HVAC SYSTEM MAINTENANCE - PATIENT CARE AREAS CHECKLIST Created by ChecklistGuro (https://checklistguro.com) --- GENERAL SYSTEM OVERVIEW & DOCUMENTATION --- [ ] Last System Performance Review Date [ ] System Serial Number(s) [ ] Brief Description of Current System Configuration [ ] System Type (e.g., VAV, RTU, VRF) (VAV, RTU, VRF, Other) [ ] System Operational Status (Operational, Needs Repair, Decommissioned) [ ] Upload Current System Schematics (if available) [ ] Contact Person for HVAC System Information [ ] Total System Capacity (BTU/hr) --- AIR FILTRATION & VENTILATION --- [ ] Filter Change Date [ ] Filter Type (MERV 8, MERV 11, MERV 13, HEPA) [ ] Air Exchange Rate (ACH) [ ] Exhaust Fan Operation (Operating Correctly, Operating Incorrectly, Not Operating) [ ] Notes on Air Quality/Ventilation [ ] Ventilation Issues Observed (Drafts, Stale Air, Odors, Uneven Airflow, None) [ ] Last Duct Cleaning Date --- TEMPERATURE & HUMIDITY CONTROL --- [ ] Ambient Temperature (Degrees F) [ ] Supply Air Temperature (Degrees F) [ ] Return Air Temperature (Degrees F) [ ] Relative Humidity (%) [ ] Thermostat Mode (Cool/Heat/Auto/Off) (Cool, Heat, Auto, Off) [ ] Dew Point Setting (if applicable) (Default, Adjusted) [ ] Notes on Temperature/Humidity Control [ ] Last Calibration Date (Thermostat/Sensors) --- EQUIPMENT PERFORMANCE & SAFETY --- [ ] Supply Air Temperature (Patient Zone 1) - °F [ ] Return Air Temperature (Patient Zone 1) - °F [ ] Static Pressure (Supply Duct) - Inches of Water [ ] Equipment Condition (e.g., Excellent, Good, Fair, Poor) (Excellent, Good, Fair, Poor) [ ] Visible Signs of Leaks (Refrigerant, Water) (None, Minor, Major) [ ] Any unusual noises or vibrations observed? [ ] Safety Guarding Intact and Secure? (Yes, No) [ ] Date of Last Belt Inspection/Replacement --- NOISE & VIBRATION --- [ ] Sound Level (dB) at Patient Bed [ ] Vibration Measurement (mm/s) - Equipment Base [ ] Describe any unusual noises observed (e.g., humming, rattling) (None, Humming, Rattling, Clicking, Other (Specify in LONG_TEXT)) [ ] If 'Other' noise selected, please describe: [ ] Is vibration noticeable to patients/staff? (Yes, No, Uncertain) [ ] Notes on vibration reduction measures taken (if any): [ ] Date of last vibration/noise mitigation work: --- AIRFLOW & DISTRIBUTION --- [ ] Supply Air Volume (CFM) - Verify setpoint & reading [ ] Return Air Volume (CFM) - Verify setpoint & reading [ ] Airflow Direction - Correct? (Yes, No) [ ] Air Outlets - Free of Obstructions? (Yes, No) [ ] Areas with Airflow Concerns? (Patient Rooms, Waiting Areas, Nursing Stations, Hallways, None) [ ] Notes/Comments on Airflow Distribution [ ] Location of Airflow Issues (if any) --- EMERGENCY & BACKUP SYSTEMS --- [ ] Last Generator Test Date [ ] Generator Run Time (Hours) [ ] Generator Status (Operational, Needs Repair, Out of Service) [ ] Emergency Power Transfer Switch Status (Functional, Needs Repair, Out of Service) [ ] Last Battery System Inspection Date [ ] Battery Voltage (Volts) [ ] Comments/Observations regarding Emergency Systems [ ] Verification of Emergency Contact List Availability (Available & Current, Needs Update, Unavailable) --- END OF TEMPLATE --- Transform this text into a digital, automated, and trackable mobile app! Visit: https://checklistguro.com/templates/facility-management/hvac-system-maintenance-patient-care-areas-checklist (Click "Install Template" to launch your digital inspection tool immediately)