RFP 240000002841 Attachment 1 - Dental PM Checklist.docx
DOCX document 53 KB Posted
- Solicitation number
- RFP-171-240000002841-2
- Issued by
- Arenac County, Michigan
About this file
This document is an Attachment 1 - Dental Equipment Preventative Maintenance Checklist related to RFP 240000002841 issued by the State of Michigan. The checklist provides detailed inspection and maintenance requirements for various dental equipment such as air compressors, vacuum pumps, amalgam separators, x-ray machines, sterilizers, patient chairs, and dental units. The checklist requires the service technician to indicate whether each equipment component passes, fails, or is not applicable during the inspection. The checklist also includes sections for recording serial/model numbers, manufacturers, and any additional comments or recommendations. This preventative maintenance program ensures the proper upkeep and functionality of the dental equipment utilized across the state's dental clinics.
The document outlines the comprehensive scope of work required to maintain the dental equipment in good working order. It does not include any pricing terms, set-asides, incumbents, funding sources, or other commercial details. The focus is purely on the technical requirements for the preventative maintenance services to be provided under this contract.
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Other files
| File | Type | Posted |
|---|---|---|
| RFP 240000002841 Attachment 3 - PREA Standards.doc | DOC document | |
| RFP 240000002841 - Schedule A1 - Dental Equipment & Supplies.docx | DOCX document | |
| RFP 240000002841 Questions and Answers Template.docx | DOCX document | |
| RFP 240000002841 Standard Contract Terms.docx | DOCX document | |
| RFP 240000002841 Schedule C Insurance Requirements.docx | DOCX document | |
| RFP 240000002841 - Schedule B1 - Dental Equipment and Supplies Pricing.xlsx | XLSX spreadsheet | |
| RFP 240000002841 - Schedule A2 - Dental Preventative Maintenance & Repair Services.docx | DOCX document | |
| RFP 240000002841 Schedule B2 - Preventative Maintenance & Repair Services Pricing.xlsx | XLSX spreadsheet | |
| RFP 240000002841 Attachment 2 - Dental Equipment List by Facility.xlsx | XLSX spreadsheet | |
| RFP 240000002841 Proposal Instructions.docx | DOCX document |
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Michigan.gov/MiProcurement
RFP 240000002841
Dental Equipment Preventative Maintenance Checklist
Facility Name: ___________________________________________________ Date: _______________________
Technician will indicate Pass (P), Fail (F), or Not Applicable (N/A) for each unit or piece of equipment present when check is completed. Each clinic will provide an inventory checklist.
Equipment Inventory:
☐ Annually: Review and update the inventory, if necessary.
Air compressor: Serial/Model #_______________________________ Manufacturer: ___________________________ P F N/A Check oil level, if applicable.
P F N/A Change oil if applicable (semi-annually).
P F N/A Check desiccant moisture indicator. Change desiccant, as required.
P F N/A Drain tank if needed.
P F N/A Inspect, clean, and change air intake filter, as needed.
Vacuum Pump: Serial/Model #________________________________ Manufacturer: ___________________________ P F N/A Check and/or replace disposable traps, if needed.
P F N/A Check water input.
P F N/A Check vacuum level and adjust, if needed.
P F N/A Check collection tank drainage, if applicable.
P F N/A Inspect vacuum breaker.
Vacuum Pump: Serial/Model #________________________________ Manufacturer: ___________________________ P F N/A Check and/or replace disposable traps, if needed.
P F N/A Check water input.
P F N/A Check vacuum level and adjust, if needed.
P F N/A Check collection tank drainage, if applicable.
P F N/A Inspect vacuum breaker.
Amalgam Separator:
P F N/A Check sediment level.
P F N/A Change collection container, if necessary.
Intra-Oral X-Rays: Serial/Model #_______________________________ Manufacturer: ___________________________ P F N/A Check for drifting and adjust as required.
P F N/A Inspect for oil leaks.
P F N/A Inspect for ease of positioning and adjust, P F N/A Ensure the hand switch (exposure button) fires properly.
Intra-Oral X-Rays: Serial/Model #_______________________________ Manufacturer: ___________________________ P F N/A Check for drifting and adjust as required.
P F N/A Inspect for oil leaks.
P F N/A Inspect for ease of positioning and adjust, P F N/A Ensure the hand switch (exposure button) fires properly.
Intra-Oral X-Rays: Serial/Model #_______________________________ Manufacturer: ___________________________ P F N/A Check for drifting and adjust as required.
P F N/A Inspect for oil leaks.
P F N/A Inspect for ease of positioning and adjust, P F N/A Ensure the hand switch (exposure button) fires properly.
Note: Calibrations are not part of the Preventative Maintenance process. Calibrations should be scheduled in accordance with the appropriate state regulations.
Sterilizers: Serial/Model #_____________________________________ Manufacturer: ___________________________ P F N/A Inspect the door gasket.
P F N/A Inspect water filters.
P F N/A Inspect chamber for cleanliness.
P F N/A Run cycle and observe.
Sterilizers: Serial/Model #_____________________________________ Manufacturer: ___________________________ P F N/A Inspect the door gasket.
P F N/A Inspect water filters.
P F N/A Inspect chamber for cleanliness.
P F N/A Run cycle and observe.
Miscellaneous:
P F N/A Test ultrasonic scaler.
P F N/A Test ultrasonic cleaner.
P F N/A Inspect model trimmer. Check for cracked/worn wheel, plumbing issues, and operation.
P F N/A Inspect plaster trap.
P F N/A Inspect operator and assistant chairs/stools for wear or missing parts.
Patient Chair: Serial/Model #__________________________________ Manufacturer: __________________________ P F N/A Check functioning of controls.
P F N/A Cycle chair, inspect for smoothness of function, hesitations, and unusual noise.
P F N/A Check fluid levels and inspect for leaks, if applicable.
P F N/A Inspect upholstery.
P F N/A Check limit switch functions.
Patient Chair: Serial/Model #_________________________________ _Manufacturer: __________________________ P F N/A Check functioning of controls.
P F N/A Cycle chair, inspect for smoothness of function, hesitations, and unusual noise.
P F N/A Check fluid levels and inspect for leaks, if applicable.
P F N/A Inspect upholstery.
P F N/A Check limit switch functions.
Patient Chair: Serial/Model #_________________________________ _ Manufacturer: __________________________ P F N/A Check functioning of controls.
P F N/A Cycle chair, inspect for smoothness of function, hesitations, and unusual noise.
P F N/A Check fluid levels and inspect for leaks, if applicable.
P F N/A Inspect upholstery.
P F N/A Check limit switch functions.
Patient Chair: Serial/Model #__________________________________ Manufacturer: __________________________ P F N/A Check functioning of controls.
P F N/A Cycle chair, inspect for smoothness of function, hesitations, and unusual noise.
P F N/A Check fluid levels and inspect for leaks, if applicable.
P F N/A Inspect upholstery.
P F N/A Check limit switch functions.
Patient Chair: Serial/Model #__________________________________ Manufacturer: _________________________ P F N/A Check functioning of controls.
P F N/A Cycle chair, inspect for smoothness of function, hesitations, and unusual noise.
P F N/A Check fluid levels and inspect for leaks, if applicable.
P F N/A Inspect upholstery.
P F N/A Check limit switch functions.
Patient Chair: Serial/Model #__________________________________ Manufacturer: _________________________ P F N/A Check functioning of controls.
P F N/A Cycle chair, inspect for smoothness of function, hesitations, and unusual noise.
P F N/A Check fluid levels and inspect for leaks, if applicable.
P F N/A Inspect upholstery.
P F N/A Check limit switch functions.
Dental Unit: Serial/Model #___________________________________ Manufacturer: __________________________ P F N/A Change air and water filters in the utility center, as needed.
P F N/A Check air and water pressures and regulators.
P F N/A Inspect air, water, vacuum, and electrical connections.
P F N/A Ensure unit arms are not drifting.
P F N/A Inspect all tubing (handpiece, HVE, S.E., foot controls, etc.) for excessive wear.
P F N/A Check HVE vacuum level and valve function and security.
P F N/A Check handpiece spray (Must test all handpieces).
P F N/A Check handpiece pressure and adjust. (Must test all handpieces).
Dental Unit: Serial/Model #___________________________________ Manufacturer: __________________________ P F N/A Change air and water filters in the utility center, as needed.
P F N/A Check air and water pressures and regulators.
P F N/A Inspect air, water, vacuum, and electrical connections.
P F N/A Ensure unit arms are not drifting.
P F N/A Inspect all tubing (handpiece, HVE, S.E., foot controls, etc.) for excessive wear.
P F N/A Check HVE vacuum level and valve function and security.
P F N/A Check handpiece spray (Must test all handpieces).
P F N/A Check handpiece pressure and adjust. (Must test all handpieces).
Dental Unit: Serial/Model #________________________________ ___Manufacturer: __________________________ P F N/A Change air and water filters in the utility center, as needed.
P F N/A Check air and water pressures and regulators.
P F N/A Inspect air, water, vacuum, and electrical connections.
P F N/A Ensure unit arms are not drifting.
P F N/A Inspect all tubing (handpiece, HVE, S.E., foot controls, etc.) for excessive wear.
P F N/A Check HVE vacuum level and valve function and security.
P F N/A Check handpiece spray (Must test all handpieces).
P F N/A Check handpiece pressure and adjust. (Must test all handpieces).
Dental Unit: Serial/Model #________________________________ ___Manufacturer: __________________________ P F N/A Change air and water filters in the utility center, as needed.
P F N/A Check air and water pressures and regulators.
P F N/A Inspect air, water, vacuum, and electrical connections.
P F N/A Ensure unit arms are not drifting.
P F N/A Inspect all tubing (handpiece, HVE, S.E., foot controls, etc.) for excessive wear.
P F N/A Check HVE vacuum level and valve function and security.
P F N/A Check handpiece spray (Must test all handpieces).
P F N/A Check handpiece pressure and adjust. (Must test all handpieces).
Dental Unit: Serial/Model #________________________________ ___Manufacturer: __________________________ P F N/A Change air and water filters in the utility center, as needed.
P F N/A Check air and water pressures and regulators.
P F N/A Inspect air, water, vacuum, and electrical connections.
P F N/A Ensure unit arms are not drifting.
P F N/A Inspect all tubing (handpiece, HVE, S.E., foot controls, etc.) for excessive wear.
P F N/A Check HVE vacuum level and valve function and security.
P F N/A Check handpiece spray (Must test all handpieces).
P F N/A Check handpiece pressure and adjust. (Must test all handpieces).
Dental Unit: Serial/Model #________________________________ ___ Manufacturer: __________________________ P F N/A Change air and water filters in the utility center, as needed.
P F N/A Check air and water pressures and regulators.
P F N/A Inspect air, water, vacuum, and electrical connections.
P F N/A Ensure unit arms are not drifting.
P F N/A Inspect all tubing (handpiece, HVE, S.E., foot controls, etc.) for excessive wear.
P F N/A Check HVE vacuum level and valve function and security.
P F N/A Check handpiece spray (Must test all handpieces).
P F N/A Check handpiece pressure and adjust. (Must test all handpieces).
Operating Light: Serial/Model #________________________________ Manufacturer: __________________________ P F N/A Inspect light and adjust focus.
P F N/A Lubricate connections and knuckles.
P F N/A Check for drifting and adjust as required.
P F N/A Check light covers for wear/cracks and replace, if needed.
P F N/A Ensure spare bulbs are available in dental clinic, order if needed.
Operating Light: Serial/Model #_______________________________ Manufacturer: ___________________________ P F N/A Inspect light and adjust focus.
P F N/A Lubricate connections and knuckles.
P F N/A Check for drifting and adjust as required.
P F N/A Check light covers for wear/cracks and replace, if needed.
P F N/A Ensure spare bulbs are available in dental clinic, order if needed.
Operating Light: Serial/Model #_______________________________ Manufacturer: ___________________________ P F N/A Inspect light and adjust focus.
P F N/A Lubricate connections and knuckles.
P F N/A Check for drifting and adjust as required.
P F N/A Check light covers for wear/cracks and replace, if needed.
P F N/A Ensure spare bulbs are available in dental clinic, order if needed.
Operating Light: Serial/Model #_______________________________ Manufacturer: ___________________________ P F N/A Inspect light and adjust focus.
P F N/A Lubricate connections and knuckles.
P F N/A Check for drifting and adjust as required.
P F N/A Check light covers for wear/cracks and replace, if needed.
P F N/A Ensure spare bulbs are available in dental clinic, order if needed.
Operating Light: Serial/Model #________________________________ Manufacturer: __________________________ P F N/A Inspect light and adjust focus.
P F N/A Lubricate connections and knuckles.
P F N/A Check for drifting and adjust as required.
P F N/A Check light covers for wear/cracks and replace, if needed.
P F N/A Ensure spare bulbs are available in dental clinic, order if needed.
Operating Light: Serial/Model #________________________________ Manufacturer: __________________________ P F N/A Inspect light and adjust focus.
P F N/A Lubricate connections and knuckles.
P F N/A Check for drifting and adjust as required.
P F N/A Check light covers for wear/cracks and replace, if needed.
P F N/A Ensure spare bulbs are available in dental clinic, order if needed.
Inspection Label:
☐ Each piece of equipment has been inspected and labeled. Label includes service technician’s initials and date.
Additional Comments/Recommendations:
I verify that all of the procedures identified above have been completed on today’s date.
Service Technician’s Signature Date To the best of my knowledge, the technician provided these procedures today.
| _________________________________________________________________ | __________________________ | |
| Dental Staff’s Signature | Date |
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