Xenex Incident Report.

Xenex Incident Report

Call Type

(Choose call type)

Choose Model and Call Type

Service Call Details

MCM Ticket #

Serial Number of
Robot

LS6 - Serial Number of Robot Being Returned to Xenex

X4/X5 - Serial Number of Robot Being Returned to Xenex

LS6 - Serial Number for new lamp

(PM)

LS6 - Serial Number for new lamp

(Repair)

LS6 - Serial Number for new lamp

(Upgrade)

X4/X5 - Serial Number for new lamp

(PM)

X4/X5 - Serial Number for new lamp

(Repair)

X4/X5 - Serial Number for new lamp

(Upgrade)

Provide the number of LS6 Pulse Cycles before replacing lamp

Provide the number of X4/X5 Pulse Cycles before replacing lamp

LS6 - Repair Checklist

Confirm with the on-site customer contact that the symptom they are experiencing with the robot is correctly listed on the service request

If the on-site customer describes any other issues, make sure all these symptoms are addressed before leaving the site

Correct any issue(s) they are experiencing trouble with and document the repairs you made to the Xenex system

Test for proper operation by running the Xenex disinfection system through 5 disinfection cycles to verify its proper operation

Check the Motion Sensor Cone for proper operation

Check the Door (orange) Cone for proper operation

If necessary order any additional parts to restore the robot to proper operation if you do not have these parts with you. Inform the On-site customer contact that these parts are on order and give them and ETA of the parts arrival and your ETA return time to correct the issue

If Xenex robot is repaired, inform the on-site customer contact the robot is back in operation and fully tested and have them sign and date this form

X4/X5 - Repair Checklist

Confirm with the on-site customer contact that the symptom they are experiencing with the robot is correctly listed on the service request

If the on-site customer describes any other issues, make sure all these symptoms are addressed before leaving the site

Correct any issue(s) they are experiencing trouble with and document the repairs you made to the Xenex system

Test for proper operation by running the Xenex disinfection system through 5 disinfection cycles to verify its proper operation

Check the Motion Sensor Cone for proper operation

Check the Remote Cone for proper operation

If Xenex robot is repaired, inform the on-site customer contact the unit is back in operation and fully tested and have them sign and date this form

LS6 - Swap Out Checklist

Unpack the replacement Xenex robot (Save Packing Material for the returning Xenex robot)

Move the replacement Xenex robot to the appropriate location for customer usage

On the LS6 you will need to contact Xenex to obtain the unique Username and Password for this robot

Raise the Dome (Dome tab in Settings menu) and Install the UVC lamp (Use Cotton or Rubber Gloves to handle the UVC lamp and VLA Glass lenses)

On the LS6 you will need to enter the Lamp Serial Number in the touchscreen (Lamp Tab in Settings Menu)

Install the VLA Glass lenses and clean if necessary

X4/X5 Swap Out Checklist

Unpack the replacement Xenex robot (Save Packing Material for the returning Xenex robot)

Move the replacement Xenex robot to the appropriate location for customer usage

On the X4/X5 you will need to contact Xenex to obtain the unique Username and Password for this robot

Raise the VLA Assembly (Hardware Status Menu) and Install the UVC lamp (Use Cotton or Rubber Gloves to handle the UVC lamp and VLA Glass lenses)

On the X4/X5 you will need to enter the Lamp Serial Number in the touchscreen (Hardware Status Menu)

Install the VLA Glass lenses and clean if necessary

LS6 Robot Swap Setup and Test

Preform robot test by running the robot for 5 disinfection cycles

Verify that the Motion Sensor is functioning properly on the Tethered/Black Cone

Verify the Door (orange) Cone is functioning properly and test the Remote Stop Button

X4/X5 Robot Swap Setup and Test

Preform robot test by running the robot for 5 disinfection cycles

Verify that the Motion Sensor is functioning properly on the Tethered/Black Cone

Verify the Remote Cone is functioning properly and test the Remote Stop Button

Prepare LS6 faulty Robot for return

Unplug the faulty robot and move the unit close to the return crate for shipment

Power robot up and Remove the VLA Glass lenses

Confirm the voltage on the UVC lamp connection is 0.0v

Remove UVC lamp and place into the box provided

Place the VLA Glass lenses into box provided

Make sure the dome is returned to the bottom position or damage will occur in shipping

Turn off the touchscreen

Place proper packing material on the Xenex robot and insert into the crate

Place the UVC bulb box in the appropriate place in the crate

Pack the VLA Glass lense Box in the appropriate place in the crate

Insure everything is packed correctly to survive the return shipment before closing the create.

Prepare X4/X5 faulty system for return

Unplug the faulty robot and move the robot close to the return crate for shipment

Power robot up and Remove the dome and VLA Glass lenses

Test the voltage on the UVC lamp connection with the high voltage probe for 0.0v

Remove UVC lamp and place into the box provided

Place the VLA Glass lenses into box provided

Make sure the dome is returned to the bottom position or damage will occur in shipping

On the X4/X5 robot you need to deactivate the robot in the Diagnostic setup screen

On the X4/X5 robot press the Red Button on bottom of display to turn off the tablet

Place proper packing material on the Xenex robot and insert into the crate

Place the UVC lamp box in the appropriate place in the crate

Pack the VLA Glass lense Box in the appropriate place in the crate

Place the dome in the appropriate package in the appropriate space.

Insure everything is packed correctly to survive the return shipment before closing the create.

Inspection Checklist for LS6

VLF glass panes: Remove, Inspect and Clean if necessary (gloves and alcohol wipes required)

UVC Lamp replaced (cotton or latex gloves required)

New Lamp serial # entered in Lamp tab on touchscreen. (new serial # is on banana jack of lamp)

Pulse count of old lamp and robot ID recorded on Xenex incident report. (Pulse count found in lamp tab)

Cleaned Air Intake Screen and Static Drag Under Robot

Ozone filter replaced (if required)

Inspect reflective surface of reflector assembly for damage

Clean reflective surface of reflector assembly

Verify plenum fan operation during full range of lift

Verity dome has normal rotation

Performed PM hardware check list

Verify casters are not loose or worn

Verify locks on all 4 casters functional

Disconnect tethered cord, unravel and inspect for damage

Inspect tethered cone for damage and verify operational

Inspect door (orange) cone for damage and verify operational.

Door cone stop button works and green LED light at end of cycle

Verify door cone charging when docked on robot

Inspect extension cords for wear or damage

5 consecutive 5 minute cycles ran on robot with no errors

Take pictures of any damage to robot or cones and forward to Xenex

TAKE A PICTURE CONFIRMING DMS IS CONNECTED

Inspection Checklist for X4/X5

Quartz panes: Remove, inspect and clean if necessary (gloves and alcohol wipes required)

UVC Lamp replaced (Replaced every 800 rooms disinfected) (cotton or latex gloves required)

New Lamp serial # entered in hardware status screen. (new serial # is on banana jack of wire)

Pulse count of old lamp recorded on Xenex incident report

Cleaned Air Intake Screen and Static Drag Under Robot

Ozone filter replaced (if required)

Inspect reflective surface of reflector assembly for damage

Clean reflective surface of reflector assembly

Verify plenum fan operation during full range of lift

Performed PM hardware check list

Verify casters are not loose or worn

Verify locks on rear casters functional

Disconnect tethered cord, unravel and inspect for damage

Inspect tethered cone for damage and verify operational

Inspect remote cone for damage and verify operational

Remote cone stop button works and green LED lights at end of cycle

Verify remote cone charger output (4.2 Vdc pulsing)

Verify back up battery charging

Inspect extension cords and power pigtail for wear or damage

5 consecutive 5 minute cycles ran on robot with no errors

Take pictures of any damage to robot or cones and forward to Xenex

TAKE A PICTURE SHOWING DMS IS CONNECTED

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Notes Section (Provide DETAILED notes about what you did onsite)

Was job completed and job area cleaned?

Yes

Technician Name

Technician email

Technician Branch ID

Time technician arrived

Time technician departed

Technician Signature

Clear

Customer Contact Name

Customer email

Customer Signature

Clear

Service Date

YYYY

Time Signed