 Condition Appraisal

(formerly known as Pantai Medivest Sdn

 Technical Report
Bhd)

Hospital : Hospital Sultanah Aminah, Johor Facility

Equipment Description: Sinki seramik pecah di Engineering
CB 18 Wad Barat 4 Induk (HSA-FCBLD07-2435) Maintenance
Ref No : MSB/HSA/FEMS/RPT/0098/2014 Services
Date : 08 / 09 / 2014 (FEMS)
Contents

1. Objective. ...............................................................................................................................3
2. Asset Details. ........................................................................................................................3
3. Current Condition of the Asset. .............................................................................................4
4. Root Cause. ...........................................................................................................................5
5. Technical Advise and Proposal. ............................................................................................6
6. List of Attachments. ...............................................................................................................7
7. Photo. ...................................................................................................................................8
8. Verification. ............................................................................................................................9
9. Recommendation. .................................................................................................................9
10. Conclusion. ............................................................................................................................9

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1. Objective. (Tujuan laporan ini disediakan)

Objective Statement:
 For General Status / Condition
(Untuk makluman status semasa)
 Consideration for Exemption
(Untuk pertimbangan Pengecualian)
 Testing & Commissioning
( Ujian & Pentauliahan)
 Others (lain-lain):
 Proposal for Upgrading Works
(Cadangan kerja Naiktaraf )
 Replacement
(Penggantian)
 Proposal for Decommissioning
(Cadangan untuk dihentitugas)

Remarks (if any):

Laporan Teknikal ini disediakan adalah untuk memaklumkan kepada Pihak Hospital dan Jurutera yang berkaitan
mengenai status semasa wash-basin yang jatuh dan pecah di Wad Barat 4, Hospital Sultanah Aminah Johor dan
seterusnya untuk menggantikan wash-basin yang telah pecah. Terdapat aduan bernombor RQ/A4/F13176/14 pada
07/08/2014.

2. Asset Details. (Maklumat aset)

Asset Number** HSA – FCBLD07-2435

Description BUILDING, ROOMS

Model & Brand: TIDAK BERKENAAN

Manufacturer: MALAYSIA

Make (country of origin) MALAYSIA

Chasis No. TIDAK BERKENAAN

Registration No. TIDAK BERKENAAN

Engine No. TIDAK BERKENAAN

Serial No. TIDAK BERKENAAN

Software Version TIDAK BERKENAAN

User Department WEST 4

Location WEST 4

Purchase Date 1/01/1997

Purchase Cost (RM) TIDAK BERKENAAN

Warranty Start 1/01/1997

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 Warranty Expired 31/12/1997

Supplier PANTAI MEDIVEST SDN.BHD

Total Count of breakdown TIDAK BERKENAAN

Accumulated Maintenance Cost (RM) TIDAK BERKENAAN

List of accessories TIDAK BERKENAAN

** Note1 Attach list of asset if more than one (1) unit.

3. Current Condition of the Asset. (Penjelasan keadaan terkini dan masalah berkaitan aset)

 Good & Functioning  Frequent breakdown/ unreliable

(Berfungsi dengan baik) (Kerap rosak / Keupayaan Diragukan)

 Functioning but Not Satisfactory  Not in use

(Tidak berfungsi dengan baik) (Tidak digunakan)

 Performance Not to Specification.  Operating At Maximum Capacity

Does not comply to specification (Beroperasi pada kapasiti maksima)
(Tidak mengikut spesifikasi)

 Not Functioning  Not safe

(Rosak & Tidak Berfungsi) (Tidak selamat digunakan)

 Legal requirement (Please specified)  Environmental effect

Remarks (if any):

1. Wash Basin

- Terdapat Wash-basin di wad pembedahan lelaki Barat 4 di bangunan

Induk pecah akibat dari insiden pengguna pihak hospital.

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 Wear & Tear  Accident
(Kadar pengunaan) (Kerosakan akibat kemalangan)

 Outdated technology/software  Obsolescence

(Teknologi/perisian luput) (Pengeluaran alat/alat ganti/aksesori ditamatkan dan tiada di pasaran)

 Mishandling  Environmental
(Penyalahgunaan) (Faktor persekitaran)

 Others (Please specify)  Exceed Capacity

(Lain-lain – sila nyatakan)

 Installation defects

Further explanation (penerangan lanjut):

1) Daripada pemerhatian yang di buat dari pihak MSB mendapati punca wash-basin yang pecah adalah di
sebabkan oleh kemalangan di mana kakitangan wad telah melanggar wash-basin tersebut dengan troli.

2) Wash-basin mudah pecah apabila terlanggar dengan kuat dengan objek yang besar kerana ia diperbuat
daripada seramik .

3) Kerja-kerja membuang sisa singki yang pecah telah dilakukan dan sinki baru perlu dipasang bagi
memberi keselesaan kepada penghuni dan kakitangan wad berkenaan.

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4. Root Cause. (Punca masalah)

5. Technical Advice and Proposal (Nasihat teknikal dan cadangan)

 Safety Scope Description (Cadangan Skop Kerja):

(Keselamatan)

 Service Interruption 1. Pihak MSB menyediakan laporan ini untuk pemberitahuan kepada
(Gangguan perkhidmatan)
Pihak Hospital dan Jurutera yang berkaitan.
 Upgrading
(Naiktaraf)
2. Pihak MSB memerlukan masa untuk melakukan kerja-kerja
 Replacement penggantian kerana pihak kami sedang menunggu barangan dari
(Penggantian)
pembekal.
 Others (Lain-lain)
3. Insiden ini berlaku daripada kecuaian pihak hospital yang tidak
berhati-hati apabila menggunakan wash basin tersebut.

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6. List of Attachments. (Senarai dokumen sokongan yang disertakan)

No Document Name
1  KEW PA3 from User
2  Log Card (Asset Details and Maintenance History) from CMIS or User
3  Service Request
4  Obsolete or any discontinuation (Service/Parts) letter from Supplier /Authorised Agent
5  Quotation
6  Letter from User (Request from User)
7  Estimated Useful Lives of Depreciable Hospital Assets – American Hospital Association
8  Operating data (log sheet) / Relevant Job Sheet / PPM Job Sheet
9  Defect list / Work Order Form
10  Facilities Acceptance Certificate.
11  BER 1

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7. Photo. (Gambar menunjukkan keadaan asset)
oto

Rajah 1: Keadaan semasa lokasi wash-basin yang pecah

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8. Verification. (Pengesahan maklumat laporan)

Prepared by: Checked by: Approved by:

Prepared By Check By Customer Service Manager
Signature & Official Stamp: Signature & Official Stamp: Signature & Official Stamp:

Name:Mohammad Nasrul B
Name: Noor Farisya bte Azahar Name: Mohamad Fadhil B Uyub
Othman
Designation: Engineer (RW) Designation: Engineer (Civil) Designation: Facilities Manager

Date: 08 / 09 / 2014 Date: 08/ 09 / 2014 Date: 08 / 09 / 2014

9. Recommendation. (Sokongan / pandangan dari pihak JOHN)

Remarks (if any):

Signature: Official Stamp:

Name:
Designation:
Date:

Conclusion. (Keputusan dari pihak Pengarah atau Pegawai yang diberi kuasa)
1.
 Acknowledged  Approved for Reimbursable Works
 Approved for Exemption  Approved for Decommissioning
Remarks (if any):

Signature: Official Stamp:

Name:
Designation:
Date:

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