Sample Report

Each room that MAS analyzes gives you irrefutable documentation as in the report seen below. We can perform our "Basic", "Standard" or "Standard PLUS" analysis. Each analysis will enable us to certify a room for JCAHO and OSHA as long as all requirements are met. For "due diligence" purposes, we strongly recommend that you select the "Standard" analysis and certification as your preference.

The report is issued to the individual in the facility that has requested and authorized the funds to conduct the analysis or certification. MAS will provide two (2) copies of this report. If more copies are required it should be requested on the purchase order or requested at a later date by contacting the corporate office.

Some reports will have more or less fields depending on the design and layout of the area being surveyed. This sample is representative of a standard isolation room. Surgical suite report can be very different as can other negative or positive pressure rooms survey result forms.

Field Designation	Field Description
Institution/Company	Name of the institution or company issuing the purchase order for the analysis/certification.
Facility	Name of the facility in which the room resides.
Address	Street address of the facility in which the room resides.
City	City in which the facility resides.
State	State in which the facility resides.
ZIP Code	USPS ZIP Code in which the facility resides.
Analysis/Certification Date	Date upon which the Analysis/Certification.
Room #	Room designation for which the Analysis/Certification was performed.
Attention of	Primary recipient of the completed report.
Title	Title of the primary recipient of the completed report.
"Room Analysis Results"	Check box indicating whether a room analysis was performed. An "X" signifies an affirmative.
"Room Certification Results"	Check box indicating whether a room certification was performed. An "X" signifies an affirmative.
Prepared by	Name of MAS representative preparing the report.

This page gives a graphical representation of the data collected to determine the ventilation efficiency. It takes the actual versus calculated air exchanges to give efficiency expressed as a percentage based on the "ideal" efficiency determined by the CDC.

This analysis is only done in the patient retirement area. This is the area most important for the safety of the health care worker, service personnel or visitors that may enter the room.

The Basic Analysis, which is a three (3) page report, will determine just the air flows in and out of the room with calculated ACH along with pressure readings and a few other basic parameters.

The StandardPLUS analysis will give you all that the Standard Analysis gives you plus air gas analysis in the room complete with a report demoting any remediation measures needed to correct any problems that are discovered. You can also opt to have a pathogen analysis to check for any airborne or surface microbes that may be present.

This irrefutable documentation is sent to you in duplicate so that both the engineering department and infection control can maintain copies for their files. There is also a certificate suitable for framing that is provided for each room.

Call us at 800-645-1059 with any questions, comments, concerns or to schedule your room analysis and/or certifications.