Cleaners Name

  • Cleaners name and photograph.

Uniform and Equipment .

  • Is the staff member wearing the correct uniform, and well groomed?

  • Equipment is kept in good condition.

  • Correct shoes worn and in good condition.

Professionalism and manner.

  • Is courteous and polite to public.

  • Effectively handles difficult situations.

  • Displays a friendly and calm demeanour .

  • Follows instructions promptly


  • Effective radio communications (call codes)

  • Understands report writing (slip and fall Procedures)

Site duties

  • Does timely floor and toilet checks.

  • Monitors and reports OH&S issues.

  • Is familiar with the site and surroundings.

  • Site operating hours

Legal awareness knowledge.

  • Customer experience program.

  • Lost child scenario .


  • Aware of emergency exits and passages and understands emergency procedure .

  • Aware of hose reel and and fire extinguishers positions.

  • Aware of the location and of the first aid kit?

  • Aware of hazardous chemicals and where they are stored.

  • Understand the material safety data sheet (MSDS) on site.


  • Managers signature.

  • Staff members Signiture.

  • Select date

  • What is the outcome of this report?

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