Ancenta Cleaning Technician Inspection Form - Sample

• Audit Title

• Location
  Address

• Conducted on

  Date

• Prepared by

• Personnel

• Select date

  Date

Men's Restroom

• Floor's swept and mopped

  Yes

  No

  N/A

• Toilet bowls, & urinals clean

  Yes

  No

  N/A

• Hand soap refilled

  Yes

  No

  N/A

• Trash emptied and liner replaced

  Yes

  No

  N/A

• Toilet paper refill

  Yes

  No

  N/A

• Paper towel refilled

  Yes

  No

  N/A

• Sink cleaned and chrome handles disinfected and polished

  Yes

  No

  N/A

• Glass cleaned and streak free

  Yes

  No

  N/A

• High dusting and cobweb removed

  Yes

  No

  N/A

• Other

Kitchen / Dining Area

• Countertop and cupboard cleaned

  Yes

  No

  N/A

• Tables & chairs sanitized, cleaned and arranged orderly

  Yes

  No

  N/A

• Floors swept, mopped and clean.

  Yes

  No

  N/A

• Soap and paper towels replenished

  Yes

  No

  N/A

• Inside of microwave cleaned

  Yes

  No

  N/A

• Outside of refrigerator cleaned

  Yes

  No

  N/A

• Load / unload dishwasher

  Yes

  No

  N/A

• Dusting high

  Yes

  No

  N/A

• Trash emptied, cleaned and liner replaced

  Yes

  No

  N/A

• undefined

Cubicles and Common Area

• Carpets vacuumed and spot cleaned

  Yes

  No

  N/A

• Hard floors swept and mopped

  Yes

  No

  N/A

• Desks dusted and spot cleaned

  Yes

  No

  N/A

• Dusting walls and cubicle top

  Yes

  No

  N/A

• Stairs, fire stairs, lifts etc

  Yes

  No

  N/A

• Trash emptied, cleaned and liner replaced

  Yes

  No

  N/A

• undefined

Foyer and Entrance

• Glass entry doors cleaned

  Yes

  No

  N/A

• Hard floor swept and mopped

  Yes

  No

  N/A

• Carpet vacuumed

  Yes

  No

  N/A

• Furniture dusted and cleaned

  Yes

  No

  N/A

• Elevator doors polished

  Yes

  No

  N/A

• Trash emptied, cleaned and liner replaced

  Yes

  No

  N/A

• undefined

CLEANING COMMENTS / COMPLAINTS / OTHER SOFT SERVICE ISSUES IDENTIFIED

• undefined

• Employee Signature

  Sign