1. Planned Preventive Maintenance for Fridges To improve your fridge’s function do the following tasks all the time: 2) Defrost your fridge once a month OR when the ice thickness is more than 3 mm.  Remove the vaccines from the fridge to a cold box with ice packs and a working thermometer inside.  Pour warm water on the evaporator to clean the ice.  Clean the fridge compartments and the door seal with a clean cloth.  Restart the fridge by setting the thermostat to the maximum on 7. Place a thermometer inside of the fridge or check the ColdTrace’s main page to check when the temperature is in the 2-8 C range.  Then you can place the vaccines back in the fridge.  Make sure to monitor the temperature in the next few hours or days and adjust the thermostat if necessary. Keep record of when you defrost your fridge. 3) Make sure the fridge is stable and on a flat surface. 4) Ensure the room is ventilated all the time. Open the windows during the working hours to allow flow of air. 5) Ensure there are 8 ice packs in the fridge at the end of the day during the evening. The 4 ice packs should always stay in the fridge and the other 4 can be used in the cold container with vaccines during the day. 6) Properly close the fridge door at all times. Make sure you check the door before you leave everyday. 7) DO NOT place any items or other medicines inside of the fridge.  The fridge should only store vaccines. NO food or water should be placed in fridge. Placing other items like food or water (or anything other than vaccines) will raise the temperature inside of fridge.  Always take out the vaccines from their boxes upon delivery and place them on the baskets. Keeping the vaccines in the boxes will increase the fridge temperature and will not allow the right temperature to get to the vaccine vials. 8) Keep record of when you change the propane on a sheet and track the days based on the usual usage to avoid running out of gas. 1)Record the temperature inside of your fridge twice a day. ColdTrace will provide you with the Status Messages that indicate the temperature in the morning and afternoon everyday. These recordings will be helpful to the maintenance person to track the performance and functionality of the fridge. x 8x 8

2. When The Temperature in Your Fridge is TOO COLD: Below 2° C When you receive an ALERT from ColdTrace that the temperature in your fridge is too cold, go through the following checklist 3. Do the shake test on one vial for every type of vaccine in the fridge. If the shake test fails for any vaccine: Perform the shake test on more vaccines and if they fail the test then remove all vaccines of that type. Record the failure in a vaccine wastage log. This step is important for showing the malfunction of your fridge. Set all failed vaccines aside for returning to the MOH. You call ----------for guidelines on how to proceed. 5. If the vaccines are OK, and if the fridge problem continues, move the vaccines to a safe place. Choose one of the following options: Option #1) Move the vaccine to back-up storage unit, if available OR store the vaccines in a pre-cooler insulted container with cold packs and a thermometer. Continue to monitor the temperature inside the container until the normal vaccine refrigerator is ready for use again. Option #2) Call ___________________to coordinate moving the vaccines to a clinic in close proximity with a working fridge. For transferring the vaccines, have a cold box with enough cold packs to keep the temp between 2-8 ° C Check the temperature of the box with a thermometer before placing and transferring the vaccines. 4. If Alert is not cleared (and you continue to get additional SMS alerts), then: Move thermostat down 1 or 2 steps. For example if the knob is at 4, you will place it on 2. If the knob is at the lowest setting, then your fridge has a problem and you need to report this issue. After adjusting the knob, monitor the temperature inside of the fridge until it is between 2-8 ° C. Make sure the door is securely closed. If you tried all these steps and it did not solve the problem then follow the next step for moving vaccines. 2. Defrost the fridge if necessary. Check your defrost log: if you have not defrosted the fridge this month, please defrost If the ice thickness if more than 3 mm, then you need to defrost your fridge. Follow the guides on the PPM SOP for steps on how to defrost the fridge properly. Contact Information to report problems with your fridge: ________________, Phone Number: _______________ 1. Make sure ColdTrace probe is not touching the ice, the metal wall or the bottom of the fridge. The probe should be secured on the wall with the clips. If you act immediately, you can help keep vaccines safe!

3. When The Temperature in Your Fridge is TOO HOT: Above 8° C When you receive an ALERT from ColdTrace that the temperature in your fridge is too hot, go through the following checklist 2) Make sure fridge is flat and on a stable surface 7) If the vaccines are OK, and if the fridge problem continues, move the vaccines to a safe place. Choose one of the following options: Option #1) Move the vaccine to back-up storage unit, if available OR store the vaccines in a pre-cooler insulted container with cold packs and a thermometer. Continue to monitor the temperature inside the container until the normal vaccine refrigerator is ready for use again. Option #2) Call ________________to coordinate moving the vaccines to a clinic in close proximity with a working fridge. For transferring the vaccines, have a cold box with enough cold packs to keep the temp between 2-8 ° C Check the temperature of the box with a thermometer before placing and transferring the vaccines. 6) Move thermostat up 1 or 2 steps. For example if the knob is at 5, you will place it on 7. After adjusting the knob, monitor the temperature inside of the fridge until it is between 2-8 ° C. Make sure the door is securely closed. 1) Ensure the room is ventilated all the time. Open the windows during the working hours to allow flow of air. 3) Check the power or propane gas. Make sure there is power in the clinic and the fridge is connected to a power source. If the fridge is using propane, make sure the container is not empty. 5) Check the VVM on at least one vial for every type of vaccine in the fridge. If the VVM for any vaccine is at a 3 or 4, then check all of the vaccines. Record any vaccines with a VVM of 3 or 4 in the vaccine log. Set all vaccines with a VVM of 3 or 4 aside for returning to MOH. You can call _____________________for guidelines on how to proceed. Contact Information to report problems with your fridge: ____________________, Phone Number: _____________ 4) Perform the paper test to check your fridge seal. Place a piece of paper on the door seal and then close the fridge door. Try to pull the paper out using your hand while the door is securely closed. If you are able to pull out paper easily, the fridge seal is damaged and you need to let _______________ know as soon as possible. If you act immediately, you can help keep vaccines safe!