Attachment J COA (M) RAP Med Equip Inventory.pdf
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- Solicitation number
- BD-24-1022-DMH02-8420A-99954
- Issued by
- Bristol County, Massachusetts
About this file
This document is an attachment related to a state and local contract opportunity in Massachusetts for medical equipment inspections, inventory services, and repairs. The contract opportunity is designated as RFR 2025-DMH-3134-01 and covers jurisdictions in Worcester County and Worcester City. The scope of work includes performing bi-annual electrical safety inspections, calibrating and testing medical equipment such as AEDs, blood pressure monitors, pulse oximeters, and other devices. The attachment provides detailed inspection records for the various equipment, including asset tag numbers, manufacturer details, and test results. The contract has a target completion date of June 12, 2024 and may be eligible for renewal options.
The pricing for this contract is not explicitly stated, but the attachment indicates that the awarded vendor must utilize certified testing devices and follow manufacturer specifications for calibration and performance testing. There are no details provided about any set-aside requirements or incumbent information. The funding for this contract likely comes from the state and local government budgets, but the specific amounts are not disclosed.
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Text version
STAT Bio-Medical certifies that the equipment included in the Bi - Annual Electrical Safety Inspection has been tested and/or calibrated using software and instrumentation producing traceable results as outlined by the National Institute Of Standards and Technology (NIST). Evidence of Traceability is on file at our corporate service center.
Acct: 20491 60 Hodges Ave
Taunton MA 02780
Bi - Annual Electrical Safety Inspection Record: 10328
Completion Date: 12/12/2023 Due Date: 6/12/2024
CERTIFICATE OF INSPECTION
STAT Bio-Medical
RECOVERY FOR ADDICTIONS PROGRAM - M-RAP
If you have questions in regards to our testing or need service for your medical equipment, please contact us at (508) 923-8701 bill@statbiomedical.net
Continued on Next Page
If Blank - Electrical Safety Test Not Performed
Electrical Safety Test Results
Inspections Performed Visual
AED
Tag Number: 0752555 Manufacturer: ZOLL Model: AEDPLUS Serial: 010084794600224421X21H405777 Medical Risk Factor: 1
Entry Type Inspd/Tstd
Location South Chamber 02 Code Cart
Result Pass
CERTIFICATE OF INSPECTION
Inspections Performed
EST: NA
NIBP: NA
Sp02: NA EKG Wave: NA Calibration: NA Performance: NA Visual: Pad Date Expires - 10/28/26
Inspection Notes
AED Tag Number: 0752555
If Blank - No Asset Image Acguired
Asset Test Image
Electrica l
Calibratio n
Performance Visua l
Result: Pass
Electrical Safety Test Results
Inspections Performed Visual
AED
Tag Number: 0752561 Manufacturer: ZOLL Model: AEDPLUS Serial: 010084794600224421X21H406072 Medical Risk Factor: 1
Entry Type Inspd/Tstd
Location North Chamber 02 Code Cart
Result
NIBP: NA
Sp02: NA EKG Wave: NA Calibration: NA Performance: NA Visual: Pad Date Expires - 12/18/26
Inspection Notes
AED Tag Number: 0752561
If Blank - No Asset Image Acguired
Asset Test Image
Electrica l
Calibratio n
Performance Visua
Electrical Safety Test Results
Inspections Performed Visual
AED
Tag Number: 0752575 Manufacturer: ZOLL Model: AEDPLUS Serial: 010084794600224421X21F381085 Medical Risk Factor: 1
Entry Type Inspd/Tstd
Location North Chamber 03
Result
NIBP: NA
Sp02: NA EKG Wave: NA Calibration: NA Performance: NA Visual: Pad Date Expires - 12/18/26
Inspection Notes
AED Tag Number: 0752575
If Blank - No Asset Image Acguired
Asset Test Image
Electrica l
Calibratio n
Performance Visua
Electrical Safety Test Results
Inspections Performed Visual
AED
Tag Number: 0752582 Manufacturer: ZOLL Model: AEDPLUS Serial: 010084794600224421X21H405851 Medical Risk Factor: 1
Entry Type Inspd/Tstd
Location South Chamber 03 Code Cart
Result
NIBP: NA
Sp02: NA EKG Wave: NA Calibration: NA Performance: NA Visual: Pad Date Expires - 08/28/26
Inspection Notes
AED Tag Number: 0752582
If Blank - No Asset Image Acguired
Asset Test Image
Electrica l
Calibratio n
Performance Visua
Electrical Safety Test Results
Inspections Performed Performance Visual
Blood Pressure - Gauge - Handheld Tag Number: 0752557 Manufacturer: ADC Model: lifetime Certified Serial: 15167626 Medical Risk Factor:
Entry Type Inspd/Tstd
Location South Chamber 02 Medicine Room
Result Pass
BP Gauge Calibration
0 mm
ActualExpct'd Tolerance
+/- 3 mm
50 mm +/- 3 mm
100 mm +/- 3 mm
200 mm +/- 3 mm
300 mm +/- 3 mm
NIBP: Blood Pressure Simulation was performed. See Test Results.
Sp02: NA EKG Wave: NA Calibration: Adjusted to manufacturer Specifications.
Performance: Blood Pressure Performance Testing.
Visual: Inspected case, gauge, tubing, and cuff.
Inspection Notes
Blood Pressure - Gauge - Handheld Tag Number: 0752557
If Blank - No Asset Image Acguired
Asset Test Image
Electrica l
Calibratio n
Performance Visua
Electrical Safety Test Results
Inspections Performed Performance Visual
Blood Pressure - Gauge - Handheld Tag Number: 0752563 Manufacturer: ADC Model: certified Serial: 21300772 Medical Risk Factor: 3
Entry Type Inspd/Tstd
Location North Chamber 02 Medicine Room
Result Pass
BP Gauge Calibration
0 mm
ActualExpct'd Tolerance
+/- 3 mm
50 mm +/- 3 mm
100 mm +/- 3 mm
200 mm +/- 3 mm
NIBP: Blood Pressure Simulation was performed. See Test Results.
Sp02: NA EKG Wave: NA Calibration: Adjusted to manufacturer Specifications.
Performance: Blood Pressure Performance Testing.
Visual: Inspected case, gauge, tubing, and cuff.
Inspection Notes
Blood Pressure - Gauge - Handheld Tag Number: 0752563
If Blank - No Asset Image Acguired
Asset Test Image
Electrica l
Calibratio n
Performance Visua
Electrical Safety Test Results
Inspections Performed Performance Visual
Blood Pressure - Gauge - Handheld Tag Number: 0752583 Manufacturer: ADC Model: sphygmomanometer Serial: 20236141 Medical Risk Factor: 3
Entry Type Inspd/Tstd
Location South Chamber 03 Code Cart
Result Pass
BP Gauge Calibration
0 mm
ActualExpct'd Tolerance
+/- 3 mm
50 mm +/- 3 mm
100 mm +/- 3 mm
200 mm +/- 3 mm
NIBP: Blood Pressure Simulation was performed. See Test Results.
Sp02: NA EKG Wave: NA Calibration: Adjusted to manufacturer Specifications.
Performance: Blood Pressure Performance Testing.
Visual: Inspected case, gauge, tubing, and cuff.
Inspection Notes
Blood Pressure - Gauge - Handheld Tag Number: 0752583
If Blank - No Asset Image Acguired
Asset Test Image
Electrica l
Calibratio n
Performance Visua
Electrical Safety Test Results
Inspections Performed Performance Visual
Blood Pressure - Gauge - Handheld Tag Number: 0748878 Manufacturer: ADC Model: BP Serial: 150108488 Medical Risk Factor: 3
Entry Type Inspd/Tstd
Location South Chamber 02 Code Cart
Result Pass
BP Gauge Calibration
0 mm
ActualExpct'd Tolerance
+/- 3 mm
50 mm +/- 3 mm
100 mm +/- 3 mm
200 mm +/- 3 mm
NIBP: Blood Pressure Simulation was performed. See Test Results.
Sp02: NA EKG Wave: NA Calibration: Adjusted to manufacturer Specifications.
Performance: Blood Pressure Performance Testing.
Visual: Inspected case, gauge, tubing, and cuff.
Inspection Notes
Blood Pressure - Gauge - Handheld Tag Number: 0748878
If Blank - No Asset Image Acguired
Asset Test Image
Electrica l
Calibratio n
Performance Visua
Electrical Safety Test Results
Inspections Performed Performance Visual
Blood Pressure - Gauge - Handheld Tag Number: 0748876 Manufacturer: Welch Allyn Model: Shock Resistant Serial: N/A Medical Risk Factor: 3
Entry Type Inspd/Tstd
Location South Chamber 02 Medicine Room
Result Pass
BP Gauge Calibration
0 mm
ActualExpct'd Tolerance
+/- 3 mm
50 mm +/- 3 mm
100 mm +/- 3 mm
200 mm +/- 3 mm
NIBP: Blood Pressure Simulation was performed. See Test Results.
Sp02: NA EKG Wave: NA Calibration: Adjusted to manufacturer Specifications.
Performance: Blood Pressure Performance Testing.
Visual: Inspected case, gauge, tubing, and cuff.
Inspection Notes
Blood Pressure - Gauge - Handheld Tag Number: 0748876
If Blank - No Asset Image Acguired
Asset Test Image
Electrica l
Calibratio n
Performance Visua
Electrical Safety Test Results
Inspections Performed Performance Visual
Blood Pressure - Gauge - Handheld Tag Number: 0753780 Manufacturer: ADC Model: Sphygmomanometer Serial: N/A Medical Risk Factor: 3
Entry Type Inspd/Tstd
Location South Chamber 03 Medicine Room
Result Pass
BP Gauge Calibration
0 mm
ActualExpct'd Tolerance
+/- 3 mm
50 mm +/- 3 mm
100 mm +/- 3 mm
200 mm +/- 3 mm
NIBP: Blood Pressure Simulation was performed. See Test Results.
Sp02: NA EKG Wave: NA Calibration: Adjusted to manufacturer Specifications.
Performance: Blood Pressure Performance Testing.
Visual: Inspected case, gauge, tubing, and cuff.
Inspection Notes
Blood Pressure - Gauge - Handheld Tag Number: 0753780
If Blank - No Asset Image Acguired
Asset Test Image
Electrica l
Calibratio n
Performance Visua
Electrical Safety Test Results
Inspections Performed Performance Visual
Blood Pressure - Gauge - Handheld Tag Number: 0753781 Manufacturer: ADC Model: sphygmomanometer Serial: N/A Medical Risk Factor:
Entry Type Inspd/Tstd
Location South Chamber 03 Medicine Room
Result Pass
BP Gauge Calibration
0 mm
ActualExpct'd Tolerance
+/- 3 mm
50 mm +/- 3 mm
100 mm +/- 3 mm
200 mm +/- 3 mm
NIBP: Blood Pressure Simulation was performed. See Test Results.
Sp02: NA EKG Wave: NA Calibration: Adjusted to manufacturer Specifications.
Performance: Blood Pressure Performance Testing.
Visual: Inspected case, gauge, tubing, and cuff.
Inspection Notes
Blood Pressure - Gauge - Handheld Tag Number: 0753781
If Blank - No Asset Image Acguired
Asset Test Image
Electrica l
Calibratio n
Performance Visua
Electrical Safety Test Results
Inspections Performed Performance Visual
Blood Pressure - Gauge - Handheld Tag Number: 0753795 Manufacturer: ADC Model: sphygmomanometer Serial: N/A Medical Risk Factor: 3
Entry Type Inspd/Tstd
Location North Chamber 03 Medicine Room
Result Pass
BP Gauge Calibration
0 mm
ActualExpct'd Tolerance
+/- 3 mm
50 mm +/- 3 mm
100 mm +/- 3 mm
200 mm +/- 3 mm
NIBP: Blood Pressure Simulation was performed. See Test Results.
Sp02: NA EKG Wave: NA Calibration: Adjusted to manufacturer Specifications.
Performance: Blood Pressure Performance Testing.
Visual: Inspected case, gauge, tubing, and cuff.
Inspection Notes
Blood Pressure - Gauge - Handheld Tag Number: 0753795
If Blank - No Asset Image Acguired
Asset Test Image
Electrica l
Calibratio n
Performance Visua
Electrical Safety Test Results
Inspections Performed Performance Visual
Blood Pressure - Gauge - Handheld Tag Number: 0753794 Manufacturer: Adc Model: sphygmomanometer Serial: NA Medical Risk Factor: 3
Entry Type Inspd/Tstd
Location North Chamber 03 Medicine Room
Result Pass
BP Gauge Calibration
0 mm
ActualExpct'd Tolerance
+/- 3 mm
50 mm +/- 3 mm
100 mm +/- 3 mm
200 mm +/- 3 mm
NIBP: Blood Pressure Simulation was performed. See Test Results.
Sp02: NA EKG Wave: NA Calibration: Adjusted to manufacturer Specifications.
Performance: Blood Pressure Performance Testing.
Visual: Inspected case, gauge, tubing, and cuff.
Inspection Notes
Blood Pressure - Gauge - Handheld Tag Number: 0753794
If Blank - No Asset Image Acguired
Asset Test Image
Electrica l
Calibratio n
Performance Visua
Electrical Safety Test Results
Inspections Performed Performance Visual
Blood Pressure - Gauge - Handheld Tag Number: 0758163 Manufacturer: ADC Model: lifetime certified Serial: NA Medical Risk Factor: 3
Entry Type Inspd/Tstd
Location Med Room
Result Pass
BP Gauge Calibration
0 mm
ActualExpct'd Tolerance
+/- 3 mm
50 mm +/- 3 mm
100 mm +/- 3 mm
200 mm +/- 3 mm
NIBP: Blood Pressure Simulation was performed. See Test Results.
Sp02: NA EKG Wave: NA Calibration: Adjusted to manufacturer Specifications.
Performance: Blood Pressure Performance Testing.
Visual: Inspected case, gauge, tubing, and cuff.
Inspection Notes
Blood Pressure - Gauge - Handheld Tag Number: 0758163
If Blank - No Asset Image Acguired
Asset Test Image
Electrica l
Calibratio n
Performance Visua
Electrical Safety Test Results
Inspections Performed Performance Visual
Blood Pressure - Gauge - Handheld Tag Number: 0754348 Manufacturer: sphygmomanometer Model: Ce1434 Serial: 21337002 Medical Risk Factor: 3
Entry Type Inspd/Tstd
Location Med room
Result Pass
BP Gauge Calibration
0 mm
ActualExpct'd Tolerance
+/- 3 mm
50 mm +/- 3 mm
100 mm +/- 3 mm
200 mm +/- 3 mm
NIBP: Blood Pressure Simulation was performed. See Test Results.
Sp02: NA EKG Wave: NA Calibration: NA Blood Pressure Performance Testing Visual: NA
Inspection Notes
Blood Pressure - Gauge - Handheld Tag Number: 0754348
If Blank - No Asset Image Acguired
Asset Test Image
Electrica l
Calibratio n
Performance Visua
Electrical Safety Test Results
Inspections Performed Performance Visual
Blood Pressure - Gauge - Handheld Tag Number: 0754351 Manufacturer: Adc Model: Ce1434 Serial: 21320920 Medical Risk Factor: 3
Entry Type Inspd/Tstd
Location Med room
Result Pass
BP Gauge Calibration
0 mm
ActualExpct'd Tolerance
+/- 3 mm
50 mm +/- 3 mm
100 mm +/- 3 mm
200 mm +/- 3 mm
NIBP: Blood Pressure Simulation was performed. See Test Results.
Sp02: NA EKG Wave: NA Calibration: NA Blood Pressure Performance Testing Visual: NA
Inspection Notes
Blood Pressure - Gauge - Handheld Tag Number: 0754351
If Blank - No Asset Image Acguired
Asset Test Image
Electrica l
Calibratio n
Performance Visua
Electrical Safety Test Results
Inspections Performed Performance Visual
Blood Pressure - Gauge - Handheld Tag Number: 0760607 Manufacturer: Adc Model: Ce1434 Serial: 21325722 Medical Risk Factor: 3
Entry Type Inspd/Tstd
Location Exam 213
Result Pass
BP Gauge Calibration
0 mm
ActualExpct'd Tolerance
+/- 3 mm
50 mm +/- 3 mm
100 mm +/- 3 mm
200 mm +/- 3 mm
NIBP: Blood Pressure Simulation was performed. See Test Results.
Sp02: NA EKG Wave: NA Calibration: NA Blood Pressure Performance Testing Visual: NA
Inspection Notes
Blood Pressure - Gauge - Handheld Tag Number: 0760607
If Blank - No Asset Image Acguired
Asset Test Image
Electrica l
Calibratio n
Performance Visua
Electrical Safety Test Results
Inspections Performed Performance Visual
Blood Pressure - Gauge - Handheld Tag Number: 0760609 Manufacturer: Adc Model: Ce1434 Serial: 21320630 Medical Risk Factor: 3
Entry Type Inspd/Tstd
Location Med room
Result Pass
BP Gauge Calibration
0 mm
ActualExpct'd Tolerance
+/- 3 mm
50 mm +/- 3 mm
100 mm +/- 3 mm
200 mm +/- 3 mm
NIBP: Blood Pressure Simulation was performed. See Test Results.
Sp02: NA EKG Wave: NA Calibration: NA Blood Pressure Performance Testing Visual: NA
Inspection Notes
Blood Pressure - Gauge - Handheld Tag Number: 0760609
If Blank - No Asset Image Acguired
Asset Test Image
Electrica l
Calibratio n
Performance Visua
Electrical Safety Test Results
Inspections Performed Performance Visual
Blood Pressure - Gauge - Handheld Tag Number: 0760610 Manufacturer: Adc Model: Ce1434 Serial: 21324827 Medical Risk Factor: 3
Entry Type Inspd/Tstd
Location Med room
Result Pass
BP Gauge Calibration
0 mm
ActualExpct'd Tolerance
+/- 3 mm
50 mm +/- 3 mm
100 mm +/- 3 mm
200 mm +/- 3 mm
NIBP: Blood Pressure Simulation was performed. See Test Results.
Sp02: NA EKG Wave: NA Calibration: NA Blood Pressure Performance Testing Visual: NA
Inspection Notes
Blood Pressure - Gauge - Handheld Tag Number: 0760610
If Blank - No Asset Image Acguired
Asset Test Image
Electrica l
Calibratio n
Performance Visua
Electrical Safety Test Results
Inspections Performed Performance Visual
Blood Pressure - Gauge - Handheld Tag Number: 0760615 Manufacturer: Adc Model: Ce1434 Serial: 21336491 Medical Risk Factor: 3
Entry Type Inspd/Tstd
Location Med room
Result Pass
BP Gauge Calibration
0 mm
ActualExpct'd Tolerance
+/- 3 mm
50 mm +/- 3 mm
100 mm +/- 3 mm
200 mm +/- 3 mm
NIBP: Blood Pressure Simulation was performed. See Test Results.
Sp02: NA EKG Wave: NA Calibration: NA Blood Pressure Performance Testing Visual: NA
Inspection Notes
Blood Pressure - Gauge - Handheld Tag Number: 0760615
If Blank - No Asset Image Acguired
Asset Test Image
Electrica l
Calibratio n
Performance Visua
Electrical Safety Test Results
Inspections Performed Performance Visual
Blood Pressure - Gauge - Handheld Tag Number: 0762346 Manufacturer: Adc Model: Na Serial: 20337929 Medical Risk Factor: 3
Entry Type Inspd/Tstd
Location Med Room
Result Pass
BP Gauge Calibration
0 mm
ActualExpct'd Tolerance
+/- 3 mm
50 mm +/- 3 mm
100 mm +/- 3 mm
200 mm +/- 3 mm
NIBP: Blood Pressure Simulation was performed. See Test Results.
Sp02: NA EKG Wave: NA Calibration: NA Blood Pressure Performance Testing Visual: NA
Inspection Notes
Blood Pressure - Gauge - Handheld Tag Number: 0762346
If Blank - No Asset Image Acguired
Asset Test Image
Electrica l
Calibratio n
Performance Visua
Electrical Safety Test Results
Inspections Performed Performance Visual
Blood Pressure - Gauge - Handheld Tag Number: 0762347 Manufacturer: Adc Model: Na Serial: 2132438 Medical Risk Factor: 3
Entry Type Inspd/Tstd
Location Med Room
Result Pass
BP Gauge Calibration
0 mm
ActualExpct'd Tolerance
+/- 3 mm
50 mm +/- 3 mm
100 mm +/- 3 mm
200 mm +/- 3 mm
NIBP: Blood Pressure Simulation was performed. See Test Results.
Sp02: NA EKG Wave: NA Calibration: NA Blood Pressure Performance Testing Visual: NA
Inspection Notes
Blood Pressure - Gauge - Handheld Tag Number: 0762347
If Blank - No Asset Image Acguired
Asset Test Image
Electrica l
Calibratio n
Performance Visua
Electrical Safety Test Results
Inspections Performed Performance Visual
Blood Pressure - Gauge - Handheld Tag Number: 0754347 Manufacturer: sphygmomanometer Model: Ce1434 Serial: 20281816 Medical Risk Factor: 3
Entry Type Inspd/Tstd
Location Med Room
Result Pass
BP Gauge Calibration
0 mm
ActualExpct'd Tolerance
+/- 3 mm
50 mm +/- 3 mm
100 mm +/- 3 mm
200 mm +/- 3 mm
NIBP: Blood Pressure Simulation was performed. See Test Results.
Sp02: NA EKG Wave: NA Calibration: NA Blood Pressure Performance Testing Visual: NA
Inspection Notes
Blood Pressure - Gauge - Handheld Tag Number: 0754347
If Blank - No Asset Image Acguired
Asset Test Image
Electrica l
Calibratio n
Performance Visua
Electrical Safety Test Results
Inspections Performed Performance Visual
Blood Pressure - Gauge - Handheld Tag Number: 0762398 Manufacturer: Omron Model: Certified Serial: 820528 Medical Risk Factor: 3
Entry Type Inspd/Tstd
Location Med Room
Result Pass
BP Gauge Calibration
0 mm
ActualExpct'd Tolerance
+/- 3 mm
50 mm +/- 3 mm
100 mm +/- 3 mm
200 mm +/- 3 mm
NIBP: Blood Pressure Simulation was performed. See Test Results.
Sp02: NA EKG Wave: NA Calibration: NA Blood Pressure Performance Testing Visual: NA
Inspection Notes
Blood Pressure - Gauge - Handheld Tag Number: 0762398
If Blank - No Asset Image Acguired
Asset Test Image
Electrica l
Calibratio n
Performance Visua
STAT Bio-Medical Mobilize App Report Facility: Recovery for Addictions Program - M-RAP Technician: Brittany Asset ID: 0762400 Test Eqpt Model: Safe-T ST-1 S/N 1034 Last Cal: 11/28/23 Electrical Safety Test Profile: EST NO GD Date/Time: 2023/12/12 11:24 AC Voltage: 126 V Peak Load Current: 0.1 A Norm Pol Earth Leak:
PASS Norm Cond = 1 uA (< 500 uA) Norm Pol Chassis Leak:
PASS Norm Cond = 1 uA (< 100 uA) PASS Open Gnd = 1 uA (< 500 uA) < Electrical Safety Overall Result: PASS >
Electrical Safety Test Results
Inspections Performed Electrical
Compression System Tag Number: 0762400 Manufacturer: Invacare Model: Na Serial: Na Medical Risk Factor: 2
Entry Type Inspd/Tstd
Location Basement
Result
EST: Electrical Safety Test utilizing Certified Testing Devices. See results enclosed.
NIBP: NA
Sp02: NA EKG Wave: NA Calibration: NA Performance: NA Visual: NA
Inspection Notes
Compression System Tag Number: 0762400
If Blank - No Asset Image Acguired
Asset Test Image
Electrica l
Calibratio n
Performance Visua
Facility: Recovery for Addictions Program - M-RAP Technician: Brittany Asset ID: 0762401 Test Eqpt Model: Safe-T ST-1 S/N 1034 Last Cal: 11/28/23 Electrical Safety Test Profile: EST NO GD Date/Time: 2023/12/12 11:25 AC Voltage: 126 V Peak Load Current: 0.1 A Norm Pol Earth Leak:
PASS Norm Cond = 1 uA (< 500 uA) Norm Pol Chassis Leak:
PASS Norm Cond = 1 uA (< 100 uA) PASS Open Gnd = 1 uA (< 500 uA) < Electrical Safety Overall Result: PASS >
Electrical Safety Test Results
Inspections Performed Electrical
Compression System Tag Number: 0762401 Manufacturer: Invacare Model: Na Serial: Na Medical Risk Factor: 2
Entry Type Inspd/Tstd
Location Basement
Result
NIBP: NA
Sp02: NA EKG Wave: NA Calibration: NA Performance: NA Visual: NA
Inspection Notes
Compression System Tag Number: 0762401
If Blank - No Asset Image Acguired
Asset Test Image
Electrica l
Calibratio n
Performance Visua
Facility: Recovery for Addictions Program - M-RAP Technician: Brittany Asset ID: 0752565 Test Eqpt Model: Safe-T ST-1 S/N 1034 Last Cal: 11/28/23 Electrical Safety Test Profile: EST NO GD NO SW Date/Time: 2023/12/12 08:55 AC Voltage: 126 V Peak Load Current: 0.2 A Norm Pol Earth Leak:
PASS Norm Cond = 88 uA (< 500 uA) Norm Pol Chassis Leak:
PASS Norm Cond = 0 uA (< 100 uA) PASS Open Gnd = 1 uA (< 500 uA) < Electrical Safety Overall Result: PASS >
Electrical Safety Test Results
Inspections Performed Electrical
Exam Light Tag Number: 0752565 Manufacturer: Welch Allyn Model: GS00 Serial: N/A Medical Risk Factor: 3
Entry Type Inspd/Tstd
Location Exam Room 304
Result
NIBP: NA
Sp02: NA EKG Wave: NA Calibration: NA Performance: NA Visual: NA
Inspection Notes
Exam Light Tag Number: 0752565
If Blank - No Asset Image Acguired
Asset Test Image
Electrica l
Calibratio n
Performance Visua
Facility: Recovery for Addictions Program - M-RAP Technician: Brittany Asset ID: 0748882 Test Eqpt Model: Safe-T ST-1 S/N 1034 Last Cal: 11/28/23 Electrical Safety Test Profile: EST NO GD NO SW Date/Time: 2023/12/12 10:05 AC Voltage: 125 V Peak Load Current: 0.1 A Norm Pol Earth Leak:
PASS Norm Cond = 83 uA (< 500 uA) Norm Pol Chassis Leak:
PASS Norm Cond = 1 uA (< 100 uA) PASS Open Gnd = 1 uA (< 500 uA) < Electrical Safety Overall Result: PASS >
Electrical Safety Test Results
Inspections Performed Electrical
Exam Light Tag Number: 0748882 Manufacturer: Welch Allyn Model: GS300 Serial: N/A Medical Risk Factor: 3
Entry Type Inspd/Tstd
Location Exam Room 213
Result
NIBP: NA
Sp02: NA EKG Wave: NA Calibration: NA Performance: NA Visual: NA
Inspection Notes
Exam Light Tag Number: 0748882
If Blank - No Asset Image Acguired
Asset Test Image
Electrica l
Calibratio n
Performance Visua
Facility: Recovery for Addictions Program - M-RAP Technician: Brittany Asset ID: 0748892 Test Eqpt Model: Safe-T ST-1 S/N 1034 Last Cal: 11/28/23 Electrical Safety Test Profile: EST NO GD NO SW Date/Time: 2023/12/12 08:56 AC Voltage: 126 V Peak Load Current: 0.1 A Norm Pol Earth Leak:
PASS Norm Cond = 88 uA (< 500 uA) Norm Pol Chassis Leak:
PASS Norm Cond = 0 uA (< 100 uA) PASS Open Gnd = 1 uA (< 500 uA) < Electrical Safety Overall Result: PASS >
Electrical Safety Test Results
Inspections Performed Electrical
Exam Light Tag Number: 0748892 Manufacturer: Welch Allyn Model: GS300 Serial: N/A Medical Risk Factor: 3
Entry Type Inspd/Tstd
Location Exam Room 301
Result
NIBP: NA
Sp02: NA EKG Wave: NA Calibration: NA Performance: NA Visual: NA
Inspection Notes
Exam Light Tag Number: 0748892
If Blank - No Asset Image Acguired
Asset Test Image
Electrica l
Calibratio n
Performance Visua
Facility: Recovery for Addictions Program - M-RAP Technician: Sydney Asset ID: 0753778 Test Eqpt Model: Safe-T ST-1 S/N 3756 Last Cal: 06/02/23 Electrical Safety Test Profile: EST NO GD NO SW Date/Time: 2023/12/12 08:57 AC Voltage: 125 V Peak Load Current: 0.1 A Norm Pol Earth Leak:
PASS Norm Cond = 90 uA (< 500 uA) Norm Pol Chassis Leak:
PASS Norm Cond = 0 uA (< 100 uA) PASS Open Gnd = 89 uA (< 500 uA) < Electrical Safety Overall Result: PASS >
Electrical Safety Test Results
Inspections Performed Electrical
Exam Light Tag Number: 0753778 Manufacturer: Welch Allyn Model: GS300 Serial: N/A Medical Risk Factor: 3
Entry Type Inspd/Tstd
Location Exam Room 314
Result
NIBP: NA
Sp02: NA EKG Wave: NA Calibration: NA Performance: NA Visual: NA
Inspection Notes
Exam Light Tag Number: 0753778
If Blank - No Asset Image Acguired
Asset Test Image
Electrica l
Calibratio n
Performance Visua
Facility: Recovery for Addictions Program - M-RAP Technician: Brittany Asset ID: 0752550 Test Eqpt Model: Safe-T ST-1 S/N 1034 Last Cal: 11/28/23 Electrical Safety Test Profile: EST NO SW Date/Time: 2023/12/12 10:08 AC Voltage: 124 V Peak Load Current: 0.2 A Gnd Resist:
PASS Test Gnd = 21 mOhm (<500 mOhm) Norm Pol Earth Leak:
PASS Norm Cond = 118 uA (< 500 uA) Norm Pol Chassis Leak:
PASS Norm Cond = 1 uA (< 100 uA) PASS Open Gnd = 1 uA (< 500 uA) < Electrical Safety Overall Result: PASS >
Electrical Safety Test Results
Inspections Performed Electrical
Exam Table Tag Number: 0752550 Manufacturer: Ritter Model: 224-001 Serial: V2330415 Medical Risk Factor: 3
Entry Type Inspd/Tstd
Location Exam Room 212
Result
NIBP: NA
Sp02: NA EKG Wave: NA Calibration: NA Performance: NA Visual: NA
Inspection Notes
Exam Table Tag Number: 0752550
If Blank - No Asset Image Acguired
Asset Test Image
Electrica l
Calibratio n
Performance Visua
Facility: Recovery for Addictions Program - M-RAP Technician: Brittany Asset ID: 0752568 Test Eqpt Model: Safe-T ST-1 S/N 1034 Last Cal: 11/28/23 Electrical Safety Test Profile: EST NO SW Date/Time: 2023/12/12 08:54 AC Voltage: 125 V Peak Load Current: 0.1 A Gnd Resist:
PASS Test Gnd = 19 mOhm (<500 mOhm) Norm Pol Earth Leak:
PASS Norm Cond = 9 uA (< 500 uA) Norm Pol Chassis Leak:
PASS Norm Cond = 0 uA (< 100 uA) PASS Open Gnd = 1 uA (< 500 uA) < Electrical Safety Overall Result: PASS >
Electrical Safety Test Results
Inspections Performed Electrical
Exam Table Tag Number: 0752568 Manufacturer: Ritter Model: 224-001 Serial: V2352181 Medical Risk Factor: 3
Entry Type Inspd/Tstd
Location Exam Room 304
Result
NIBP: NA
Sp02: NA EKG Wave: NA Calibration: NA Performance: NA Visual: NA
Inspection Notes
Exam Table Tag Number: 0752568
If Blank - No Asset Image Acguired
Asset Test Image
Electrica l
Calibratio n
Performance Visua
Facility: Recovery for Addictions Program - M-RAP Technician: Brittany Asset ID: 0752952 Test Eqpt Model: Safe-T ST-1 S/N 1034 Last Cal: 11/28/23 Electrical Safety Test Profile: EST NO SW Date/Time: 2023/12/12 10:04 AC Voltage: 125 V Peak Load Current: 0.2 A Gnd Resist:
PASS Test Gnd = 20 mOhm (<500 mOhm) Norm Pol Earth Leak:
PASS Norm Cond = 120 uA (< 500 uA) Norm Pol Chassis Leak:
PASS Norm Cond = 1 uA (< 100 uA) PASS Open Gnd = 1 uA (< 500 uA) < Electrical Safety Overall Result: PASS >
Electrical Safety Test Results
Inspections Performed Electrical
Exam Table Tag Number: 0752952 Manufacturer: Ritter Model: 224 Serial: V2330694 Medical Risk Factor: 3
Entry Type Inspd/Tstd
Location Exam Room 213
Result
NIBP: NA
Sp02: NA EKG Wave: NA Calibration: NA Performance: NA Visual: NA
Inspection Notes
Exam Table Tag Number: 0752952
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Facility: Recovery for Addictions Program - M-RAP Technician: Sydney Asset ID: 0748891 Test Eqpt Model: Safe-T ST-1 S/N 3756 Last Cal: 06/02/23 Electrical Safety Test Profile: EST NO SW Date/Time: 2023/12/12 08:55 AC Voltage: 125 V Peak Load Current: 0.2 A Gnd Resist:
PASS Test Gnd = 10 mOhm (<500 mOhm) Norm Pol Earth Leak:
PASS Norm Cond = 117 uA (< 500 uA) Norm Pol Chassis Leak:
PASS Norm Cond = 0 uA (< 100 uA) PASS Open Gnd = 117 uA (< 500 uA) < Electrical Safety Overall Result: PASS >
Electrical Safety Test Results
Inspections Performed Electrical
Exam Table Tag Number: 0748891 Manufacturer: Ritter Model: 224 Serial: V2348179 Medical Risk Factor: 3
Entry Type Inspd/Tstd
Location Exam Room 301
Result
NIBP: NA
Sp02: NA EKG Wave: NA Calibration: NA Performance: NA Visual: NA
Inspection Notes
Exam Table Tag Number: 0748891
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Facility: Recovery for Addictions Program - M-RAP Technician: Brittany Asset ID: 0762397 Test Eqpt Model: Safe-T ST-1 S/N 1034 Last Cal: 11/28/23 Electrical Safety Test Profile: EST NO SW Date/Time: 2023/12/12 10:51 AC Voltage: 125 V Peak Load Current: 0.1 A Gnd Resist:
PASS Test Gnd = 18 mOhm (<500 mOhm) Norm Pol Earth Leak:
PASS Norm Cond = 15 uA (< 500 uA) Norm Pol Chassis Leak:
PASS Norm Cond = 1 uA (< 100 uA) PASS Open Gnd = 1 uA (< 500 uA) < Electrical Safety Overall Result: PASS >
Electrical Safety Test Results
Inspections Performed Electrical
Exam Table Tag Number: 0762397 Manufacturer: Na Model: Na Serial: Na Medical Risk Factor: 3
Entry Type Inspd/Tstd
Location Exam 219
Result
NIBP: NA
Sp02: NA EKG Wave: NA Calibration: NA Performance: NA Visual: NA
Inspection Notes
Exam Table Tag Number: 0762397
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Facility: Recovery for Addictions Program - M-RAP Technician: Brittany Asset ID: 0752585 Test Eqpt Model: Safe-T ST-1 S/N 1034 Last Cal: 11/28/23 Electrical Safety Test Profile: EST NO SW Date/Time: 2023/12/12 09:53 AC Voltage: 125 V Peak Load Current: 0.1 A Gnd Resist:
PASS Test Gnd = 33 mOhm (<500 mOhm) Norm Pol Earth Leak:
PASS Norm Cond = 16 uA (< 500 uA) Norm Pol Chassis Leak:
PASS Norm Cond = 0 uA (< 100 uA) PASS Open Gnd = 2 uA (< 500 uA) < Electrical Safety Overall Result: PASS >
Electrical Safety Test Results
Inspections Performed Electrical
Hospital Bed Tag Number: 0752585 Manufacturer: Stryker Model: CHG Serial: N/A Medical Risk Factor: 3
Entry Type Inspd/Tstd
Location South Chamber 03 Room 326
Result
NIBP: NA
Sp02: NA EKG Wave: NA Calibration: NA Performance: NA Visual: NA
Inspection Notes
Hospital Bed Tag Number: 0752585
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Facility: Recovery for Addictions Program - M-RAP Technician: Brittany Asset ID: 0753793 Test Eqpt Model: Safe-T ST-1 S/N 1034 Last Cal: 11/28/23 Electrical Safety Test Profile: EST NO SW Date/Time: 2023/12/12 09:25 AC Voltage: 126 V Peak Load Current: 0.1 A Gnd Resist:
PASS Test Gnd = 23 mOhm (<500 mOhm) Norm Pol Earth Leak:
PASS Norm Cond = 15 uA (< 500 uA) Norm Pol Chassis Leak:
PASS Norm Cond = 1 uA (< 100 uA) PASS Open Gnd = 1 uA (< 500 uA) < Electrical Safety Overall Result: PASS >
Electrical Safety Test Results
Inspections Performed Electrical
Hospital Bed Tag Number: 0753793 Manufacturer: Stryker Model: CHG Serial: NA Medical Risk Factor: 3
Entry Type Inspd/Tstd
Location North Chamber 03 Patient Room N325
Result
NIBP: NA
Sp02: NA EKG Wave: NA Calibration: NA Performance: NA Visual: NA
Inspection Notes
Hospital Bed Tag Number: 0753793
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Facility: Recovery for Addictions Program - M-RAP Technician: Brittany Asset ID: 0753792 Test Eqpt Model: Safe-T ST-1 S/N 1034 Last Cal: 11/28/23 Electrical Safety Test Profile: EST NO SW Date/Time: 2023/12/12 09:22 AC Voltage: 127 V Peak Load Current: 0.1 A Gnd Resist:
PASS Test Gnd = 19 mOhm (<500 mOhm) Norm Pol Earth Leak:
PASS Norm Cond = 15 uA (< 500 uA) Norm Pol Chassis Leak:
PASS Norm Cond = 1 uA (< 100 uA) PASS Open Gnd = 2 uA (< 500 uA) < Electrical Safety Overall Result: PASS >
Electrical Safety Test Results
Inspections Performed Electrical
Hospital Bed Tag Number: 0753792 Manufacturer: Stryker Model: CHG Serial: NA Medical Risk Factor: 3
Entry Type Inspd/Tstd
Location North Chamber 03 Patient Room N308
Result
NIBP: NA
Sp02: NA EKG Wave: NA Calibration: NA Performance: NA Visual: NA
Inspection Notes
Hospital Bed Tag Number: 0753792
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Facility: Recovery for Addictions Program - M-RAP Technician: Brittany Asset ID: 0753783 Test Eqpt Model: Safe-T ST-1 S/N 1034 Last Cal: 11/28/23 Electrical Safety Test Profile: EST NO GD Date/Time: 2023/12/12 11:17 AC Voltage: 125 V Peak Load Current: 0.3 A Norm Pol Earth Leak:
PASS Norm Cond = 15 uA (< 500 uA) Norm Pol Chassis Leak:
PASS Norm Cond = 1 uA (< 100 uA) PASS Open Gnd = 1 uA (< 500 uA) < Electrical Safety Overall Result: PASS >
Electrical Safety Test Results
Inspections Performed Electrical
Hospital Bed Tag Number: 0753783 Manufacturer: Stryker Model: CHG Serial: N/a Medical Risk Factor: 3
Entry Type Inspd/Tstd
Location North Chamber 02 Patient Room N212
Result
NIBP: NA
Sp02: NA EKG Wave: NA Calibration: NA Performance: NA Visual: NA
Inspection Notes
Hospital Bed Tag Number: 0753783
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Performance Visua
Facility: Recovery for Addictions Program - M-RAP Technician: Brittany Asset ID: 0753801 Test Eqpt Model: Safe-T ST-1 S/N 1034 Last Cal: 11/28/23 Electrical Safety Test Profile: EST NO SW Date/Time: 2023/12/12 10:18 AC Voltage: 126 V Peak Load Current: 0.1 A Gnd Resist:
PASS Test Gnd =146 mOhm (<500 mOhm) Norm Pol Earth Leak:
PASS Norm Cond = 16 uA (< 500 uA) Norm Pol Chassis Leak:
PASS Norm Cond = 1 uA (< 100 uA) PASS Open Gnd = 1 uA (< 500 uA) < Electrical Safety Overall Result: PASS >
Electrical Safety Test Results
Inspections Performed Electrical
Hospital Bed Tag Number: 0753801 Manufacturer: Stryker Model: CHG Serial: NA Medical Risk Factor: 3
Entry Type Inspd/Tstd
Location Basement Chart Room
Result
NIBP: NA
Sp02: NA EKG Wave: NA Calibration: NA Performance: NA Visual: NA
Inspection Notes
Hospital Bed Tag Number: 0753801
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Facility: Recovery for Addictions Program - M-RAP Technician: Brittany Asset ID: 0753802 Test Eqpt Model: Safe-T ST-1 S/N 1034 Last Cal: 11/28/23 Electrical Safety Test Profile: EST NO SW Date/Time: 2023/12/12 11:41 AC Voltage: 127 V Peak Load Current: 0.1 A Gnd Resist:
PASS Test Gnd = 18 mOhm (<500 mOhm) Norm Pol Earth Leak:
PASS Norm Cond = 16 uA (< 500 uA) Norm Pol Chassis Leak:
PASS Norm Cond = 1 uA (< 100 uA) PASS Open Gnd = 1 uA (< 500 uA) < Electrical Safety Overall Result: PASS >
Electrical Safety Test Results
Inspections Performed Electrical
Hospital Bed Tag Number: 0753802 Manufacturer: Stryker Model: CHG Serial: NA Medical Risk Factor: 3
Entry Type Inspd/Tstd
Location Basement Chart Room
Result
NIBP: NA
Sp02: NA EKG Wave: NA Calibration: NA Performance: NA Visual: NA
Inspection Notes
Hospital Bed Tag Number: 0753802
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Facility: Recovery for Addictions Program - M-RAP Technician: Brittany Asset ID: 0753803 Test Eqpt Model: Safe-T ST-1 S/N 1034 Last Cal: 11/28/23 Electrical Safety Test Profile: EST NO SW Date/Time: 2023/12/12 11:39 AC Voltage: 126 V Peak Load Current: 0.1 A Gnd Resist:
PASS Test Gnd = 17 mOhm (<500 mOhm) Norm Pol Earth Leak:
PASS Norm Cond = 16 uA (< 500 uA) Norm Pol Chassis Leak:
PASS Norm Cond = 1 uA (< 100 uA) PASS Open Gnd = 1 uA (< 500 uA) < Electrical Safety Overall Result: PASS >
Electrical Safety Test Results
Inspections Performed Electrical
Hospital Bed Tag Number: 0753803 Manufacturer: Stryker Model: CHG Serial: NA Medical Risk Factor: 3
Entry Type Inspd/Tstd
Location Basement Chart Room
Result
NIBP: NA
Sp02: NA EKG Wave: NA Calibration: NA Performance: NA Visual: NA
Inspection Notes
Hospital Bed Tag Number: 0753803
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Facility: Recovery for Addictions Program - M-RAP Technician: Brittany Asset ID: 0753804 Test Eqpt Model: Safe-T ST-1 S/N 1034 Last Cal: 11/28/23 Electrical Safety Test Profile: EST NO SW Date/Time: 2023/12/12 11:37 AC Voltage: 126 V Peak Load Current: 0.9 A Gnd Resist:
PASS Test Gnd = 21 mOhm (<500 mOhm) Norm Pol Earth Leak:
PASS Norm Cond = 15 uA (< 500 uA) Norm Pol Chassis Leak:
PASS Norm Cond = 1 uA (< 100 uA) PASS Open Gnd = 1 uA (< 500 uA) < Electrical Safety Overall Result: PASS >
Electrical Safety Test Results
Inspections Performed Electrical
Hospital Bed Tag Number: 0753804 Manufacturer: Stryker Model: CHG Serial: NA Medical Risk Factor: 3
Entry Type Inspd/Tstd
Location Basement Chart Room
Result
NIBP: NA
Sp02: NA EKG Wave: NA Calibration: NA Performance: NA Visual: NA
Inspection Notes
Hospital Bed Tag Number: 0753804
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Facility: Recovery for Addictions Program - M-RAP Technician: Brittany Asset ID: 0760614 Test Eqpt Model: Safe-T ST-1 S/N 1034 Last Cal: 11/28/23 Electrical Safety Test Profile: EST NO SW Date/Time: 2023/12/12 10:46 AC Voltage: 124 V Peak Load Current: 0.1 A Gnd Resist:
PASS Test Gnd = 20 mOhm (<500 mOhm) Norm Pol Earth Leak:
PASS Norm Cond = 15 uA (< 500 uA) Norm Pol Chassis Leak:
PASS Norm Cond = 1 uA (< 100 uA) PASS Open Gnd = 1 uA (< 500 uA) < Electrical Safety Overall Result: PASS >
Electrical Safety Test Results
Inspections Performed Electrical
Hospital Bed Tag Number: 0760614 Manufacturer: Tmotion Model: N/a Serial: N/a Medical Risk Factor:
Entry Type Inspd/Tstd
Location Bedroom 216
Result
NIBP: NA
Sp02: NA EKG Wave: NA Calibration: NA Performance: NA Visual: NA
Inspection Notes
Hospital Bed Tag Number: 0760614
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Facility: Recovery for Addictions Program - M-RAP Technician: Brittany Asset ID: 0752556 Test Eqpt Model: Safe-T ST-1 S/N 1034 Last Cal: 11/28/23 Electrical Safety Test Profile: EST NO SW Date/Time: 2023/12/12 11:01 AC Voltage: 125 V Peak Load Current: 0.1 A Gnd Resist:
PASS Test Gnd = 21 mOhm (<500 mOhm) Norm Pol Earth Leak:
PASS Norm Cond = 1 uA (< 500 uA) Norm Pol Chassis Leak:
PASS Norm Cond = 1 uA (< 100 uA) PASS Open Gnd = 1 uA (< 500 uA) < Electrical Safety Overall Result: PASS >
Electrical Safety Test Results
Inspections Performed Electrical
Medicine Sorting System Tag Number: 0752556 Manufacturer: Omnicell Model: Full Size Serial: N/A Medical Risk Factor: 4
Entry Type Inspd/Tstd
Location South Chamber 02 Med Room
Result
NIBP: NA
Sp02: NA EKG Wave: NA Calibration: NA Performance: NA Visual: NA
Inspection Notes
Medicine Sorting System Tag Number: 0752556
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Performance Visua
Facility: Recovery for Addictions Program - M-RAP Technician: Brittany Asset ID: 0748875 Test Eqpt Model: Safe-T ST-1 S/N 1034 Last Cal: 11/28/23 Electrical Safety Test Profile: EST NO SW Date/Time: 2023/12/12 10:29 AC Voltage: 126 V Peak Load Current: 0.1 A Gnd Resist:
PASS Test Gnd =250 mOhm (<500 mOhm) Norm Pol Earth Leak:
PASS Norm Cond = 1 uA (< 500 uA) Norm Pol Chassis Leak:
PASS Norm Cond = 3 uA (< 100 uA) PASS Open Gnd = 3 uA (< 500 uA) < Electrical Safety Overall Result: PASS >
Electrical Safety Test Results
Inspections Performed Electrical
Medicine Sorting System Tag Number: 0748875 Manufacturer: Omnicell Model: Full Size Serial: N/A Medical Risk Factor: 4
Entry Type Inspd/Tstd
Location North Chamber 02 Medicine Room
Result
NIBP: NA
Sp02: NA EKG Wave: NA Calibration: NA Performance: NA Visual: NA
Inspection Notes
Medicine Sorting System Tag Number: 0748875
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Performance Visua
Facility: Recovery for Addictions Program - M-RAP Technician: Brittany Asset ID: 0752975 Test Eqpt Model: Safe-T ST-1 S/N 1034 Last Cal: 11/28/23 Electrical Safety Test Profile: EST NO SW Date/Time: 2023/12/12 09:39 AC Voltage: 127 V Peak Load Current: 0.1 A Gnd Resist:
PASS Test Gnd =222 mOhm (<500 mOhm) Norm Pol Earth Leak:
PASS Norm Cond = 1 uA (< 500 uA) Norm Pol Chassis Leak:
PASS Norm Cond = 3 uA (< 100 uA) PASS Open Gnd = 0 uA (< 500 uA) < Electrical Safety Overall Result: PASS >
Electrical Safety Test Results
Inspections Performed Electrical
Medicine Sorting System Tag Number: 0752975 Manufacturer: Omnicell Model: Full Size Serial: N/A Medical Risk Factor: 4
Entry Type Inspd/Tstd
Location South Chamber 03 Medicine Room
Result
NIBP: NA
Sp02: NA EKG Wave: NA Calibration: NA Performance: NA Visual: NA
Inspection Notes
Medicine Sorting System Tag Number: 0752975
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Performance Visua
Facility: Recovery for Addictions Program - M-RAP Technician: Brittany Asset ID: 0760613 Test Eqpt Model: Safe-T ST-1 S/N 1034 Last Cal: 11/28/23 Electrical Safety Test Profile: EST NO GD Date/Time: 2023/12/12 10:06 AC Voltage: 126 V Peak Load Current: 0.1 A Norm Pol Earth Leak:
PASS Norm Cond = 1 uA (< 500 uA) Norm Pol Chassis Leak:
PASS Norm Cond = 1 uA (< 100 uA) PASS Open Gnd = 1 uA (< 500 uA) < Electrical Safety Overall Result: PASS >
Electrical Safety Test Results
Inspections Performed Electrical
Nebulizer Tag Number: 0760613 Manufacturer: Devilbiss Model: 3655D Serial: D2889980 Medical Risk Factor: 3
Entry Type Inspd/Tstd
Location Med room
Result
NIBP: NA
Sp02: NA EKG Wave: NA Calibration:
Performance: NA Visual: NA
Inspection Notes
Nebulizer Tag Number: 0760613
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Facility: Recovery for Addictions Program - M-RAP Technician: Brittany Asset ID: 0762395 Test Eqpt Model: Safe-T ST-1 S/N 1034 Last Cal: 11/28/23 Electrical Safety Test Profile: EST NO GD Date/Time: 2023/12/12 10:36 AC Voltage: 126 V Peak Load Current: 0.1 A Norm Pol Earth Leak:
PASS Norm Cond = 1 uA (< 500 uA) Norm Pol Chassis Leak:
PASS Norm Cond = 1 uA (< 100 uA) PASS Open Gnd = 1 uA (< 500 uA) < Electrical Safety Overall Result: PASS >
Electrical Safety Test Results
Inspections Performed Electrical
Nebulizer Tag Number: 0762395 Manufacturer: Drive medical Model: 18080 Serial: 212V2005079215 Medical Risk Factor: 3
Entry Type Inspd/Tstd
Location Med room
Result
NIBP: NA
Sp02: NA EKG Wave: NA Calibration:
Performance: NA Visual: NA
Inspection Notes
Nebulizer Tag Number: 0762395
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Performance Visua
Facility: Recovery for Addictions Program - M-RAP Technician: Brittany Asset ID: 0753521 Test Eqpt Model: Safe-T ST-1 S/N 1034 Last Cal: 11/28/23 Electrical Safety Test Profile: EST NO GD Date/Time: 2023/12/12 11:22 AC Voltage: 126 V Peak Load Current: 0.1 A Norm Pol Earth Leak:
PASS Norm Cond = 1 uA (< 500 uA) Norm Pol Chassis Leak:
PASS Norm Cond = 1 uA (< 100 uA) PASS Open Gnd = 1 uA (< 500 uA) < Electrical Safety Overall Result: PASS >
Electrical Safety Test Results
Inspections Performed Electrical
Oxygen Concentrator Tag Number: 0753521 Manufacturer: Invacare Model: Platinum10 Serial: N/A Medical Risk Factor: 2
Entry Type Inspd/Tstd
Location Basement
Result
NIBP: NA
Sp02: NA EKG Wave: NA Calibration: NA Performance: NA Visual: NA
Inspection Notes
Oxygen Concentrator Tag Number: 0753521
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Performance Visua
Vital Signs Testing Profile: URL Preset: Vitals Simulation Date/Time: 2023/12/12 10:39 Sim Time: 0:24 Param Sim Result HR 95 95 Pass SpO2 95 95 Pass ( SpO2 Perfusion:95% )
< PASS >
Info-ST=S/N 1034 Last Cal:11/28/23 Info-SC=S/N 03288 Last Cal:01/11/23 Info-OX=S/N 03455 Last Cal:11/21/23
Electrical Safety Test Results
Inspections Performed Visual Performance Electrical
Pulse Oximeter - Handheld Tag Number: 0752560 Manufacturer: ADC Model: 2200 Serial: N/A Medical Risk Factor: 3
Entry Type Inspd/Tstd
Location North Chamber 02 Code Cart
Result
NIBP: NA
Sp02: Simulation was performed. See Test Results.
EKG Wave: NA Calibration: NA Pulse Oximeter Performance Testing Visual: NA
Inspection Notes
Pulse Oximeter - Handheld Tag Number: 0752560
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Calibratio n
Performance Visua
Profile: URL Preset: Vitals Simulation Date/Time: 2023/12/12 09:48 Sim Time: 0:15 Param Sim Result HR 95 95 Pass SpO2 95 95 Pass ( SpO2 Perfusion:95% )
< PASS >
Info-ST=S/N 1034 Last Cal:11/28/23 Info-SC=S/N 03288 Last Cal:01/11/23 Info-OX=S/N 03455 Last Cal:11/21/23
Electrical Safety Test Results
Inspections Performed Visual Performance Electrical
Pulse Oximeter - Handheld Tag Number: 0752584 Manufacturer: ADC Model: 2200 Serial: N/A Medical Risk Factor: 3
Entry Type Inspd/Tstd
Location South Chamber 03 Code Cart
Result
NIBP: NA
Sp02: Simulation was performed. See Test Results.
EKG Wave: NA Calibration: NA Pulse Oximeter Performance Testing Visual: NA
Inspection Notes
Pulse Oximeter - Handheld Tag Number: 0752584
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Asset Test Image
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Calibratio n
Performance Visua
Profile: URL Preset: Vitals Simulation Date/Time: 2023/12/12 10:24 Sim Time: 0:12 Param Sim Result HR 95 95 Pass SpO2 95 95 Pass ( SpO2 Perfusion:95% )
< PASS >
Info-ST=S/N 1034 Last Cal:11/28/23 Info-OX=S/N 03455 Last Cal:11/21/23
Electrical Safety Test Results
Inspections Performed Visual Performance Electrical
Pulse Oximeter - Handheld Tag Number: 0753787 Manufacturer: ADC Model: 2200 Serial: N/A Medical Risk Factor: 3
Entry Type Inspd/Tstd
Location North Chamber 02 Medicine Room
Result
NIBP: NA
Sp02: Simulation was performed. See Test Results.
EKG Wave: NA Calibration: NA Pulse Oximeter Performance Testing Visual: NA
Inspection Notes
Pulse Oximeter - Handheld Tag Number: 0753787
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Asset Test Image
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Calibratio n
Performance Visua
Profile: URL Preset: Vitals Simulation Date/Time: 2023/12/12 09:42 Sim Time: 0:28 Param Sim Result HR 95 95 Pass SpO2 95 95 Pass ( SpO2 Perfusion:95% )
< PASS >
Info-ST=S/N 1034 Last Cal:11/28/23 Info-SC=S/N 03288 Last Cal:01/11/23 Info-OX=S/N 03455 Last Cal:11/21/23
Electrical Safety Test Results
Inspections Performed Visual Performance Electrical
Pulse Oximeter - Handheld Tag Number: 0754350 Manufacturer: Covidien Model: Nellcor Serial: N/a Medical Risk Factor: 3
Entry Type Inspd/Tstd
Location Med room
Result
NIBP: NA
Sp02: Simulation was performed. See Test Results.
EKG Wave: NA Calibration: NA Pulse Oximeter Performance Testing Visual: NA
Inspection Notes
Pulse Oximeter - Handheld Tag Number: 0754350
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Asset Test Image
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Calibratio n
Performance Visua
Profile: URL Preset: Vitals Simulation Date/Time: 2023/12/12 10:34 Sim Time: 0:10 Param Sim Result HR 95 95 Pass SpO2 95 95 Pass ( SpO2 Perfusion:95% )
< PASS >
Info-ST=S/N 1034 Last Cal:11/28/23 Info-OX=S/N 03455 Last Cal:11/21/23
Electrical Safety Test Results
Inspections Performed Visual Performance Electrical
Pulse Oximeter - Handheld Tag Number: 0760611 Manufacturer: Covidien Model: Nellcor Serial: N/a Medical Risk Factor: 3
Entry Type Inspd/Tstd
Location Med room
Result
NIBP: NA
Sp02: Simulation was performed. See Test Results.
EKG Wave: NA Calibration: NA Pulse Oximeter Performance Testing Visual: NA
Inspection Notes
Pulse Oximeter - Handheld Tag Number: 0760611
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Asset Test Image
Electrica l
Calibratio n
Performance Visua
Profile: URL Preset: Vitals Simulation Date/Time: 2023/12/12 10:30 Sim Time: 0:03 Param Sim Result HR 95 95 Pass SpO2 95 95 Pass ( SpO2 Perfusion:95% )
< PASS >
Info-ST=S/N 1034 Last Cal:11/28/23 Info-OX=S/N 03455 Last Cal:11/21/23
Electrical Safety Test Results
Inspections Performed Visual Performance Electrical
Pulse Oximeter - Handheld Tag Number: 0760612 Manufacturer: Adc Model: 2200 Serial: N/a Medical Risk Factor: 3
Entry Type Inspd/Tstd
Location Med room
Result
NIBP: NA
Sp02: Simulation was performed. See Test Results.
EKG Wave: NA Calibration: NA Pulse Oximeter Performance Testing Visual: NA
Inspection Notes
Pulse Oximeter - Handheld Tag Number: 0760612
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Performance Visua
Facility: Recovery for Addictions Program - M-RAP Technician: Brittany Asset ID: 0752562 Test Eqpt Model: Safe-T ST-1 S/N 1034 Last Cal: 11/28/23 Electrical Safety Test Profile: EST NO SW Date/Time: 2023/12/12 10:28 AC Voltage: 125 V Peak Load Current: 0.1 A Gnd Resist:
PASS Test Gnd =250 mOhm (<500 mOhm) Norm Pol Earth Leak:
PASS Norm Cond = 1 uA (< 500 uA) Norm Pol Chassis Leak:
PASS Norm Cond = 0 uA (< 100 uA) PASS Open Gnd = 0 uA (< 500 uA) < Electrical Safety Overall Result: PASS >
Electrical Safety Test Results
Inspections Performed Electrical
Refrigerator Tag Number: 0752562 Manufacturer: Accucold Model: half size under counter Serial: N/A Medical Risk Factor: 4
Entry Type Inspd/Tstd
Location North Chamber 02 Medicine Room
Result
NIBP: NA
Sp02: NA EKG Wave: NA Calibration: NA Performance: NA Visual: NA
Inspection Notes
Refrigerator Tag Number: 0752562
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Performance Visua
Facility: Recovery for Addictions Program - M-RAP Technician: Brittany Asset ID: 0748877 Test Eqpt Model: Safe-T ST-1 S/N 1034 Last Cal: 11/28/23 Electrical Safety Test Profile: EST NO SW Date/Time: 2023/12/12 11:00 AC Voltage: 126 V Peak Load Current: 0.1 A Gnd Resist:
PASS Test Gnd = 17 mOhm (<500 mOhm) Norm Pol Earth Leak:
PASS Norm Cond = 1 uA (< 500 uA) Norm Pol Chassis Leak:
PASS Norm Cond = 1 uA (< 100 uA) PASS Open Gnd = 1 uA (< 500 uA) < Electrical Safety Overall Result: PASS >
Electrical Safety Test Results
Inspections Performed Electrical
Refrigerator Tag Number: 0748877 Manufacturer: Accucold Model: 1/2 Size Serial: N/A Medical Risk Factor: 4
Entry Type Inspd/Tstd
Location South Chamber 02 Medicine Room
Result
NIBP: NA
Sp02: NA EKG Wave: NA Calibration: NA Performance: NA Visual: NA
Inspection Notes
Refrigerator Tag Number: 0748877
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Performance Visua
Facility: Recovery for Addictions Program - M-RAP Technician: Sydney Asset ID: 0748894 Test Eqpt Model: Safe-T ST-1 S/N 3756 Last Cal: 06/02/23 Electrical Safety Test Profile: EST NO SW Date/Time: 2023/12/12 08:58 AC Voltage: 124 V Peak Load Current: 0.1 A Gnd Resist:
PASS Test Gnd = 5 mOhm (<500 mOhm) Norm Pol Earth Leak:
PASS Norm Cond = 3 uA (< 500 uA) Norm Pol Chassis Leak:
PASS Norm Cond = 0 uA (< 100 uA) PASS Open Gnd = 3 uA (< 500 uA) < Electrical Safety Overall Result: PASS >
Electrical Safety Test Results
Inspections Performed Electrical
Refrigerator Tag Number: 0748894 Manufacturer: Danby Model: 1/2 Size Serial: N/A Medical Risk Factor: 4
Entry Type Inspd/Tstd
Location Exam Room 301
Result
NIBP: NA
Sp02: NA EKG Wave: NA Calibration: NA Performance: NA Visual: NA
Inspection Notes
Refrigerator Tag Number: 0748894
If Blank - No Asset Image Acguired
Asset Test Image
Electrica l
Calibratio n
Performance Visua
Facility: Recovery for Addictions Program - M-RAP Technician: Brittany Asset ID: 0748898 Test Eqpt Model: Safe-T ST-1 S/N 1034 Last Cal: 11/28/23 Electrical Safety Test Profile: EST NO SW Date/Time: 2023/12/12 09:11 AC Voltage: 125 V Peak Load Current: 0.1 A Gnd Resist:
PASS Test Gnd = 17 mOhm (<500 mOhm) Norm Pol Earth Leak:
PASS Norm Cond = 1 uA (< 500 uA) Norm Pol Chassis Leak:
PASS Norm Cond = 1 uA (< 100 uA) PASS Open Gnd = 1 uA (< 500 uA) < Electrical Safety Overall Result: PASS >
Electrical Safety Test Results
Inspections Performed Electrical
Refrigerator Tag Number: 0748898 Manufacturer: Accucold Model: 1/2 Size Serial: N/A Medical Risk Factor: 4
Entry Type Inspd/Tstd
Location North Chamber 03 Medicine Room
Result
NIBP: NA
Sp02: NA EKG Wave: NA Calibration: NA Performance: NA Visual: NA
Inspection Notes
Refrigerator Tag Number: 0748898
If Blank - No Asset Image Acguired
Asset Test Image
Electrica l
Calibratio n
Performance Visua
Facility: Recovery for Addictions Program - M-RAP Technician: Brittany Asset ID: 0752974 Test Eqpt Model: Safe-T ST-1 S/N 1034 Last Cal: 11/28/23 Electrical Safety Test Profile: EST NO SW Date/Time: 2023/12/12 09:38 AC Voltage: 127 V Peak Load Current: 0.1 A Gnd Resist:
PASS Test Gnd =223 mOhm (<500 mOhm) Norm Pol Earth Leak:
PASS Norm Cond = 1 uA (< 500 uA) Norm Pol Chassis Leak:
PASS Norm Cond = 3 uA (< 100 uA) PASS Open Gnd = 0 uA (< 500 uA) < Electrical Safety Overall Result: PASS >
Electrical Safety Test Results
Inspections Performed Electrical
Refrigerator Tag Number: 0752974 Manufacturer: Accucold Model: 1/2 Size Serial: N/A Medical Risk Factor: 4
Entry Type Inspd/Tstd
Location South Chamber 03 Medicine Room
Result
NIBP: NA
Sp02: NA EKG Wave: NA Calibration: NA Performance: NA Visual: NA
Inspection Notes
Refrigerator Tag Number: 0752974
If Blank - No Asset Image Acguired
Asset Test Image
Electrica l
Calibratio n
Performance Visua
Facility: Recovery for Addictions Program - M-RAP Technician: Brittany Asset ID: 0758162 Test Eqpt Model: Safe-T ST-1 S/N 1034 Last Cal: 11/28/23 Electrical Safety Test Profile: EST NO SW Date/Time: 2023/12/12 10:10 AC Voltage: 125 V Peak Load Current: 0.1 A…
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