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Decontamination in primary care dental practices - Gov.uk

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<strong>Decontam<strong>in</strong>ation</strong>: Health Technical Memorandum 01-05 – <strong>Decontam<strong>in</strong>ation</strong> <strong>in</strong> <strong>primary</strong> <strong>care</strong> <strong>dental</strong> <strong>practices</strong> (2013 edition)Table A3 Weekly test sheetTests to be carried out <strong>in</strong> accordance with HTM 01-05Sterilizer location Serial No. DepartmentMake/modelRef. No.Weekbeg<strong>in</strong>n<strong>in</strong>gCyclenumberAutomatic airleakage testresult*Pass/FailResidual airtestPass/FailAutomaticcontrol testresultPass/FailSteampenetrationtestPass/Fail/NotapplicableP/F P/F P/F P/F/NA S/UP/F P/F P/F P/F S/UP/F P/F P/F P/F S/UP/F P/F P/F P/F S/UP/F P/F P/F P/F S/UP/F P/F P/F P/F S/UP/F P/F P/F P/F S/UP/F P/F P/F P/F S/UWeekly safetychecksSatisfactory/UnsatisfactoryCertified fitfor use byuser* Only where the sterilizer has an <strong>in</strong>-built self-test programme. Otherwise the test should be carried out by a CP(D) and copiesof the CP(D)’s test sheets should be <strong>in</strong>serted.Weekly safety checks (tick if satisfactory)Weekbeg<strong>in</strong>n<strong>in</strong>gCyclenumberDoor sealDoor pressure<strong>in</strong>terlockDoor closed<strong>in</strong>terlockSatisfactory/UnsatisfactoryTested byS/US/US/US/US/US/UFaults – new or exist<strong>in</strong>g (also enter <strong>in</strong> plant history record)80

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