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    Inspection Form: For Gsoba-Rigpa Wellness Services

    Uploaded by

    Sonam Phuntsho
    This document contains an inspection form for gSoba-Rigpa wellness services. [1] It has two sections - Section A is a general checklist for the entire facility covering things like signage, licenses, location, reception, washrooms, therapy rooms, staffing, and hygiene. [2] Section B contains a specific checklist for individual wellness services assessing facilities, equipment, and protocols for services like massage, herbal baths, and meditation. [3] The form is to be signed by both the inspector and wellness center's representative.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Inspection Form: For Gsoba-Rigpa Wellness Services

    Uploaded by

    Sonam Phuntsho
    21 views3 pages
    This document contains an inspection form for gSoba-Rigpa wellness services. [1] It has two sections - Section A is a general checklist for the entire facility covering things like signage, licenses, location, reception, washrooms, therapy rooms, staffing, and hygiene. [2] Section B contains a specific checklist for individual wellness services assessing facilities, equipment, and protocols for services like massage, herbal baths, and meditation. [3] The form is to be signed by both the inspector and wellness center's representative.

    Original Title

    5-Inspection-Form

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    This document contains an inspection form for gSoba-Rigpa wellness services. [1] It has two sections - Section A is a general checklist for the entire facility covering things like signage, licenses, location, reception, washrooms, therapy rooms, staffing, and hygiene. [2] Section B contains a specific checklist for individual wellness services assessing facilities, equipment, and protocols for services like massage, herbal baths, and meditation. [3] The form is to be signed by both the inspector and wellness center's representative.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    21 views3 pages

    Inspection Form: For Gsoba-Rigpa Wellness Services

    Uploaded by

    Sonam Phuntsho
    This document contains an inspection form for gSoba-Rigpa wellness services. [1] It has two sections - Section A is a general checklist for the entire facility covering things like signage, licenses, location, reception, washrooms, therapy rooms, staffing, and hygiene. [2] Section B contains a specific checklist for individual wellness services assessing facilities, equipment, and protocols for services like massage, herbal baths, and meditation. [3] The form is to be signed by both the inspector and wellness center's representative.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 3

    Inspection Form

    For gSoba-Rigpa Wellness Services

    Section A (Checklist for the entire setup)


    Name of the Hotel/Resort/Center:
    Place: Inspection Date:
    Status:

    Please mark a ( or X) or else provide remarks


    General Inspection /X Remarks
    Display of sign board
    Display of Technical Authorization
    certificate
    Display of Trade License
    Location and Environment
    Clean
    Calm & relaxing
    Reception Counter
    Dedicated Staff
    Well furnished waiting area
    Wash Rooms
    Separate for male and female
    Adequate water supply
    Adequate toiletries
    Clean
    Locker Room
    Separate for male & female
    Shower Room
    Separate for male & female
    Equipped with proper facility
    Changing Room
    For Staff
    For Client
    Therapy Room
    Male therapy room
    Female therapy room
    Services
    Types of services offered( attach
    the list)
    Choices of service offered( attach
    the list)
    Staff & Therapist
    Adequate number of trained
    therapist
    Adequate number of supportive
    staff
    Uniform
    Properly attired
    Well groomed
    Clean
    Linen
    Adequate supply
    Clean
    Appropriate
    Employees & Staff’s facility
    Separate Staff room
    Staff toilets ( separate male &
    female)
    Fist Aid
    Well stocked First Aid Cabinet
    Trained staff on First Aid
    Facilities for Disabled
    Sanitation and Hygiene
    Clean surrounding of the center
    Neat & tidy work place
    SOP for cleaning
    Waste storage & Disposal system
    Proper drainage system

    Corrective action(s) required:

    Signature of the Inspector Signature of the Wellness Center’s Representative


    (Name & Designation) (Name & Designation)
    Section B (Checklist for Specific Service)

    Name of the Hotel/Center


    Name of Service

    Please mark a ( or X) or else provide remarks


    Specific Service /X Remarks
    Dry Service
    Jukpa (Traditional Massage)
    Numtshuk (Heated Oil Compression)
    Chinglum (Herbal Compression)
    Driduk (Aromatherapy)
    Wet Service
    Dhotso (Hot Stones Bath)
    Langlum (Herbal Steam Bath)
    Langduk (Herbal Steam Application)
    Chhulum (Herbal Bath)
    Herbal Bath
    electrical and water facilities
    bathing equipments
    changing and resting area
    Water proof wall
    Jukpa (Massage)
    Changing room with lockers for male and female
    Massage bed with comfortable mattress
    Massage oil
    Proper dress code for both the service provider and the client
    Proper bathroom facilities for male and female
    Towel and linen
    Other services
    gSorig Zheney & Luejong (Meditation and Exercise)
    Food and diet counseling.
    Stress Counseling and Management.
    Information Materials
    Brochures
    Leaf lets
    Record keeping for the services
    Proper record maintenance for each services
    Data sharing (bi-annual basis)
    Other remarks if any:

    Signature of the Inspector Signature of the Wellness Center’s Representative


    (Name & Designation) (Name & Designation)

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