ALC 3g. Cubicle checks - monthly

• Conducted on

  Date

• Prepared by

• Location
  Address

• Select date

  Date

Male Foyer toilet cubicle

Toilet door 1

• Door hinges - Is this safe and operational

  Okay

  Needs Attention

  At risk

• Door decor front - Is this presentable

  Okay

  Needs Attention

  At risk

• Door decor back - Is this presentable

  Okay

  Needs Attention

  At risk

• Door handle - Is this safe and operational

  Okay

  Needs Attention

  At risk

• Door Lock - Is this safe and operational

  Okay

  Needs Attention

  At risk

• Cubical lighting - Is this safe and operational

  Okay

  Needs Attention

  At risk

• Toilet Bowl - is this safe and operational

  Okay

  Needs Attention

  At risk

• Toilet roll dispenser - Is this safe, attached to the side and operational

  Okay

  Needs Attention

  At risk

• Toilet lid - is this attached, safe and operational

  Okay

  Needs Attention

  At risk

• Chain Flush - Is this attached, safe and operational

  Okay

  Needs Attention

  At risk

• Toilet cleanliness - Clean and tidy

  Okay

  Needs Attention

  At risk

Male dry changing room toilet cubicle

Toilet door 1 (Disabled toilet)

• Door hinges - Is this safe and operational

  Okay

  Needs Attention

  At risk

• Door decor front - Is this presentable

  Okay

  Needs Attention

  At risk

• Door decor back - Is this presentable

  Okay

  Needs Attention

  At risk

• Door handle - Is this safe and operational

  Okay

  Needs Attention

  At risk

• Door Lock - Is this safe and operational

  Okay

  Needs Attention

  At risk

• Cubical lighting - Is this safe and operational

  Okay

  Needs Attention

  At risk

• Toilet Bowl - is this safe and operational

  Okay

  Needs Attention

  At risk

• Toilet roll dispenser - Is this safe, attached to the side and operational

  Okay

  Needs Attention

  At risk

• Toilet lid - is this attached, safe and operational

  Okay

  Needs Attention

  At risk

• Chain Flush - Is this attached, safe and operational

  Okay

  Needs Attention

  At risk

• Toilet cleanliness - Clean and tidy

  Okay

  Needs Attention

  At risk

Toilet door 1 (middle toilet)

• Door hinges - Is this safe and operational

  Okay

  Needs Attention

  At risk

• Door decor front - Is this presentable

  Okay

  Needs Attention

  At risk

• Door decor back - Is this presentable

  Okay

  Needs Attention

  At risk

• Door handle - Is this safe and operational

  Okay

  Needs Attention

  At risk

• Door Lock - Is this safe and operational

  Okay

  Needs Attention

  At risk

• Cubical lighting - Is this safe and operational

  Okay

  Needs Attention

  At risk

• Toilet Bowl - is this safe and operational

  Okay

  Needs Attention

  At risk

• Toilet roll dispenser - Is this safe, attached to the side and operational

  Okay

  Needs Attention

  At risk

• Toilet lid - is this attached, safe and operational

  Okay

  Needs Attention

  At risk

• Chain Flush - Is this attached, safe and operational

  Okay

  Needs Attention

  At risk

• Toilet cleanliness - Clean and tidy

  Okay

  Needs Attention

  At risk

Toilet door 1 (far toilet)

• Door hinges - Is this safe and operational

  Okay

  Needs Attention

  At risk

• Door decor front - Is this presentable

  Okay

  Needs Attention

  At risk

• Door decor back - Is this presentable

  Okay

  Needs Attention

  At risk

• Door handle - Is this safe and operational

  Okay

  Needs Attention

  At risk

• Door Lock - Is this safe and operational

  Okay

  Needs Attention

  At risk

• Cubical lighting - Is this safe and operational

  Okay

  Needs Attention

  At risk

• Toilet Bowl - is this safe and operational

  Okay

  Needs Attention

  At risk

• Toilet roll dispenser - Is this safe, attached to the side and operational

  Okay

  Needs Attention

  At risk

• Toilet lid - is this attached, safe and operational

  Okay

  Needs Attention

  At risk

• Chain Flush - Is this attached, safe and operational

  Okay

  Needs Attention

  At risk

• Toilet cleanliness - Clean and tidy

  Okay

  Needs Attention

  At risk

• Name and sign

  Sign

• Select date

  Date

Female foyer toilet cubicle

Toilet door 1 (First toilet)

• Door hinges - Is this safe and operational

  Okay

  Needs Attention

  At risk

• Door decor front - Is this presentable

  Okay

  Needs Attention

  At risk

• Door decor back - Is this presentable

  Okay

  Needs Attention

  At risk

• Door handle - Is this safe and operational

  Okay

  Needs Attention

  At risk

• Door Lock - Is this safe and operational

  Okay

  Needs Attention

  At risk

• Cubical lighting - Is this safe and operational

  Okay

  Needs Attention

  At risk

• Toilet roll dispenser - Is this safe, attached to the side and operational

  Okay

  Needs Attention

  At risk

• Toilet Bowl - is this safe and operational

  Okay

  Needs Attention

  At risk

• Toilet lid - is this attached, safe and operational

  Okay

  Needs Attention

  At risk

• Chain Flush - Is this attached, safe and operational

  Okay

  Needs Attention

  At risk

• Toilet cleanliness - Clean and tidy

  Okay

  Needs Attention

  At risk

Toilet door 2 (middle toilet)

• Door hinges - Is this safe and operational

  Okay

  Needs Attention

  At risk

• Door decor front - Is this presentable

  Okay

  Needs Attention

  At risk

• Door decor back - Is this presentable

  Okay

  Needs Attention

  At risk

• Door handle - Is this safe and operational

  Okay

  Needs Attention

  At risk

• Door Lock - Is this safe and operational

  Okay

  Needs Attention

  At risk

• Cubical lighting - Is this safe and operational

  Okay

  Needs Attention

  At risk

• Toilet roll dispenser - Is this safe, attached to the side and operational

  Okay

  Needs Attention

  At risk

• Toilet Bowl - is this safe and operational

  Okay

  Needs Attention

  At risk

• Toilet lid - is this attached, safe and operational

  Okay

  Needs Attention

  At risk

• Chain Flush - Is this attached, safe and operational

  Okay

  Needs Attention

  At risk

• Toilet cleanliness - Clean and tidy

  Okay

  Needs Attention

  At risk

Toilet door 3 (furthest toilet)

• Door hinges - Is this safe and operational

  Okay

  Needs Attention

  At risk

• Door decor front - Is this presentable

  Okay

  Needs Attention

  At risk

• Door decor back - Is this presentable

  Okay

  Needs Attention

  At risk

• Door handle - Is this safe and operational

  Okay

  Needs Attention

  At risk

• Door Lock - Is this safe and operational

  Okay

  Needs Attention

  At risk

• Cubical lighting - Is this safe and operational

  Okay

  Needs Attention

  At risk

• Toilet roll dispenser - Is this safe, attached to the side and operational

  Okay

  Needs Attention

  At risk

• Toilet Bowl - is this safe and operational

  Okay

  Needs Attention

  At risk

• Toilet lid - is this attached, safe and operational

  Okay

  Needs Attention

  At risk

• Chain Flush - Is this attached, safe and operational

  Okay

  Needs Attention

  At risk

• Toilet cleanliness - Clean and tidy

  Okay

  Needs Attention

  At risk

Female dry changing room toilet cubicle

Toilet door 1 (disabled)

• Door hinges - Is this safe and operational

  Okay

  Needs Attention

  At risk

• Door decor front - Is this presentable

  Okay

  Needs Attention

  At risk

• Door decor back - Is this presentable

  Okay

  Needs Attention

  At risk

• Door handle - Is this safe and operational

  Okay

  Needs Attention

  At risk

• Door Lock - Is this safe and operational

  Okay

  Needs Attention

  At risk

• Cubical lighting - Is this safe and operational

  Okay

  Needs Attention

  At risk

• Toilet roll dispenser - Is this safe, attached to the side and operational

  Okay

  Needs Attention

  At risk

• Toilet Bowl - is this safe and operational

  Okay

  Needs Attention

  At risk

• Toilet lid - is this attached, safe and operational

  Okay

  Needs Attention

  At risk

• Chain Flush - Is this attached, safe and operational

  Okay

  Needs Attention

  At risk

• Toilet cleanliness - Clean and tidy

  Okay

  Needs Attention

  At risk

Toilet door 2 (next to the disabled)

• Door hinges - Is this safe and operational

  Okay

  Needs Attention

  At risk

• Door decor front - Is this presentable

  Okay

  Needs Attention

  At risk

• Door decor back - Is this presentable

  Okay

  Needs Attention

  At risk

• Door handle - Is this safe and operational

  Okay

  Needs Attention

  At risk

• Door Lock - Is this safe and operational

  Okay

  Needs Attention

  At risk

• Cubical lighting - Is this safe and operational

  Okay

  Needs Attention

  At risk

• Toilet roll dispenser - Is this safe, attached to the side and operational

  Okay

  Needs Attention

  At risk

• Toilet Bowl - is this safe and operational

  Okay

  Needs Attention

  At risk

• Toilet lid - is this attached, safe and operational

  Okay

  Needs Attention

  At risk

• Chain Flush - Is this attached, safe and operational

  Okay

  Needs Attention

  At risk

• Toilet cleanliness - Clean and tidy

  Okay

  Needs Attention

  At risk

Toilet door 3 (2nd from right)

• Door hinges - Is this safe and operational

  Okay

  Needs Attention

  At risk

• Door decor front - Is this presentable

  Okay

  Needs Attention

  At risk

• Door decor back - Is this presentable

  Okay

  Needs Attention

  At risk

• Door handle - Is this safe and operational

  Okay

  Needs Attention

  At risk

• Door Lock - Is this safe and operational

  Okay

  Needs Attention

  At risk

• Cubical lighting - Is this safe and operational

  Okay

  Needs Attention

  At risk

• Toilet roll dispenser - Is this safe, attached to the side and operational

  Okay

  Needs Attention

  At risk

• Toilet Bowl - is this safe and operational

  Okay

  Needs Attention

  At risk

• Toilet lid - is this attached, safe and operational

  Okay

  Needs Attention

  At risk

• Chain Flush - Is this attached, safe and operational

  Okay

  Needs Attention

  At risk

• Toilet cleanliness - Clean and tidy

  Okay

  Needs Attention

  At risk

Toilet door 4 (furthest toilet)

• Door hinges - Is this safe and operational

  Okay

  Needs Attention

  At risk

• Door decor front - Is this presentable

  Okay

  Needs Attention

  At risk

• Door decor back - Is this presentable

  Okay

  Needs Attention

  At risk

• Door handle - Is this safe and operational

  Okay

  Needs Attention

  At risk

• Door Lock - Is this safe and operational

  Okay

  Needs Attention

  At risk

• Cubical lighting - Is this safe and operational

  Okay

  Needs Attention

  At risk

• Toilet roll dispenser - Is this safe, attached to the side and operational

  Okay

  Needs Attention

  At risk

• Toilet Bowl - is this safe and operational

  Okay

  Needs Attention

  At risk

• Toilet lid - is this attached, safe and operational

  Okay

  Needs Attention

  At risk

• Chain Flush - Is this attached, safe and operational

  Okay

  Needs Attention

  At risk

• Toilet cleanliness - Clean and tidy

  Okay

  Needs Attention

  At risk

• Name and sign

  Sign