLS AND INDICATORS FOR PROPER OPERATION
Passed: CHECK DISPLAY FOR PROPER LINEARITY, SIZE, AND INTENSITY
Passed: CHECK HEART RATE ACCURACY PER MFG. SPECS
Passed: CHECK HEART RATE ALARMS PER MFG. SPECS.
Passed: CHECK RESPIRATION PARAMETERS PER MFG. SPECS. IF APPLICABLE
Passed: CHECK INVASIVE PRESSURE ACCURACY AND ALARMS PER MFG. SPECS. IF APPLICABLE
Passed: CHECK NIBP ACCURACY AND ALARMS PER MFG. SPECS. IF APPLICABLE
Passed: RESULTS:
Passed: SETTING ACTUAL
Passed: 120/80 mmHg 121/81 mmHg
Passed: ---------------------------------------------------------------------------
Passed: CHECK RECORDER FOR PROPER OPERATION AND DISPLAY IF APPLICABLE
Passed: CHECK TRENDING OPTIONS FOR PROPER OPERATION IF APPLICABLE
Passed: CHECK SPO2 ACCURACY AND ALARMS PER MFG. SPECS. IF APPLICABLE
Passed: RESULTS:
Passed: SETTING ACTUAL
Passed: 98% SPO2 98% SPO2
Passed: ---------------------------------------------------------------------------
Passed: CHECK ALL CONNECTORS FOR DAMAGE
03/18/19 07:26 PM Page 1
American Bio~Medics Work Order #: 23664
Equipment Data MediMizer™
Control #: 1889 Description: Chair Dental
Manufacturer: Midmark Corporation Model #: 153592-003
Status: In Service
Serial #: V1597009
Work Order PO #: Pref. Team: CLINENG
Team Leader:
Facility: CFHC Winter Heaven
Department: Dental, CFHC Winter Haven
Location: Dental, Winter Haven System:
Floor: 1 Room #: 1 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: (863) 413-8600
Service Requested: Safety and Performance.
Date WO # Service Requested Past Service Information Service
03/01/19 23664 Safety and Performance. Completed All Scheduled Inspect
03/09/18 21581 Safety and Performance. Completed All Scheduled Inspect
03/10/17 19596 Safety and Performance. Completed All Scheduled Inspect
04/11/16 17634 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 7 minutes Completed All Scheduled Inspections (Quick Entry)
Passed: CHECK ELECTRICAL SAFETY
Passed: CHECK GROUND RESISTANCE {pass < .5 OHMS} .06 Ohms
Passed: CHECK ELECTRICAL LEAKAGE {pass < 300 uA} 29 uA
Passed: CHECK MECHANICAL INTEGRITY OF HEAD AND FOOT REST AND OTHER ACCESSORIES.
Passed: CHECK ALL CONTROLS FOR PROPER OPERATION
Passed: CHECK FOR PROPER OPERATION BY CYCLING THROUGH ALL POSSIBLE MOVEMENTS.
Passed: CHECK THAT ALL MOVEMENTS ARE SMOOTH AND WITHOUT HESITATION OR BINDING.
Passed: CHECK OVERALL CONDITION OF TABLE FOR DAMAGE
Passed: VISUALLY CHECK THE EXTERIOR OF THE TABLE FOR ANY SIGNS OF DAMAGE.
Passed: VERIFY CORRECT ARTICULATION OF ALL MECHANICAL ASSEMBLIES.
Passed: VISUALLY INSPECT ELECTRICAL FOR SIGNS OF DAMAGE AND/OR OVERHAEATING
Passed: VISUALLY CHECK THE CONDITION OF THE POWER CORD AND PLUG FOR CRACKS, CUTS,
Passed: BARE OR BROKEN WIRES AND SIGNS OF EXCESSIVE HEAT (DISCOLORATION).
03/18/19 07:26 PM Page 1
American Bio~Medics Work Order #: 23665
Equipment Data MediMizer™
Control #: 1890 Description: Chair Dental
Manufacturer: Midmark Corporation Model #: 153592-003
Status: In Service
Serial #: V1596694
Work Order PO #: Pref. Team: CLINENG
Team Leader:
Facility: CFHC Winter Heaven
Department: Dental, CFHC Winter Haven
Location: Dental, Winter Haven System:
Floor: 1 Room #: 2 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: (863) 413-8600
Service Requested: Safety and Performance.
Date WO # Service Requested Past Service Information Service
03/01/19 23665 Safety and Performance. Completed All Scheduled Inspect
03/09/18 21582 Safety and Performance. Completed All Scheduled Inspect
03/10/17 19597 Safety and Performance. Completed All Scheduled Inspect
04/11/16 17635 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 7 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} 25 uA
Passed: CHECK MECHANICAL INTEGRITY OF HEAD AND FOOT REST AND OTHER ACCESSORIES.
Passed: CHECK ALL CONTROLS FOR PROPER OPERATION
Passed: CHECK FOR PROPER OPERATION BY CYCLING THROUGH ALL POSSIBLE MOVEMENTS.
Passed: CHECK THAT ALL MOVEMENTS ARE SMOOTH AND WITHOUT HESITATION OR BINDING.
Passed: CHECK OVERALL CONDITION OF TABLE FOR DAMAGE
Passed: VISUALLY CHECK THE EXTERIOR OF THE TABLE FOR ANY SIGNS OF DAMAGE.
Passed: VERIFY CORRECT ARTICULATION OF ALL MECHANICAL ASSEMBLIES.
Passed: VISUALLY INSPECT ELECTRICAL FOR SIGNS OF DAMAGE AND/OR OVERHAEATING
Passed: VISUALLY CHECK THE CONDITION OF THE POWER CORD AND PLUG FOR CRACKS, CUTS,
Passed: BARE OR BROKEN WIRES AND SIGNS OF EXCESSIVE HEAT (DISCOLORATION).
03/18/19 07:26 PM Page 1
American Bio~Medics Work Order #: 23666
Equipment Data MediMizer™
Control #: 1891 Description: AMALGAMATOR OPTIMIX
Manufacturer: Kerr Corporation Model #: 100
Status: In Service
Serial #: 15028499
Work Order PO #: Pref. Team: CLINENG
Team Leader:
Facility: CFHC Winter Heaven
Department: Dental, CFHC Winter Haven
Location: Dental, Winter Haven 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: (863) 413-8600
Service Requested: Safety and Performance.
Date WO # Service Requested Past Service Information Service
03/01/19 23666 Safety and Performance. Completed All Scheduled Inspect
10/05/18 22972 Safety and Performance Safety and Performance
03/09/18 21583 Safety and Performance. Unit Not Located
03/10/17 19598 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 ELECTRICAL SAFETY
Passed: CHECK GROUND RESISTANCE {pass < .5 OHMS} .27 Ohms
Passed: CHECK ELECTRICAL LEAKAGE {pass < 300 uA} 6 uA
Passed: CHECK UNIT FOR SMOOTH AND QUIET OPERATION.
Passed: CHECK SAMPLE HOLDER FOR MECHANICAL INTEGRITY. CHECK TIMER IF APPLICABLE.
Passed: CHECK SPEED CALIBRATION AND METER IF APPLICABLE.
Passed: CHECK MOTOR AND BRUSHES IF APPLICABLE. CHECK DRIVE BELT.
Passed: CHECK MECHANICAL INTEGRITY OF ALL MOVING PARTS.
Passed: LUBRICATE AS RECOMMENED. CHECK ROTATION SPEED.
Passed: COMPLETE OPERATIONAL CHECK.
03/18/19 07:26 PM Page 1
American Bio~Medics Work Order #: 23667
Equipment Data MediMizer™
Control #: 1892 Description: Chair Dental
Manufacturer: Midmark Corporation Model #: 153592-003
Status: In Service
Serial #: V1597717
Work Order PO #: Pref. Team: CLINENG
Team Leader:
Facility: CFHC Winter Heaven
Department: Dental, CFHC Winter Haven
Location: Dental, Winter Haven System:
Floor: 1 Room #: 3 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: (863) 413-8600
Service Requested: Safety and Performance.
Date WO # Service Requested Past Service Information Service
03/01/19 23667 Safety and Performance. Completed All Scheduled Inspect
03/09/18 21584 Safety and Performance. Completed All Scheduled Inspect
03/10/17 19599 Safety and Performance. Completed All Scheduled Inspect
04/11/16 17637 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 7 minutes Completed All Scheduled Inspections (Quick Entry)
Passed: CHECK ELECTRICAL SAFETY
Passed: CHECK GROUND RESISTANCE {pass < .5 OHMS} .05 Ohms
Passed: CHECK ELECTRICAL LEAKAGE {pass < 300 uA} 19 uA
Passed: CHECK MECHANICAL INTEGRITY OF HEAD AND FOOT REST AND OTHER ACCESSORIES.
Passed: CHECK ALL CONTROLS FOR PROPER OPERATION
Passed: CHECK FOR PROPER OPERATION BY CYCLING THROUGH ALL POSSIBLE MOVEMENTS.
Passed: CHECK THAT ALL MOVEMENTS ARE SMOOTH AND WITHOUT HESITATION OR BINDING.
Passed: CHECK OVERALL CONDITION OF TABLE FOR DAMAGE
Passed: VISUALLY CHECK THE EXTERIOR OF THE TABLE FOR ANY SIGNS OF DAMAGE.
Passed: VERIFY CORRECT ARTICULATION OF ALL MECHANICAL ASSEMBLIES.
Passed: VISUALLY INSPECT ELECTRICAL FOR SIGNS OF DAMAGE AND/OR OVERHAEATING
Passed: VISUALLY CHECK THE CONDITION OF THE POWER CORD AND PLUG FOR CRACKS, CUTS,
Passed: BARE OR BROKEN WIRES AND SIGNS OF EXCESSIVE HEAT (DISCOLORATION).
03/18/19 07:26 PM Page 1
American Bio~Medics Work Order #: 23668
Equipment Data MediMizer™
Control #: 1893 Description: BATTERY CHARGER
Manufacturer: Kerr Corporation Model #: DEMI PLUS
Status: In Service
Serial #: 760046744
Work Order PO #: Pref. Team: CLINENG
Team Leader:
Facility: CFHC Winter Heaven
Department: Dental, CFHC Winter Haven
Location: Dental, Winter Haven 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: (863) 413-8600
Service Requested: Safety, Performance and PM.
Date WO # Service Requested Past Service Information Service
03/01/19 23668 Safety, Performance and PM. Completed All Scheduled Inspect
03/09/18 21585 Safety, Performance and PM. Completed All Scheduled Inspect
03/10/17 19600 Safety, Performance and PM. Performance
04/11/16 17638 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: 12vDC 2.5A
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 #: 23669
Equipment Data MediMizer™
Control #: 1894 Description: Dental Hand Piece Cleaner
Manufacturer: Kaltenbach and Voigt Model #: QUATTROCARE PLUS
Status: In Service
Serial #: 0010244
Work Order PO #: Pref. Team: CLINENG
Team Leader:
Facility: CFHC Winter Heaven
Department: Dental, CFHC Winter Haven
Location: Dental, Winter Haven 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: (863) 413-8600
Service Requested: Safety, Performance and PM.
Date WO # Service Requested Past Service Information Service
03/01/19 23669 Safety, Performance and PM. Completed All Scheduled Inspect
03/09/18 21586 Safety, Performance and PM. Completed All Scheduled Inspect
03/10/17 19601 Safety, Performance and PM. Completed All Scheduled Inspect
04/11/16 17639 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 GROUND RESISTANCE {pass < .5 OHMS} .11 Ohms
Passed: CHECK ELECTRICAL LEAKAGE {pass < 300 uA} 164 uA
Passed: CHECK DOOR AND LATCH MECHANISM IF APPLICABLE.
Passed: ON FLOOR MODELS CHECK WASH, RINSE AND DRY CYCLES AND COMPARTMENTS.
Passed: CHECK ULTRASOUND OUTPUT FOR EVEN AND SMOOTH OPERATION.
Passed: CHECK TIMER ACCURACY. CHECK EXTERNAL PLUMBING FOR DETERIORATION OR LEAKS.
Passed: CLEAN INTERIOR INCLUDING FANS AND FAN FILTERS.
Passed: CHECK INTERIOR FOR SIGNS OF WATER DAMAGE. CHECK ELECTRICAL COMPONETS.
Passed: CHECK TRANSDUCERS FOR SECURE MOUNTING TO TANK. CHECK FOR DAMAGE.
03/18/19 07:26 PM Page 1
American Bio~Medics Work Order #: 23670
Equipment Data MediMizer™
Control #: 1895 Description: ULTRASONIC CLEANER
Manufacturer: Midmark Corporation Model #: MM250
Status: In Service
Serial #: BVV081445820
Work Order PO #: Pref. Team: CLINENG
Team Leader:
Facility: CFHC Winter Heaven
Department: Dental, CFHC Winter Haven
Location: Dental, Winter Haven 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: (863) 413-8600
Service Requested: Safety, Performance and PM.
Date WO # Service Requested Past Service Information Service
03/01/19 23670 Safety, Performance and PM. Completed All Scheduled Inspect
03/09/18 21587 Safety, Performance and PM. Completed All Scheduled Inspect
03/10/17 19602 Safety, Performance and PM. Completed All Scheduled Inspect
04/11/16 17640 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 5 minutes Completed All Scheduled Inspections (Quick Entry)
Passed: CHECK ELECTRICAL SAFETY
Passed: CHECK GROUND RESISTANCE {pass < .5 OHMS} .23 Ohms
Passed: CHECK ELECTRICAL LEAKAGE {pass < 300 uA} 260 uA
Passed: CHECK DOOR AND LATCH MECHANISM IF APPLICABLE.
Passed: ON FLOOR MODELS CHECK WASH, RINSE AND DRY CYCLES AND COMPARTMENTS.
Passed: CHECK ULTRASOUND OUTPUT FOR EVEN AND SMOOTH OPERATION.
Passed: CHECK TIMER ACCURACY. CHECK EXTERNAL PLUMBING FOR DETERIORATION OR LEAKS.
Passed: CLEAN INTERIOR INCLUDING FANS AND FAN FILTERS.
Passed: CHECK INTERIOR FOR SIGNS OF WATER DAMAGE. CHECK ELECTRICAL COMPONETS.
Passed: CHECK TRANSDUCERS FOR SECURE MOUNTING TO TANK. CHECK FOR DAMAGE.
03/18/19 07:26 PM Page 1
American Bio~Medics Work Order #: 23671
Equipment Data MediMizer™
Control #: 1896 Description: Autoclave
Manufacturer: Midmark Corporation Model #: M11-020
Status: In Service
Serial #: V1575380
Work Order PO #: Pref. Team: CLINENG
Team Leader:
Facility: CFHC Winter Heaven
Department: Dental, CFHC Winter Haven
Location: Dental, Winter Haven System:
Floor: 1 Room #: 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: (863) 413-8600
Service Requested: Safety, Performance and PM.
Date WO # Service Requested Past Service Information Service
03/01/19 23671 Safety, Performance and PM. Completed All Scheduled Inspect
03/09/18 21588 Safety, Performance and PM. Completed All Scheduled Inspect
03/10/17 19603 Safety, Performance and PM. Completed All Scheduled Inspect
04/11/16 17641 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 10 minutes Completed All Scheduled Inspections (Quick Entry)
Passed: CHECK ELECTRICAL SAFETY
Passed: CHECK GROUND RESISTANCE {pass < .5 OHMS} .14 Ohms
Passed: CHECK ELECTRICAL LEAKAGE {pass < 300 uA} 16 uA
Passed: CHECK DOOR GASKET AND DOOR ASSEMBLY FOR PROPER FIT AND SEAL.
Passed: CHECK MECHANICAL AND OPERATIONAL INTEGRITY OF DOOR LOCKING MECHANISM.
Passed: CHECK INSIDE OF TANK FOR CRACKS AND RUSTING. ALSO CHECK TRAYS FOR SAME.
Passed: OPERATE UNIT. CHECK FOR WATER OR STEAM LEAKS.
Passed: CHECK FOR TIME TO MAX OPERATING TEMPERATURE AND PROPER GAUGE CORRELATION.
Passed: REPLACE FILL AND RESERVOIR FILTERS. REPLACE DOOR GASKET IF NEEDED.
Passed: CHECK OPERATION OF OVER PRESSURE AND OVER TEMPERATURE DEVICES.
Passed: CHECK INTERIOR FOR SIGNS OF PHYSICAL OR ELECTRICAL DAMAGE.
Passed: CLEAN INTERIOR PAYING SPECIAL ATTENTION TO SWITCHES AND CONNECTORS.
Passed: LUBRICATE TIMING MECHANISM. REMOVE AND CLEAN CONTROL VALVES.
Passed: CLEAN BELLOWS CHAMBER. REPLACE BELLOWS IF NEEDED.
03/18/19 07:26 PM Page 1
American Bio~Medics Work Order #: 23652
Equipment Data MediMizer™
Control #: 1897 Description: Autoclave, Cassette
Manufacturer: Midmark Corporation Model #: M3-001
Status: In Service
Serial #: V1561313
Work Order PO #:
Facility: CFHC Winter Heaven
Department: Dental, CFHC Winter Haven
Location: Dental, Winter Haven System:
Floor: 1 Room #: 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: (863) 413-8600
Service Requested: Safety, Performance and PM.
Date WO # Service Requested Past Service Information Service
03/01/19 23652 Safety, Performance and PM. Completed All Scheduled Inspect
03/09/18 21569 Safety, Performance and PM. Completed All Scheduled Inspect
03/10/17 19585 Safety, Performance and PM. Completed All Scheduled Inspect
04/11/16 17623 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 10 minutes Completed All Scheduled Inspections (Quick Entry)
Passed: CHECK ELECTRICAL SAFETY
Passed: CHECK GROUND RESISTANCE {pass < .5 OHMS} .08 Ohms
Passed: CHECK ELECTRICAL LEAKAGE {pass < 300 uA} 16 uA
Passed: CHECK DOOR GASKET AND DOOR ASSEMBLY FOR PROPER FIT AND SEAL.
Passed: CHECK MECHANICAL AND OPERATIONAL INTEGRITY OF DOOR LOCKING MECHANISM.
Passed: CHECK INSIDE OF TANK FOR CRACKS AND RUSTING. ALSO CHECK TRAYS FOR SAME.
Passed: OPERATE UNIT. CHECK FOR WATER OR STEAM LEAKS.
Passed: CHECK FOR TIME TO MAX OPERATING TEMPERATURE AND PROPER GAUGE CORRELATION.
Passed: REPLACE FILL AND RESERVOIR FILTERS. REPLACE DOOR GASKET IF NEEDED.
Passed: CHECK OPERATION OF OVER PRESSURE AND OVER TEMPERATURE DEVICES.
Passed: CHECK INTERIOR FOR SIGNS OF PHYSICAL OR ELECTRICAL DAMAGE.
Passed: CLEAN INTERIOR PAYING SPECIAL ATTENTION TO SWITCHES AND CONNECTORS.
Passed: LUBRICATE TIMING MECHANISM. REMOVE AND CLEAN CONTROL VALVES.
Passed: CLEAN BELLOWS CHAMBER. REPLACE BELLOWS IF NEEDED.
03/18/19 07:26 PM Page 1
American Bio~Medics Work Order #: 23672
Equipment Data MediMizer™
Control #: 1898 Description: Chair Dental
Manufacturer: Midmark Corporation Model #: 153592-003
Status: In Service
Serial #: V1597690
Work Order PO #: Pref. Team: CLINENG
Team Leader:
Facility: CFHC Winter Heaven
Department: Dental, CFHC Winter Haven
Location: Dental, Winter Haven System:
Floor: 1 Room #: 4 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: (863) 413-8600
Service Requested: Safety and Performance.
Date WO # Service Requested Past Service Information Service
03/01/19 23672 Safety and Performance. Completed All Scheduled Inspect
03/09/18 21589 Safety and Performance. Completed All Scheduled Inspect
03/10/17 19604 Safety and Performance. Completed All Scheduled Inspect
04/11/16 17642 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 7 minutes Completed All Scheduled Inspections (Quick Entry)
Passed: CHECK ELECTRICAL SAFETY
Passed: CHECK GROUND RESISTANCE {pass < .5 OHMS} .05 Ohms
Passed: CHECK ELECTRICAL LEAKAGE {pass < 300 uA} 25 uA
Passed: CHECK MECHANICAL INTEGRITY OF HEAD AND FOOT REST AND OTHER ACCESSORIES.
Passed: CHECK ALL CONTROLS FOR PROPER OPERATION
Passed: CHECK FOR PROPER OPERATION BY CYCLING THROUGH ALL POSSIBLE MOVEMENTS.
Passed: CHECK THAT ALL MOVEMENTS ARE SMOOTH AND WITHOUT HESITATION OR BINDING.
Passed: CHECK OVERALL CONDITION OF TABLE FOR DAMAGE
Passed: VISUALLY CHECK THE EXTERIOR OF THE TABLE FOR ANY SIGNS OF DAMAGE.
Passed: VERIFY CORRECT ARTICULATION OF ALL MECHANICAL ASSEMBLIES.
Passed: VISUALLY INSPECT ELECTRICAL FOR SIGNS OF DAMAGE AND/OR OVERHAEATING
Passed: VISUALLY CHECK THE CONDITION OF THE POWER CORD AND PLUG FOR CRACKS, CUTS,
Passed: BARE OR BROKEN WIRES AND SIGNS OF EXCESSIVE HEAT (DISCOLORATION).
03/18/19 07:26 PM Page 1
American Bio~Medics Work Order #: 23673
Equipment Data MediMizer™
Control #: 1899 Description: SCALER, DENTAL
Manufacturer: Dentsply International Model #: CAVITRON PLUS
Status: In Service
Serial #: G137-06852
Work Order PO #: Pref. Team: CLINENG
Team Leader:
Facility: CFHC Winter Heaven
Department: Dental, CFHC Winter Haven
Location: Dental, Winter Haven 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: (863) 413-8600
Service Requested: Safety and Performance.
Notes: Electrical Safety Check: .11 Ohms Leakage: 90.6 uA
Date WO # Service Requested Past Service Information Service
03/01/19 23673 Safety and Performance. Completed All Scheduled Inspect
03/09/18 21590 Safety and Performance. Completed All Scheduled Inspect
03/10/17 19605 Safety and Performance. Completed All Scheduled Inspect
04/11/16 17643 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 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 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 #: 23653
Equipment Data MediMizer™
Control #: 1900 Description: Dental X-Ray
Manufacturer: Gendex Dental Systems Model #: 110-0205G1
Status: In Service
Serial #: 3200739
Work Order PO #:
Facility: CFHC Winter Heaven
Department: Dental, CFHC Winter Haven
Location: Dental, Winter Haven System:
Floor: 1 Room #: 4 Building:
Risk Priority: 0 Last Seen: 03/01/19 Inspections: Last:03/01/19 Next: 03/01/20 Performance and PM
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: Performance and PM.
Notes: Fixed equipment.
Date WO # Service Requested Past Service Information Service
03/01/19 23653 Performance and PM. Completed All Scheduled Inspect
03/09/18 21570 Performance and PM. Completed All Scheduled Inspect
03/10/17 19586 Performance and PM. Completed All Scheduled Inspect
04/11/16 17624 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 7 minutes Completed All Scheduled Inspections (Quick Entry)
Passed: CHECK KVP MA-TIME FOR ACCURACY
Passed: CHECK ELECTRICAL LOCKS FOR PROPER OPERATION.
Passed: CHECK OTHER ELECTRICAL FUNCTIONS FOR PROPER OPERATION.
Passed: CHECK BATTERIES IF APPLICABLE
Passed: CHECK CONDITION OF CABLE AND DRAPES.
Passed: CHECK SPOT FILM DEVICE IF APPLICABLE.
Passed: CHECK STATIONARY AND MOVABLE RAILS FOR PROPER SUPPORT AND TRAVEL
Passed: CHECK TUBE COLUMN FOR FREE MOVEMENT
Passed: CHECK TABLE BUCKY
Passed: CHECK COLLIMATORS (OPERATIONAL WITHIN SPECS.)
Passed: CHECK INTERIOR FOR SIGNS OF ELECTRICAL OR MECHANICAL DAMAGE.
Passed: CLEAN INTERIOR PAYING SPECIAL ATTENTION TO SWITCHES AND CONTROLS.
Passed: CLEAN COOLING FANS AND FILTERS. CHECK HIGH VOLTAGE CONNECTIONS.
Passed: PERFORM CALIBRATION ACCORDING TO MANUFACTURES SPECIFICATIONS.
03/18/19 07:26 PM Page 1
American Bio~Medics Work Order #: 23654
Equipment Data MediMizer™
Control #: 1901 Description: Dental X-Ray
Manufacturer: Gendex Dental Systems Model #: 110-0205G1
Status: In Service
Serial #: 3200740
Work Order PO #:
Facility: CFHC Winter Heaven
Department: Dental, CFHC Winter Haven
Location: Dental, Winter Haven System:
Floor: 1 Room #: 1 Building:
Risk Priority: 0 Last Seen: 03/01/19 Inspections: Last:03/01/19 Next: 03/01/20 Performance and PM
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: Performance and PM.
Notes: Fixed equipment.
Date WO # Service Requested Past Service Information Service
03/01/19 23654 Performance and PM. Completed All Scheduled Inspect
03/09/18 21571 Performance and PM. Completed All Scheduled Inspect
03/10/17 19587 Performance and PM. Completed All Scheduled Inspect
04/11/16 17625 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 5 minutes Completed All Scheduled Inspections (Quick Entry)
Passed: CHECK KVP MA-TIME FOR ACCURACY
Passed: CHECK ELECTRICAL LOCKS FOR PROPER OPERATION.
Passed: CHECK OTHER ELECTRICAL FUNCTIONS FOR PROPER OPERATION.
Passed: CHECK BATTERIES IF APPLICABLE
Passed: CHECK CONDITION OF CABLE AND DRAPES.
Passed: CHECK SPOT FILM DEVICE IF APPLICABLE.
Passed: CHECK STATIONARY AND MOVABLE RAILS FOR PROPER SUPPORT AND TRAVEL
Passed: CHECK TUBE COLUMN FOR FREE MOVEMENT
Passed: CHECK TABLE BUCKY
Passed: CHECK COLLIMATORS (OPERATIONAL WITHIN SPECS.)
Passed: CHECK INTERIOR FOR SIGNS OF ELECTRICAL OR MECHANICAL DAMAGE.
Passed: CLEAN INTERIOR PAYING SPECIAL ATTENTION TO SWITCHES AND CONTROLS.
Passed: CLEAN COOLING FANS AND FILTERS. CHECK HIGH VOLTAGE CONNECTIONS.
Passed: PERFORM CALIBRATION ACCORDING TO MANUFACTURES SPECIFICATIONS.
03/18/19 07:26 PM Page 1
American Bio~Medics Work Order #: 23655
Equipment Data MediMizer™
Control #: 1902 Description: Dental X-Ray
Manufacturer: Gendex Dental Systems Model #: 110-0205G1
Status: In Service
Serial #: 3200738
Work Order PO #:
Facility: CFHC Winter Heaven
Department: Dental, CFHC Winter Haven
Location: Dental, Winter Haven System:
Floor: 1 Room #: 2 Building:
Risk Priority: 0 Last Seen: 03/01/19 Inspections: Last:03/01/19 Next: 03/01/20 Performance and PM
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: Performance and PM.
Notes: Fixed equpment.
Date WO # Service Requested Past Service Information Service
03/01/19 23655 Performance and PM. Completed All Scheduled Inspect
03/09/18 21572 Performance and PM. Completed All Scheduled Inspect
03/10/17 19588 Performance and PM. Completed All Scheduled Inspect
04/11/16 17626 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 5 minutes Completed All Scheduled Inspections (Quick Entry)
Passed: CHECK KVP MA-TIME FOR ACCURACY
Passed: CHECK ELECTRICAL LOCKS FOR PROPER OPERATION.
Passed: CHECK OTHER ELECTRICAL FUNCTIONS FOR PROPER OPERATION.
Passed: CHECK BATTERIES IF APPLICABLE
Passed: CHECK CONDITION OF CABLE AND DRAPES.
Passed: CHECK SPOT FILM DEVICE IF APPLICABLE.
Passed: CHECK STATIONARY AND MOVABLE RAILS FOR PROPER SUPPORT AND TRAVEL
Passed: CHECK TUBE COLUMN FOR FREE MOVEMENT
Passed: CHECK TABLE BUCKY
Passed: CHECK COLLIMATORS (OPERATIONAL WITHIN SPECS.)
Passed: CHECK INTERIOR FOR SIGNS OF ELECTRICAL OR MECHANICAL DAMAGE.
Passed: CLEAN INTERIOR PAYING SPECIAL ATTENTION TO SWITCHES AND CONTROLS.
Passed: CLEAN COOLING FANS AND FILTERS. CHECK HIGH VOLTAGE CONNECTIONS.
Passed: PERFORM CALIBRATION ACCORDING TO MANUFACTURES SPECIFICATIONS.
03/18/19 07:26 PM Page 1
American Bio~Medics Work Order #: 23674
Equipment Data MediMizer™
Control #: 1903 Description: BATTERY CHARGER
Manufacturer: Kerr Corporation Model #: DEMI PLUS
Status: In Service
Serial #: 760046745
Work Order PO #: Pref. Team: CLINENG
Team Leader:
Facility: CFHC Winter Heaven
Department: Dental, CFHC Winter Haven
Location: Dental, Winter Haven 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: (863) 413-8600
Service Requested: Safety, Performance and PM.
Date WO # Service Requested Past Service Information Service
03/01/19 23674 Safety, Performance and PM. Completed All Scheduled Inspect
03/09/18 21591 Safety, Performance and PM. Completed All Scheduled Inspect
03/10/17 19606 Safety, Performance and PM. Completed All Scheduled Inspect
04/11/16 17644 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: 12vDC 2.5A
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 #: 23675
Equipment Data MediMizer™
Control #: 1904 Description: INCUBATOR BIOLOGICAL INDICATOR ,
Manufacturer: 3m Health Care Model #: 116
Status: In Service
Serial #: 1774419
Work Order PO #: Pref. Team: CLINENG
Team Leader:
Facility: CFHC Winter Heaven
Department: Dental, CFHC Winter Haven
Location: Dental, Winter Haven System:
Floor: 1 Room #: Building:
Risk Priority: 0 Last Seen: 03/01/19 Inspections: Last:03/01/19 Next: 03/01/20 Safety and PM
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 PM.
Date WO # Service Requested Past Service Information Service
03/01/19 23675 Safety and PM. Completed All Scheduled Inspect
03/09/18 21592 Safety and PM. Completed All Scheduled Inspect
03/10/17 19607 Safety and PM. Completed All Scheduled Inspect
04/11/16 17645 Safety 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 GROUND RESISTANCE {pass < .5 OHMS} .28 Ohms
Passed: CHECK ELECTRICAL LEAKAGE {pass < 300 uA} 9 uA
Passed: CHECK OVERAL CONDITION OF HARDWARE ON DEVICE, LATCHES, CASTERS, COVERS
Passed: CHECK MECHANICAL INTEGRITY OF ALL CONTROLS AND SWITCHES
Passed: CHECK CONDITION OF POWER CORD AND PLUG
Passed: CLEAN INTERIOR AND EXTERIOR OF INCUBATOR
Passed: CHECK HEATING SYSTEM. CHECK HEATERS FOR SIGNS OF DETERIORATION.
03/18/19 07:26 PM Page 1
American Bio~Medics Work Order #: 23656
Equipment Data MediMizer™
Control #: 1905 Description: DEFIBRILLATOR, BATTERY POWERED
Manufacturer: Cardiac Science, Inc. Model #: POWERHEART AED G3
Status: Removed From Inventory
Serial #: 6009419
Work Order PO #:
Facility: CFHC Winter Heaven
Department: Dental, CFHC Winter Haven
Location: Dental, Winter Haven System:
Floor: 1 Room #: Building:
Risk Priority: 1 Last Seen: 03/10/17 Inspections: Last:03/10/17 Next:
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: Removed from service and equipment inventory.
Date WO # Service Requested Past Service Information Service
03/01/19 23656 Safety, Performance and PM. Removed from Inventory
03/09/18 21573 Safety, Performance and PM. Unit Not Located
03/10/17 19589 Safety, Performance and PM. Completed All Scheduled Inspect
04/11/16 17627 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 26 minutes Removed from Inventory (Quick Entry)
03/18/19 07:26 PM Page 1
American Bio~Medics Work Order #: 23657
Equipment Data MediMizer™
Control #: 1906 Description: REFRIGERATOR
Manufacturer: Electrolux Home Products Model #: FFPS31L22QM
Status: In Service
Serial #: KA41850077
Work Order PO #:
Facility: CFHC Winter Heaven
Department: Dental, CFHC Winter Haven
Location: Dental, Winter Haven 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: (863) 413-8600
Service Requested: Safety, Performance and PM.
Notes: Temperature accuracy check: Freezer 3.8 dF / -15.7 dC -------- Refrigerator: 10.2 dC / 50.3 dF
Date WO # Service Requested Past Service Information Service
03/01/19 23657 Safety, Performance and PM. Completed All Scheduled Inspect
03/09/18 21574 Safety, Performance and PM. Completed All Scheduled Inspect
03/10/17 19590 Safety, Performance and PM. Completed All Scheduled Inspect
04/11/16 17628 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 7 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} 8 uA
Passed: CHECK DOOR GASKET AND DOOR. CHECK LOCKING MECHANISM AND LATCHES.
Passed: CHECK TEMPERATURE AND REGULATION. CHECK INSIDE LAMP AND DOOR SWITCH.
Passed: CHECK INTERIOR OF BOX FOR LEAKS OR DAMAGE TO TRAYS.
Passed: CHECK AND CLEAN DRAIN HOSES. CLEAN COMPRESSOR, FAN AND CONDENSER.
Passed: CLEAN FAN FILTERS. CHECK COMPRESSOR FOR QUIET OPERATION.
Passed: CHECK COMPRESSOR AREA FOR SIGNS OF MECHANICAL OR ELECTRICAL DAMAGE.
03/18/19 07:26 PM Page 1
American Bio~Medics Work Order #: 23658
Equipment Data MediMizer™
Control #: 1907 Description: TRIMMER MODULE
Manufacturer: Buffalo Dental Mfg. Model #: 61792
Status: In Service
Serial #: 25153
Work Order PO #:
Facility: CFHC Winter Heaven
Department: Dental, CFHC Winter Haven
Location: Dental, Winter Haven System:
Floor: 1 Room #: Building:
Risk Priority: 4 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: (863) 413-8600
Service Requested: Safety and Performance.
Date WO # Service Requested Past Service Information Service
03/01/19 23658 Safety and Performance. Completed All Scheduled Inspect
03/09/18 21575 Safety and Performance. Completed All Scheduled Inspect
03/10/17 19591 Safety and Performance. Completed All Scheduled Inspect
04/11/16 17629 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} .03 Ohms
Passed: CHECK ELECTRICAL LEAKAGE {pass < 300 uA} 22 uA
Passed: CHECK BRUSHES, REPLACE IF NECESSARY. CHECK CONDITION OF COMMUTATOR.
Passed: LUBRICATE MOTOR AND BEARINGS AS APPLICABLE. CHECK TIMER ACCURACY.
Passed: CHECK AND CLEAN CIRCULATION FAN. CLEAN FAN FILTER IF APPLICABLE.
03/18/19 07:26 PM Page 1
American Bio~Medics Work Order #: 23659
Equipment Data MediMizer™
Control #: 1909 Description: MIXER, CLINICAL LABRORATORY
Manufacturer: WHIP MIX CORPORATION Model #: 10650
Status: In Service
Serial #: 0114810303
Work Order PO #:
Facility: CFHC Winter Heaven
Department: Dental, CFHC Winter Haven
Location: Dental, Winter Haven 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: (863) 413-8600
Service Requested: Safety, Performance and PM.
Date WO # Service Requested Past Service Information Service
03/01/19 23659 Safety, Performance and PM. Completed All Scheduled Inspect
03/09/18 21576 Safety, Performance and PM. Completed All Scheduled Inspect
03/10/17 19592 Safety, Performance and PM. Completed All Scheduled Inspect
04/11/16 17630 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 GROUND RESISTANCE {pass < .5 OHMS} .09 Ohms
Passed: CHECK ELECTRICAL LEAKAGE {pass < 300 uA} 13 uA
Passed: CHECK UNIT FOR SMOOTH AND QUIET OPERATION.
Passed: CHECK SAMPLE HOLDER FOR MECHANICAL INTEGRITY. CHECK TIMER IF APPLICABLE.
Passed: CHECK SPEED CALIBRATION AND METER IF APPLICABLE.
Passed: CHECK MOTOR BRUSHES AND ARMATURE. CHECK DRIVE BELT IF APPLICABLE.
Passed: CLEAN INTERIOR OF UNIT.
Passed: LUBE UNIT AS NECESSARY
Passed: CHECK OUTSIDE OF UNIT FOR SECURITY AND MISSING HARDWARE
Passed: CHECK TRAYS AND HOLDER ASSY FOR SECURITY
Passed: CHECK OVERALL CONDITION OF UNIT
03/18/19 07:26 PM Page 1
American Bio~Medics Work Order #: 23660
Equipment Data MediMizer™
Control #: 1910 Description: Dental Handpiece Controller
Manufacturer: Kaltenbach and Voigt Model #: 4957
Status: In Service
Serial #: 13-0000907
Work Order PO #:
Facility: CFHC Winter Heaven
Department: Dental, CFHC Winter Haven
Location: Dental, Winter Haven System:
Floor: 1 Room #: Building:
Risk Priority: 0 Last Seen: 03/01/19 Inspections: Last:03/01/19 Next: 03/01/20 Performance, PM 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: Performance, PM and Safety.
Notes: Unit is double insulated. Leakage: 17 uA
Date WO # Service Requested Past Service Information Service
03/01/19 23660 Performance, PM and Safety. Completed All Scheduled Inspect
03/09/18 21577 Performance, PM and Safety. Completed All Scheduled Inspect
03/10/17 19593 Performance, PM and Safety. Completed All Scheduled Inspect
04/11/16 17631 Performance, PM and Safety. 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 FILTERS
Passed: CHECK AIR OUTPUTS
Passed: CHECK EXTERIOR OF UNIT FOR CORROSION. CLEAN LINT FILTER.
Passed: CHECK AIR INLET ORIFICE FOR RESTRICTIONS.
Passed: CHECK O-RINGS AND GASKETS. CHECK OPERATION OF UNIT.
Passed: CHECK UNIT FOR SIGNS OF DAMAGE
Passed: CHECK TWO PRONG ELECTRICAL CORD.
Passed: CHECK UNIT FOR ANY DAMAGE
Passed: CHECK INTERIOR FOR SIGNS OF PHYSICAL OR ELECTRICAL DAMAGE.
Passed: CLEAN INTERIOR PAYING SPECIAL ATTENTION TO SWITCHES AND CONNECTORS.
Passed: CLEAN INTERIOR INCLUDING CIRUCLATING FAN IF APPLICABLE. LUBRICATE.
Passed: CHECK HEATER AND WIRING FOR ELECTRICAL OR MECHANICAL DAMAGE.
Passed: CLEAN INTERIOR. CHECK FOR SIGNS OF WATER LEAKAGE. CHECK ELECTRICAL.
Passed: CLEAN OR REPLACE O-RINGS AND GASKETS IF NEEDED.
Passed: CHECK ELECTRICAL SAFETY
Passed: CHECK GROUND RESISTANCE {pass < .5 OHMS} Ohms
Passed: CHECK ELECTRICAL LEAKAGE {pass < 300 uA} 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
03/18/19 07:26 PM Page 1
American Bio~Medics Work Order #: 23661
Equipment Data MediMizer™
Control #: 1911 Description: MOTOR DRIVE
Manufacturer: Handler Red Wing Intl. Model #: 26A
Status: In Service
Serial #: 816108/17/14/056
Work Order PO #:
Facility: CFHC Winter Heaven
Department: Dental, CFHC Winter Haven
Location: Dental, Winter Haven System:
Floor: 1 Room #: Building:
Risk Priority: 4 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: (863) 413-8600
Service Requested: Safety and Performance.
Date WO # Service Requested Past Service Information Service
03/01/19 23661 Safety and Performance. Completed All Scheduled Inspect
03/09/18 21578 Safety and Performance. Completed All Scheduled Inspect
03/10/17 19594 Safety and Performance. Completed All Scheduled Inspect
04/11/16 17632 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 ELECTRICAL SAFETY
Passed: CHECK GROUND RESISTANCE {pass < .5 OHMS} .09 Ohms
Passed: CHECK ELECTRICAL LEAKAGE {pass < 300 uA} 21 uA
Passed: CHECK BRUSHES, REPLACE IF NECESSARY. CHECK CONDITION OF COMMUTATOR.
Passed: LUBRICATE MOTOR AND BEARINGS AS APPLICABLE. CHECK TIMER ACCURACY.
Passed: CHECK AND CLEAN CIRCULATION FAN. CLEAN FAN FILTER IF APPLICABLE.
03/18/19 07:26 PM Page 1
American Bio~Medics Work Order #: 23565
Equipment Data MediMizer™
Control #: 2019 Description: TABLE, EXAM-TREATMENT
Manufacturer: Midmark Corporation Model #: 204-001
Status: Unit Not Located
Serial #: V1606088
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: 03/09/18 Inspections: Last:03/09/18 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: Unable to locate.
Date WO # Service Requested Past Service Information Service
03/01/19 23565 Safety, Performance and PM. Unit Not Located
03/09/18 21560 Safety, Performance and PM. Completed All Scheduled Inspect
03/10/17 19788 Safety, Performance and PM. Completed All Scheduled Inspect
04/11/16 18289 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 2 minutes Unit Not Located (Quick Entry)
03/18/19 07:26 PM Page 1
American Bio~Medics Work Order #: 23437
Equipment Data MediMizer™
Control #: 2073 Description: TABLE, EXAM-TREATMENT
Manufacturer: Midmark Corporation Model #: 204-001
Status: In Service
Serial #: V1540222
Work Order PO #:
Facility: CFHC Winter Heaven
Department: Adult Triage
Location: Winter Haven, FL System:
Floor: 1 Room #: Triage 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 23437 Safety, Performance and PM. Completed All Scheduled Inspect
03/09/18 21517 Safety, Performance and PM. Completed All Scheduled Inspect
03/10/17 19732 Safety, Performance and PM. Completed All Scheduled Inspect
05/20/16 18347 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 7 minutes Completed All Scheduled Inspections (Quick Entry)
Passed: CHECK ELECTRICAL SAFETY
Passed: CHECK GROUND RESISTANCE {pass < .5 OHMS} .06 Ohms
Passed: CHECK ELECTRICAL LEAKAGE {pass < 300 uA} 10 uA
Passed: CHECK MECHANICAL INTEGRITY OF HEAD AND FOOT REST AND OTHER ACCESSORIES.
Passed: CHECK ALL CONTROLS FOR PROPER OPERATION
Passed: CHECK FOR PROPER OPERATION BY CYCLING THROUGH ALL POSSIBLE MOVEMENTS.
Passed: CHECK THAT ALL MOVEMENTS ARE SMOOTH AND WITHOUT HESITATION OR BINDING.
Passed: CHECK OVERALL CONDITION OF TABLE FOR DAMAGE
Passed: VISUALLY CHECK THE EXTERIOR OF THE TABLE FOR ANY SIGNS OF DAMAGE.
Passed: VERIFY CORRECT ARTICULATION OF ALL MECHANICAL ASSEMBLIES.
Passed: VISUALLY INSPECT ELECTRICAL FOR SIGNS OF DAMAGE AND/OR OVERHAEATING
Passed: VISUALLY CHECK THE CONDITION OF THE POWER CORD AND PLUG FOR CRACKS, CUTS,
Passed: BARE OR BROKEN WIRES AND SIGNS OF EXCESSIVE HEAT (DISCOLORATION).
Passed: CHECK ALL MOVING SURFACES, PIVOTS, GEARS AND MECHANISMS.
Passed: LUBRICATE WHERE NECESSARY. CHECK MOTOR AND BRUSHES.
Passed: CLEAN INTERIOR. CLEAN FILTERS AND TRAPS WHERE APPLICABLE.
Passed: CHECK ELECTRICAL CABLES FOR CRACKING OR WEAR TO OUTER JACKET.
03/18/19 07:26 PM Page 1
American Bio~Medics Work Order #: 23577
Equipment Data MediMizer™
Control #: 2090 Description: ECG PREAMP
Manufacturer: Midmark Corporation Model #: IQECG
Status: Unit Not Located
Serial #: 474651
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: 03/09/18 Inspections: Last:03/09/18 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: Unable to locate.
Date WO # Service Requested Past Service Information Service
03/01/19 23577 Safety, Performance and PM. Unit Not Located
03/09/18 21561 Safety, Performance and PM. Completed All Scheduled Inspect
03/10/17 19789 Safety, Performance and PM. Completed All Scheduled Inspect
04/11/16 18250 Safety, Performance and PM. Unit Not Located
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)
Passed: PERFORM LEAD LEAKAGE PER TESTER INSTRUCTIONS. SEE NEXT CHECK FOR LIMITS.
Passed: LIMITS: ISOLATED UNITS < 20 MICRO AMPS. NON-ISOLATED UNITS < 50 MICRO AMPS
Passed: CHECK PATIENT CABLE AND CONNECTOR FOR MECHANICAL OR ELECTRICAL DAMAGE.
Passed: CHECK LEAD SELECTOR SWITCH FOR PROPER DETENTING AND LEAD SHORTING.
Passed: CHECK VERTICAL GAIN AND CALIBRATION PULSE. CHECK MONITOR/DIAGNOSTIC SWITCH
Passed: CHECK AMPLIFIER FREQENCY RESPONSE AND COMMON MODE REJECTION.
Passed: CHECK ALL CONTROLS FOR PROPER RESPONSE. CHECK INDICATOR LAMPS.
Passed: CHECK HEART METER ACCURACY AT 3 POINTS FOR + OR - 3%.
Passed: CHECK HIGH AND LOW ALARMS FOR PROPER TRIGGER AND RESPONSE TIME.
Passed: CYCLE ALARMS AND CHECK AUDIO AND VISUAL INDICATORS FOR PROPER OPERATION.
Passed: CHECK INTERIOR FOR SIGNS OF PHYSICAL OR ELECTRICAL DAMAGE.
Passed: CLEAN INTERIOR PAYING SPECIAL ATTENTION TO SWITCHES AND CONNECTORS.
03/18/19 07:26 PM Page 1
American Bio~Medics Work Order #: 23734
Equipment Data MediMizer™
Control #: 2161 Description: Centrifuge
Manufacturer: The Drucker Co. Model #: 642E
Status: In Service
Serial #: 520407-759
Work Order PO #:
Facility: CFHC Winter Heaven
Department: Laboratory
Location: Winter Haven, FL 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.
Notes: Hourmeter: 14720 hrs.
Date WO # Service Requested Past Service Information Service
03/01/19 23734 Safety, Performance and PM. Completed All Scheduled Inspect
03/09/18 21599 Safety, Performance and PM. Completed All Scheduled Inspect
03/10/17 19614 Safety, Performance and PM. Removed from Inventory
04/11/16 18331 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 10 minutes Completed All Scheduled Inspections (Quick Entry)
Passed: CHECK ELECTRICAL SAFETY
Passed: CHECK GROUND RESISTANCE {pass < .5 OHMS} .09 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 : 3366 RPM INDICATED ------- RPM ACTUAL 3360 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
American Bio~Medics Work Order #: 23438
Equipment Data MediMizer™
Control #: 2227 Description: AED Defibrillator
Manufacturer: Philips Medical Systems Model #: HEARTSTART HS1
Status: Unit Not Located
Serial #: A16C-00142
Work Order PO #:
Facility: CFHC Winter Heaven
Department: Adult Triage
Location: Nurse's Desk - WH System:
Floor: 1 Room #: Desk Building:
Risk Priority: 0 Last Seen: 08/31/18 Inspections: Last:08/31/18 Next: 03/01/20 Performance and Safety
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: Performance and Safety.
Notes: Unable to locate.
Date WO # Service Requested Past Service Information Service
03/01/19 23438 Performance and Safety. Unit Not Located
08/31/18 22437 Performance and Safety. Completed All Scheduled Inspect
08/03/17 20556 Performance and Safety. Completed All Scheduled Inspect
08/02/16 18697 Performance and Safety. 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 #: 23821
Equipment Data MediMizer™
Control #: 2228 Description: AED Defibrillator
Manufacturer: Philips Medical Systems Model #: HEARTSTART HS1
Status: In Service
Serial #: A16C-00151
Work Order PO #:
Facility: CFHC Winter Heaven
Department: Dental, CFHC Winter Haven
Location: Dental - Lake Wales System:
Floor: 1 Room #: Desk Building:
Risk Priority: 0 Last Seen: 03/15/19 Inspections: Last:03/15/19 Next: 03/01/20 Performance and Safety
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: Performance and Safety.
Notes: Battery Expiration Date: 2021 -10. Electrode Expiration Date: 2020-10.
Date WO # Service Requested Past Service Information Service
03/15/19 23821 Performance and Safety. Completed All Scheduled Inspect
08/31/18 22438 Performance and Safety. Completed All Scheduled Inspect
08/03/17 20557 Performance and Safety. Completed All Scheduled Inspect
08/02/16 18698 Performance and Safety. 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 10 minutes Completed All Scheduled Inspections (Quick Entry)
Passed: CHECK ALL CONTROLS FOR PROPER OPERATION
Passed: CHECK UNIT FOR PROPER OPERATION
Passed: CHECK OPERATION OF ANALOG/DIGITAL DISPLAY.
Passed: CHECK ENERGY SELECT SWITCH FOR MECHANICAL INTEGRITY.
Passed: CHECK SYNCHRONIZER OPERATION FOR PROPER FIRE TIME AND FLAG PULSE.
Passed: CHECK DEFIBRILLATOR OUTPUT. RECORD DATA (ALL NUMBERS ARE IN JOULES).
Passed: PERFORM CALIBRATION PROCEDURE PER SERVICE MANUAL, IF NECESSARY.
Passed: CHECK INTERNAL DISCHARGE OF STORED ENERGY.
Passed: CHECK CHARGE IS REMOVED AFTER CHANGING ENERGY SETTING.
Passed: CHECK ALL CONTROLS AND INDICATORS FOR PROPER OPERATION.
Passed: CHECK ECG WAVEFORM HAS NO DISTORTION OR CLIPPING.
Passed: CHECK THE HEART RATE WITH THE INDICATED ECG WAVEFORM RATES.
Passed: SET MONITOR ALARM TO 120 BPM AND VERIFY AUDIO AND VISUAL ALARMS WHEN THE
Passed: RATE IS INCREASED TO 120 BPM. REPEAT AT 30 BPM.
Passed: CHECK FOR 1 PULSE WAVEFORM FOR EACH 25 MM OF DISTANCE @ 25 MM/SEC SETTING.
Passed: CHECK MONITOR's ABILITY TO DETECT VENTRICULAR FIBRILLATION.
Passed: CHECK VISUAL AND AUDIO INDICATORS.
Passed: CHECK CONDITION OF ALL LAMPS AND LED's.
Passed: CLEAN PRINTER HEAD AND ROLLERS.
Passed: CHECK FOR SIGNS OF HIGH VOLTAGE ARCHING.
Passed: CHECK CONDITION OF POWER CORD AND PLUG FOR ANY SIGNS OF DAMAGE.
Passed: CHECK CONDITION OF BATTERY AND REPLACE IF NECESSARY.
Passed: CHECK BATTERY EXPIRATION DATE. EXPIRES ON 2021/ 10
Passed: CHECK OVERALL CONDITION OF UNIT FOR DAMAGE.
Passed: CLEAN EXTERNAL SURFACES
Passed: RETURN TO MFG FOR CALIBRATION IF NECESSARY
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.
03/18/19 07:26 PM Page 1
American Bio~Medics Work Order #: 23613
Equipment Data MediMizer™
Control #: 2470 Description: MONITOR, MULTIPARAMETER
Manufacturer: Welch Allyn Inc. Model #: 45MT0
Status: In Service
Serial #: 20080301492
Work Order PO #: Pref. Team: CLINENG
Team Leader:
Facility: CFHC Winter Heaven
Department: Adult Triage
Location: Winter Haven, FL System:
Floor: 1 Room #: Hallwy Building:
Risk Priority: 3 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 23613 Safety and Performance. Completed All Scheduled Inspect
03/09/18 21565 Safety and Performance. Completed All Scheduled Inspect
03/10/17 19790 Safety and Performance. Replaced
03/10/17 19790 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 10 minutes Completed All Scheduled Inspections (Quick Entry)
Passed: CHECK ELECTRICAL SAFETY
Passed: PERFORM LEAD LEAKAGE PER TESTER INSTRUCTIONS. SEE NEXT CHECK FOR LIMITS.
Passed: CHECK OVERALL CONDITION OF UNIT FOR DAMAGE
Passed: CHECK ALL CONTROLS AND INDICATORS FOR PROPER OPERATION
Passed: CHECK DISPLAY FOR PROPER LINEARITY, SIZE, AND INTENSITY
Passed: CHECK HEART RATE ACCURACY PER MFG. SPECS
Passed: CHECK HEART RATE ALARMS PER MFG. SPECS.
Passed: CHECK RESPIRATION PARAMETERS PER MFG. SPECS. IF APPLICABLE
Passed: CHECK INVASIVE PRESSURE ACCURACY AND ALARMS PER MFG. SPECS. IF APPLICABLE
Passed: CHECK NIBP ACCURACY AND ALARMS PER MFG. SPECS. IF APPLICABLE
Passed: RESULTS:
Passed: SETTING ACTUAL
Passed: 120/80 mmHg 114/82 mmHg
Passed: ---------------------------------------------------------------------------
Passed: CHECK RECORDER FOR PROPER OPERATION AND DISPLAY IF APPLICABLE
Passed: CHECK TRENDING OPTIONS FOR PROPER OPERATION IF APPLICABLE
Passed: CHECK SPO2 ACCURACY AND ALARMS PER MFG. SPECS. IF APPLICABLE
Passed: RESULTS:
Passed: SETTING ACTUAL
Passed: 98% SPO2 98% SPO2
Passed: ---------------------------------------------------------------------------
Passed: CHECK ALL CONNECTORS FOR DAMAGE
Passed: CHECK TEMPERATURE CALIBRATION USING CALIBRATION KEY.
Passed: RESULTS:
Passed: SETTING ACTUAL
Passed: 97.3 Degrees F 97.3 dF
03/18/19 07:26 PM Page 1
American Bio~Medics Work Order #: 23676
Equipment Data MediMizer™
Control #: 2516 Description: Chair Dental
Manufacturer: Midmark Corporation Model #: 153592-003
Status: In Service
Serial #: V1791220
Work Order PO #: Pref. Team: CLINENG
Team Leader:
Facility: CFHC Winter Heaven
Department: Dental, CFHC Winter Haven
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: (863) 413-8600
Service Requested: Safety and Performance.
Date WO # Service Requested Past Service Information Service
03/01/19 23676 Safety and Performance. Completed All Scheduled Inspect
03/09/18 21593 Safety and Performance. Completed All Scheduled Inspect
03/10/17 19608 Safety and Performance. Completed All Scheduled Inspect
12/13/16 19424 Safety and Performance Safety and Performance
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 7 minutes Completed All Scheduled Inspections (Quick Entry)
Passed: CHECK ELECTRICAL SAFETY
Passed: CHECK GROUND RESISTANCE {pass < .5 OHMS} .08 Ohms
Passed: CHECK ELECTRICAL LEAKAGE {pass < 300 uA} 21 uA
Passed: CHECK MECHANICAL INTEGRITY OF HEAD AND FOOT REST AND OTHER ACCESSORIES.
Passed: CHECK ALL CONTROLS FOR PROPER OPERATION
Passed: CHECK FOR PROPER OPERATION BY CYCLING THROUGH ALL POSSIBLE MOVEMENTS.
Passed: CHECK THAT ALL MOVEMENTS ARE SMOOTH AND WITHOUT HESITATION OR BINDING.
Passed: CHECK OVERALL CONDITION OF TABLE FOR DAMAGE
Passed: VISUALLY CHECK THE EXTERIOR OF THE TABLE FOR ANY SIGNS OF DAMAGE.
Passed: VERIFY CORRECT ARTICULATION OF ALL MECHANICAL ASSEMBLIES.
Passed: VISUALLY INSPECT ELECTRICAL FOR SIGNS OF DAMAGE AND/OR OVERHAEATING
Passed: VISUALLY CHECK THE CONDITION OF THE POWER CORD AND PLUG FOR CRACKS, CUTS,
Passed: BARE OR BROKEN WIRES AND SIGNS OF EXCESSIVE HEAT (DISCOLORATION).
03/18/19 07:26 PM Page 1
American Bio~Medics Work Order #: 23677
Equipment Data MediMizer™
Control #: 2517 Description: Radiography, Dental
Manufacturer: Progeny by Midmark Model #: 30-A1025
Status: In Service
Serial #: DB73493
Work Order PO #: Pref. Team: CLINENG
Team Leader:
Facility: CFHC Winter Heaven
Department: Dental, CFHC Winter Haven
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 Performance and PM
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: Performance and PM.
Notes: Fixed equipment.
Date WO # Service Requested Past Service Information Service
03/01/19 23677 Performance and PM. Completed All Scheduled Inspect
03/09/18 21594 Performance and PM. Completed All Scheduled Inspect
03/10/17 19609 Performance and PM. Completed All Scheduled Inspect
12/13/16 19420 Safety and Performance Safety and Performance
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 KVP MA-TIME FOR ACCURACY
Passed: CHECK ELECTRICAL LOCKS FOR PROPER OPERATION.
Passed: CHECK OTHER ELECTRICAL FUNCTIONS FOR PROPER OPERATION.
Passed: CHECK BATTERIES IF APPLICABLE
Passed: CHECK CONDITION OF CABLE AND DRAPES.
Passed: CHECK SPOT FILM DEVICE IF APPLICABLE.
Passed: CHECK STATIONARY AND MOVABLE RAILS FOR PROPER SUPPORT AND TRAVEL
Passed: CHECK TUBE COLUMN FOR FREE MOVEMENT
Passed: CHECK TABLE BUCKY
Passed: CHECK COLLIMATORS (OPERATIONAL WITHIN SPECS.)
Passed: CHECK INTERIOR FOR SIGNS OF ELECTRICAL OR MECHANICAL DAMAGE.
Passed: CLEAN INTERIOR PAYING SPECIAL ATTENTION TO SWITCHES AND CONTROLS.
Passed: CLEAN COOLING FANS AND FILTERS. CHECK HIGH VOLTAGE CONNECTIONS.
Passed: PERFORM CALIBRATION ACCORDING TO MANUFACTURES SPECIFICATIONS.
03/18/19 07:26 PM Page 1
American Bio~Medics Work Order #: 23678
Equipment Data MediMizer™
Control #: 2518 Description: Chair Dental
Manufacturer: Midmark Corporation Model #: 153592-003
Status: In Service
Serial #: V1798052
Work Order PO #: Pref. Team: CLINENG
Team Leader:
Facility: CFHC Winter Heaven
Department: Dental, CFHC Winter Haven
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: (863) 413-8600
Service Requested: Safety and Performance.
Date WO # Service Requested Past Service Information Service
03/01/19 23678 Safety and Performance. Completed All Scheduled Inspect
03/09/18 21595 Safety and Performance. Completed All Scheduled Inspect
03/10/17 19610 Safety and Performance. Completed All Scheduled Inspect
12/13/16 19423 Safety and Performance Safety and Performance
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 7 minutes Completed All Scheduled Inspections (Quick Entry)
Passed: CHECK ELECTRICAL SAFETY
Passed: CHECK GROUND RESISTANCE {pass < .5 OHMS} .06 Ohms
Passed: CHECK ELECTRICAL LEAKAGE {pass < 300 uA} 16 uA
Passed: CHECK MECHANICAL INTEGRITY OF HEAD AND FOOT REST AND OTHER ACCESSORIES.
Passed: CHECK ALL CONTROLS FOR PROPER OPERATION
Passed: CHECK FOR PROPER OPERATION BY CYCLING THROUGH ALL POSSIBLE MOVEMENTS.
Passed: CHECK THAT ALL MOVEMENTS ARE SMOOTH AND WITHOUT HESITATION OR BINDING.
Passed: CHECK OVERALL CONDITION OF TABLE FOR DAMAGE
Passed: VISUALLY CHECK THE EXTERIOR OF THE TABLE FOR ANY SIGNS OF DAMAGE.
Passed: VERIFY CORRECT ARTICULATION OF ALL MECHANICAL ASSEMBLIES.
Passed: VISUALLY INSPECT ELECTRICAL FOR SIGNS OF DAMAGE AND/OR OVERHAEATING
Passed: VISUALLY CHECK THE CONDITION OF THE POWER CORD AND PLUG FOR CRACKS, CUTS,
Passed: BARE OR BROKEN WIRES AND SIGNS OF EXCESSIVE HEAT (DISCOLORATION).
03/18/19 07:26 PM Page 1
American Bio~Medics Work Order #: 23679
Equipment Data MediMizer™
Control #: 2519 Description: Radiography, Dental
Manufacturer: Progeny by Midmark Model #: 30-A1025
Status: In Service
Serial #: DB73494
Work Order PO #: Pref. Team: CLINENG
Team Leader:
Facility: CFHC Winter Heaven
Department: Dental, CFHC Winter Haven
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 Performance and PM
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: Performance and PM.
Notes: Fixed equipment.
Date WO # Service Requested Past Service Information Service
03/01/19 23679 Performance and PM. Completed All Scheduled Inspect
03/09/18 21596 Performance and PM. Completed All Scheduled Inspect
03/10/17 19611 Performance and PM. Completed All Scheduled Inspect
12/13/16 19421 Safety and Performance Safety and Performance
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 KVP MA-TIME FOR ACCURACY
Passed: CHECK ELECTRICAL LOCKS FOR PROPER OPERATION.
Passed: CHECK OTHER ELECTRICAL FUNCTIONS FOR PROPER OPERATION.
Passed: CHECK BATTERIES IF APPLICABLE
Passed: CHECK CONDITION OF CABLE AND DRAPES.
Passed: CHECK SPOT FILM DEVICE IF APPLICABLE.
Passed: CHECK STATIONARY AND MOVABLE RAILS FOR PROPER SUPPORT AND TRAVEL
Passed: CHECK TUBE COLUMN FOR FREE MOVEMENT
Passed: CHECK TABLE BUCKY
Passed: CHECK COLLIMATORS (OPERATIONAL WITHIN SPECS.)
Passed: CHECK INTERIOR FOR SIGNS OF ELECTRICAL OR MECHANICAL DAMAGE.
Passed: CLEAN INTERIOR PAYING SPECIAL ATTENTION TO SWITCHES AND CONTROLS.
Passed: CLEAN COOLING FANS AND FILTERS. CHECK HIGH VOLTAGE CONNECTIONS.
Passed: PERFORM CALIBRATION ACCORDING TO MANUFACTURES SPECIFICATIONS.
03/18/19 07:26 PM Page 1
American Bio~Medics Work Order #: 23680
Equipment Data MediMizer™
Control #: 2520 Description: Chair Dental
Manufacturer: Midmark Corporation Model #: 153592-003
Status: In Service
Serial #: V1779401
Work Order PO #: Pref. Team: CLINENG
Team Leader:
Facility: CFHC Winter Heaven
Department: Dental, CFHC Winter Haven
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: (863) 413-8600
Service Requested: Safety and Performance.
Date WO # Service Requested Past Service Information Service
03/01/19 23680 Safety and Performance. Completed All Scheduled Inspect
03/09/18 21597 Safety and Performance. Completed All Scheduled Inspect
03/10/17 19612 Safety and Performance. Completed All Scheduled Inspect
12/13/16 19422 Safety and Performance Safety and Performance
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 7 minutes Completed All Scheduled Inspections (Quick Entry)
Passed: CHECK ELECTRICAL SAFETY
Passed: CHECK GROUND RESISTANCE {pass < .5 OHMS} .05 Ohms
Passed: CHECK ELECTRICAL LEAKAGE {pass < 300 uA} 14 uA
Passed: CHECK MECHANICAL INTEGRITY OF HEAD AND FOOT REST AND OTHER ACCESSORIES.
Passed: CHECK ALL CONTROLS FOR PROPER OPERATION
Passed: CHECK FOR PROPER OPERATION BY CYCLING THROUGH ALL POSSIBLE MOVEMENTS.
Passed: CHECK THAT ALL MOVEMENTS ARE SMOOTH AND WITHOUT HESITATION OR BINDING.
Passed: CHECK OVERALL CONDITION OF TABLE FOR DAMAGE
Passed: VISUALLY CHECK THE EXTERIOR OF THE TABLE FOR ANY SIGNS OF DAMAGE.
Passed: VERIFY CORRECT ARTICULATION OF ALL MECHANICAL ASSEMBLIES.
Passed: VISUALLY INSPECT ELECTRICAL FOR SIGNS OF DAMAGE AND/OR OVERHAEATING
Passed: VISUALLY CHECK THE CONDITION OF THE POWER CORD AND PLUG FOR CRACKS, CUTS,
Passed: BARE OR BROKEN WIRES AND SIGNS OF EXCESSIVE HEAT (DISCOLORATION).
03/18/19 07:26 PM Page 1
American Bio~Medics Work Order #: 23615
Equipment Data MediMizer™
Control #: 2535 Description: INTEGRATED WALL SYSTEM
Manufacturer: Welch Allyn Inc. Model #: CONNEX
Status: In Service
Serial #: 100047244316
Work Order PO #: Pref. Team: CLINENG
Team Leader:
Facility: CFHC Winter Heaven
Department: Adult Triage
Location: Triage - 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 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 23615 Safety and Performance. Completed All Scheduled Inspect
09/14/18 22948 Won't power on. Could Not Duplicate Problem
03/09/18 21566 Safety and Performance. Completed All Scheduled Inspect
02/09/17 19394 Initial inspection - Safety and Performance Safety and Performance
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 OVERALL CONDITION OF UNIT FOR DAMAGE
Passed: CHECK ALL CONTROLS AND INDICATORS FOR PROPER OPERATION
Passed: CHECK DISPLAY FOR PROPER LINEARITY, SIZE, AND INTENSITY
Passed: CHECK HEART RATE ACCURACY PER MFG. SPECS
Passed: CHECK HEART RATE ALARMS PER MFG. SPECS.
Passed: CHECK RESPIRATION PARAMETERS PER MFG. SPECS. IF APPLICABLE
Passed: CHECK INVASIVE PRESSURE ACCURACY AND ALARMS PER MFG. SPECS. IF APPLICABLE
Passed: CHECK NIBP ACCURACY AND ALARMS PER MFG. SPECS. IF APPLICABLE
Passed: RESULTS:
Passed: SETTING ACTUAL
Passed: 120/80 mmHg 116/79 mmHg
Passed: ---------------------------------------------------------------------------
Passed: CHECK RECORDER FOR PROPER OPERATION AND DISPLAY IF APPLICABLE
Passed: CHECK TRENDING OPTIONS FOR PROPER OPERATION IF APPLICABLE
Passed: CHECK SPO2 ACCURACY AND ALARMS PER MFG. SPECS. IF APPLICABLE
Passed: RESULTS:
Passed: SETTING ACTUAL
Passed: 98% SPO2 97% SPO2
Passed: ---------------------------------------------------------------------------
Passed: CHECK ALL CONNECTORS FOR DAMAGE
03/18/19 07:26 PM Page 1
American Bio~Medics Work Order #: 23616
Equipment Data MediMizer™
Control #: 2536 Description: TABLE, OBSTETRICAL
Manufacturer: Midmark Corporation Model #: 625-395121
Status: In Service
Serial #: V1805966
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: 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: (813) 413-8600
Service Requested: Safety, Performance and PM.
Date WO # Service Requested Past Service Information Service
03/01/19 23616 Safety, Performance and PM. Completed All Scheduled Inspect
03/09/18 21567 Safety, Performance and PM. Completed All Scheduled Inspect
03/10/17 19583 PM. Completed All Scheduled Inspect
02/09/17 19395 Initial inspection - Safety and Performance Safety and Performance
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 7 minutes Completed All Scheduled Inspections (Quick Entry)
Passed: CHECK ELECTRICAL SAFETY
Passed: CHECK GROUND RESISTANCE {pass < .5 OHMS} .08 Ohms
Passed: CHECK ELECTRICAL LEAKAGE {pass < 300 uA} 86 uA
Passed: CHECK MECHANICAL INTEGRITY OF STIRRUPS AND RELATED HARDWARE.
Passed: CHECK LEVEL OF HYDRAULIC FLUID. CHECK FOR LEAKS.
Passed: CHECK FOR PROPER OPERTION BY CYCLING THROUGH ALL POSSIBLE MOVEMENTS.
Passed: CHECK THAT ALL MOVEMENTS ARE SMOOTH AND WITHOUT HESITATION OR BINDING.
Passed: CHECK ALL MOVING SURFACES, PIVOTS, GEARS AND MECHANISMS.
Passed: LUBRICATE WHERE NECESSARY. CHECK MOTOR AND BRUSHES.
Passed: CLEAN INTERIOR. CLEAN FILTERS AND TRAPS WHERE APPLICABLE.
Passed: CHECK, CLEAN AND ADJUST CRUTCH SOCKETS AS NECESSARY.
Passed: CHECK FOR SIGNS OF HYDRAULIC LEAKS. IF APPLICABLE.
03/18/19 07:26 PM Page 1
American Bio~Medics Work Order #: 23738
Equipment Data MediMizer™
Control #: 2653 Description: GLUCOSE ANALYZER
Manufacturer: Hemocue Incorporated Model #: 201
Status: Unit Not Located
Serial #: 1611118036
Work Order PO #:
Facility: CFHC Winter Heaven
Department: Laboratory
Location: Winter Haven, FL System:
Floor: 1 Room #: Lab Building:
Risk Priority: 0 Last Seen: 03/09/18 Inspections: Last:03/09/18 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.
Notes: Unable to locate.
Date WO # Service Requested Past Service Information Service
03/01/19 23738 Safety, Performance and PM. Unit Not Located
03/09/18 21600 Safety, Performance and PM. Completed All Scheduled Inspect
03/10/17 19783 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 2 minutes Unit Not Located (Quick Entry)
03/18/19 07:26 PM Page 1
American Bio~Medics Work Order #: 23764
Equipment Data MediMizer™
Control #: 2654 Description: HEMOGLOBINOMETER
Manufacturer: Hemocue Incorporated Model #: HB 201+
Status: In Service
Serial #: 1607013064
Work Order PO #: Pref. Team: CLINENG
Team Leader:
Facility: CFHC Winter Heaven
Department: Laboratory
Location: Winter Haven, FL System:
Floor: 1 Room #: Lab 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:
Service Requested: Safety, Performance and PM.
Date WO # Service Requested Past Service Information Service
03/01/19 23764 Safety, Performance and PM. Completed All Scheduled Inspect
03/09/18 21608 Safety, Performance and PM. Completed All Scheduled Inspect
03/10/17 19787 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 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 PUMP OPERATION. CHECK PULLY BELTS AND TUBING.
Passed: CHECK AND CLEAN CUVETTE ASSEMBLY. CHECK CONDTION OF ASPIRATE TUBING.
Passed: CHECK LAMP AND PHOTOTUBE HOUSING. CLEAN IF NEEDED.
Passed: CHECK O-RING AND SEAL OF CUVETTE ASSEMBLY. GREASE IF NEEDED.
Passed: READ AND SET "ARTIFICIAL" STANDARD. CALIBRATE WITH CERTIFIED STANDARD.
Passed:
Passed:
Passed:
Passed:
Passed: ALL RESULTS ACCEPTABLE:______YES ______NO
Passed: DISASSEMBLE, CHECK, AND LUBRICATE PUMP. REPLACE TUBING AS NEEDED.
Passed: REMOVE AND CLEAN FLOW-THROUGH CUVETTE.
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 #: 23739
Equipment Data MediMizer™
Control #: 2655 Description: LIGHTS, EXAMINATION
Manufacturer: McKesson Medical General, Corp. Model #: 551
Status: In Service
Serial #: BH0092506
Work Order PO #:
Facility: CFHC Winter Heaven
Department: Laboratory
Location: Winter Haven, FL System:
Floor: 1 Room #: Building:
Risk Priority: 3 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 23739 Safety and Performance. Completed All Scheduled Inspect
03/09/18 21601 Safety and Performance. Completed All Scheduled Inspect
03/10/17 19784 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} .14 Ohms
Passed: CHECK ELECTRICAL LEAKAGE {pass < 300 uA} 9 uA
Passed: CHECK OPERATION OF CONTROL KNOBS, SWITCHES, AND INDICATORS.
Passed: CHECK CONDITION OF STAND AND POLE. CHECK FLEX ASSEMBLY.
Passed: COMPLETE OPERATIONAL CHECK.
Passed: CHECK LAMP SOCKET AND SHIELD FOR MECHANICAL INTEGRITY.
Passed: INSPECT CONDITION OF POLE MOUNTING HARDWARE.
Passed: VISUALLY INSPECT THE GENERAL CONDITION OF ALL CONTROLS, SWITCHES,
Passed: INDICATORS AND MICROSWITCHES. REPLACED BAD LAMPS AS NEEDED.
Passed: VISUALLY CHECK THE CONDITION OF THE POWER CORD AND PLUG FOR CRACKS, CUTS,
Passed: BARE OR BROKEN WIRES AND SIGNS OF EXCESSIVE HEAT (DISCOLORATION).
Passed: VISUALLY CHECK THE EXTERIOR OF EQUIPMENT FOR ANY SIGNS OF DAMAGE.
03/18/19 07:26 PM Page 1
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2019 Equip Safety & Cal Report CFHC Winter Haven
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