Evolv Series Checklist Name First Last Email(Required) Serial Number(Required) Belts, Straps & VestsThese are body support surface areas exposed to bodily fluids. Any component with a fabric surface or Velcro can collect debris and become unsanitary and must be replaced. Foot Straps Positioning Belts Chest Strap Chest Vests FabricAltimate Medical uses some upholstered fabric on its support surfaces. Altimate Medical recommends that upon re-issue all upholstered contact surfaces must be replaced due to the high probability of exposure to bodily fluids from the previous users. Seat Pads Back Pads Form to Fit Head Support All Hygienic Covers Elbow Pads Knee Pads Large Contoured Chest Pad Padded Tray Cover Molded Pads & Rubber GripsAltimate Medical uses foam molded support pads for some support surfaces. These pads are a sealed impermeable easily cleanable surface. If the pads become worn or cracked, they may harbor bacteria. Before re-issue inspect each molded support pad and rubber grip and replace as necessary. Lateral Support Pads Push Handle Grips Head Support Pads Hand Grips (Tray) Chest Pads Casters and wheelsExamine the caster and wheel attachment points. Ensure that bolts, nuts, washers, and caps are securely tightened. Make sure the stem is fully threaded in place. Swivel and wheel rotation should move freely without binding or excessive play. Test the locks, ensure they engage, and release as intended. Front Wheels Front Swivel Casters Rear Casters Supine Positioning System and ControllerExamine the supine system. 1. Lower the seat to the sitting position (lowest possible level). The back angle and foot support bracket should move freely between sitting and lying when the controller is placed in Neutral. 2. The back angle and foot support bracket should lock at any angle between sitting and lying when the controller is placed in Supine (test various angles with the seat down in sitting). 3. The back angle and foot support bracket should lock into place when the controller is placed in Sit to Stand, and the foot support bracket is all the way down perpendicular to the floor. (test that the foot bracket locks in place). Note: Verify the Seat Depth and Following arm adjusted to matching colors before testing the device. Supine / Mechanical Lock Sit to Stand / Latch Lock Cables / Cable attachment Points and Routing DampersDampers can lose pressure over time. Inspect and replace dampers as needed to ensure proper function. Inspect and replace as necessary. Supine Release Dampers Emergency Release Damper Hydraulic ActuatorsReplace an actuator if it is leaking fluid, or not holding its standing position. Pump Handle If the nuts and bolts connecting the pump handle to the actuator become loose, the holes in the actuator handle may elongate. If this occurs, it’s essential to replace the pump handle. Inspect and replace as necessary. Hydraulic Actuator Pump Handle CorrosionExamine all metal surfaces and hardware for corrosion: Any corroded component must be replaced. Corroded objects have irregular surfaces that are more likely to harbor bacteria. Inspect and replace as necessary Base Frame (underside) Hardware (nuts and bolts) WeldsVisually examine welds of the base frame and major components for cracks, or porous surfaces that could compromise their integrity. Inspect and replace as necessary Base Frame Seat Frame Back Frame Tray Frame Clamping Components / Adjustable Moving PartsThe Bantam product range uses a variety of locks and clamps to regulate the position of supports. Lock and clamp components are made of either metal or plastic. Inspect the following components to ensure they have full range of movement and hold, and release as expected. Inspect and replace as necessary.Foot Supports Ratchet Handles Clamp Hardware Metal Brackets Plastic Foot Plates Knee Supports Star Knobs Clamp Hardware Metal Brackets Seat Depth Adjustment Plunger Knob Push Buttons Color Indicator Stickers Full Range of Adjustment (Blue to Green) Untitled Back Angle Adjustment Knob Hip Supports Star Knobs Metal Brackets Lateral Supports Star Knobs Clamp Hardware Metal Brackets Head Support Ratchet Handles Clamp Hardware Metal Brackets Tray Ratchet Handles Clamp Hardware Plunger or Star Knobs Metal Brackets Plastic or Acrylic Surface Full Range of Adjustment High Mount Chest Vest Bracket Star Knobs Clamp Hardware Metal Brackets LabelsLabeling is important for safe and effective use of the Bantam Medium, ensure that all labels are intact and legible. Serial Number Identification Pinch Point(s) Seat Depth Colors Fitting Card Supine Controller Electric System Labels ETL Hot Surface Electric Lift Emergency Release Pin Full Charge Pow’r Up Card NotesEnter Here any notes about refurbishing the product.
