Care Facility Evaluation Form
Facility Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Certification and Documentation
Rows
Not Satisfied
Satisfied
Notes
Good company profile document
1
2
Excellent mission, vision, goals, and objectives
3
4
AS9001 certification
5
6
Maintenance of records and important documents
7
8
Operations
Rows
Not Satisfied
Satisfied
Notes
Good and excellent communication with customer
9
10
All necessary information are being delivered to the customer
11
12
Validation process
13
14
Inspection process
15
16
Monitoring process
17
18
Verifying process
19
20
Leadership and Support
Rows
Not Satisfied
Satisfied
Notes
Is the company policy displayed and understood?
21
22
Is the area for improvements being monitored or reviewed?
23
24
Does the current leaders has good leadership skills and qualities?
25
26
Does the company provide training and seminars to employees?
27
28
Does the company provide support for their employees in terms of benefits?
29
30
Does the company train their employees about their job responsibilities?
31
32
Health, Safety, Environment
Rows
Not Satisfied
Satisfied
Notes
Does the company have a safe and good working environment?
33
34
Is the office clean and arranged in orderly fashion?
35
36
Does the employees wear protective gear?
37
38
Does the office have enough lighting and working space?
39
40
Does the company have waste management process?
41
42
Does the company have a recycle process?
43
44
Please upload supporting documents here
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Please upload related images here
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Rating
1
2
3
4
5
Analysis and Feedback
Â
Print
Submit
Should be Empty: