Coverage:
1. Chapel Maintenance
2. Vehicle and equipment maintenance
3. Embalming room maintenance
4. Casket storage room
5. First call
6. Pick up
7. IA
8. Embalming
9. Set up
Equipment
Amenities
10. Tributes
Electronic
Memory board
Memory display
Tarpaulin notice
Appreciation tarpaulin
11. Last night
12. Interment proper
13. Post interment
14. Payment
15. IF replenishment
x-x-x-x-x-x-x-x-x-x-x-x-x-x-x-x-x-x-x-
149 Points Chapel Memorial Care and Services Checklist
(To be included in CMCS Fund replenishment and done meticulously)
A. Service Details
1. Name of deceased ______________________________Sex: M F Status: S/M/Separated Age:
2. Birthdate______________________________3. Death Date __________ 4. Cause of Death _______
5. Address ________________________________________6. Contact Person/Authorized Rep___________ CP #
6. Death Certificate Date: OR #______________by _____ 7. Burial Permit OR # Date
8. First Call: Date _____ Time: ____Answered by ___________________CP # ____________Time answered: _________
9. Pick up place _____________________________________ 10 Land marks ________________________
10: Pick up crew: Driver ____________________________ Helper ____________Time Picked up ______________
Time Lapse from call to Pick up __________________________________
11. TRT No _____________________Date ____________Time ______Authorized by ______________________________
11. Comments on pick up____________________________________________________________________________
12. IA Number ___________________13 CSS ___________________________________14. At Need /Pre Need/Plan
15. Package ________________________________ 16. Amount ________________ 17. Casket ___________________
18. Chapel rental _________AC Non AC 19. Rental per night___________20 Check in time ____Check out time______
B. Standby check up:
Item Key points Who Checked by Done/not done Comments
A. CHAPEL
1 CR With soap tissue
dry floors
clean bowl/
flush working
running water
smelling fragrant
B Equipment and Vehicle Maintenance
1. A/C lumalamig
2. Electric fan working/not noisy
3. Water dispenser no leak
4. Bed no molds/buo
5. Sofa no stain
no smell
6. Floors no stain/dust
not slippery
7. Chairs clean
8. Tables clean
9. Doors hinges working
locks working
buo glasses
3. Vehicles:
1. L300
2. Hearse
3. NV 350/pup
4. Others
_______
________
________
5. OR/CR copy on board
6. Insurance copy on board
7. Tools
jack with/without
tire wrench with/without
spare tire with/iwtihout
pliers with/without
screw driver with without
8, Battery no corrosion
terminals tight
charging 12.6 volts+
one click start
9. Lights
stop lights functioning /not
headlights functioning/not
park lights functioning/not
turn lights functioning/not
passenger light functioning/not
10. Oil
color dark/light
level above/below
oil lights not lighting/lighting
oil pressure
11. Cooling system
water reservoir as within level
coolant none/with
belt tight/loose
radiator with leak/no leak
12. Tires
inflation over/under/right
tread 50 to 100%
bare
cracks
valve
13. Fuel
TAnk level 1/2, below 1/2 empty full
Filter dirty clean due for replacement
14. Brakes squeaking/ok
stuck up/not stuck up
pad condition: thin, thick
15. Wiper working/not working
16. Log book with without
Posting none, updated
not updated
17. Cleanliness
Outside
Underchassis with dirt and mud.w./o
Tires muddy/soled/tire black
Paint works clean/not clean
polished./ smudgy
Inside
Smell Moldy/of spoiled food
Disinfection Sprayed with zonrox
Dirt and dust
Floor With/none
Seat With/none
Trim Moldy dirty/clean
C. EMBALMING ROOM
1. Embalming fluid Order when 70% consumed
2. Pump Clean disinfect always
3. Syringe
4. Gloves Wear always
5. Mask Wear always
6. Apron Wear always
7. Check for pests Fumigate
Insects
Rats
8. Check for leaks
9. Check for odor
10. Check for overflow of STP
11. Clean floors
12. Clean lavatory
D. CASKET ROOM
1. Adequacy of caskets
1. Social
2. De Luxe
3. Premium
4. Luxury
2. Polishing and dusting of casket
3. Swept floor
4. No other mixed ffe
E. First Call
1. Answer within 3 rings
2. Getting all information needed
3. Located the pick up fast
4. Driver available
5. Assistant available
6. Response within 30 minutes
7. Problems
8. Issuance of TRT
F. PICK UP
1. Within 25 km radius
2. With without problems
3. With competitors
4. Use of body bags
5. With/without communicable disease
6. Met contact person
7. Representation expense with caller
G. Interment authorization
1. Relative/Authorized representative
2. Sales Contract/PMS /Plan
3. Amount
4. Discount
5. Upgrade - How much
6. Freebies /what
7. How much
H. Embalming
1. No of days
4
12 days
2. Amount of embalming fluid
3..Soft embalming
4. Bath and cleaning
5. Cosmetics
I Set up
Home viewing/chapel
1. Check up of equipment
1. Curtains
2. Lights
ilan
3. Extension cord
4. Mass Card holder
5. Registry stand
6. Register
7. Memory Announcement Tarp
8. Memory board
9. Memory board stand
2. Amenities
1. Funeral pack
# coffee
# candies
# cornick
# biscuit
# cups
# stirrer
2. Water dispenser
Brand
3. No of containers
4. Memory Board
Sepia
Charcoal
5. Memory announcement
Traditional
Multipictures
6. Memory Announcement stand
For premium and luxury
7. Themes
Fountain ball
Zen garden
Forest
Flower
8. Extra food
9. Free Use of van
J. TRIBUTES
1. Free obits
2. Tributes
Dlx 40 pp
Lux 40 + pp
3. Uploading to archives
4. Memory display
5. Eulogy
K Last night
1. Memorial service by religious groups
2. Vespers (celebration prior to interment - visperas
1. Prayers
2. Eulogy
3. Presentation of ppt/moviemaker
4. Favorite music
L. Interment
1. Balloons
2. (Refreshments) (h20 at least)
3. Hearse (own)
Rented (how much)
For premium: can be
Lincoln or Suburban
4. Karuwahe
5 4 Attendants
6. Driver
7. Helper
8 Hagad/barangay vehicle
9. Memorial thanks/appreciation
10. Arrival at the house/chapel on or before time
10. Atrille
11. Loading of flowers
12. Music at the hearse
13. Key board (for premium or deluxe)
In Pangasinan
14 Wrapping of casket with Holy Gardens Shroud
15. Escort at the church
16. Assistance to the family members
17. Ride by family at the Van
18. Providing water and refreshment to family members
19. With cool box at van/
Interment
20. Giving of memorial annoucement
and memory board to the family
M.Post interment
1. Collection checking of equipment
1. Mass card stand
2. Lamps (ilan)
3. Curtain
4. Memorial announcement stand
5. Memory board stand
6. Extension cord
7. TV
8. Projector
9. Dvid player
10. Projector]
11. DVD for songs
2, Payment:
1. Agents Com
2. Upgrading com
3. Hagad
4. Uniformed escort
5. Callers
6. Balloons
3. 9 days
Food what
Amount spent
# of prospects generated
N. CMCS fund replenishment
1. Date completed
2. Date sent to 3f
3. Date replenished
4. Processed by:
Prepared by _________________________________ Checked by __________________Received by _____________CV Prepared by _____________
CMCS CSS 2
A reply/acknowledgement is required
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