Intro
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Site
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Conducted on
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Prepared by
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Conducted with
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Attendance requested by
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Date request made
Incident
Information about the guest and incident
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Name of guest
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Date of incident
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Accident report form completed by
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Select date
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Brief description of accident report form description of accident
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Did guest get a receipt at check in?
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Does receipt mention availability of bath mats at reception?
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Add media
Hotel and room
Information about the hotel and guest's room
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Age of hotel
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Number of rooms
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Number of floors
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Has hotel had a refurbishment?
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How long ago?
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Was bath in guests room included?
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Guest's room number
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Location of guest's room (description) and type e.g. Standard, UA
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Picture of room
Bath
Information about the bath room and bath within the guests room
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Condition of bathroom and flooring?
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Description of flooring type
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Picture of bathroom
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Approx. Age of bath?
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Bath condition
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Does bath have I built grab rails?
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If yes, where?
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Towel bath mat available to stand on when exiting bath?
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Pictures of bath to show location grab rails and towel bath mat
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Is shower head adjustable for angle?
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Description of anti-slip coating within bath and coverage e.g. Circles in a circle approx. 1/3 of bath floor surface
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Condition and performance of anti-slip coating when dry
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Condition and performance of anti-slip coating when wet
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Picture of anti slip surface as is
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Picture of anti slip impression on paper in place in bath
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Title of anti-slip impression
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Description of any nonstandard features within the bathroom e.g. Fixed shower screen, half bath
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Picture of any non standard features
Cleaning
Information about the cleaning of the guests room prior to the incident
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Was room cleaned by housekeeping prior to guest check in?
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Picture of guest room cleaning confirmation
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Who cleaned the room prior to guest check in ( full name - title)
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Is bath cleaned as per policy?
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Who advised this (full name - title)
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Is there evidence of above named persons training in how to clean baths?
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Picture of training record if available
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Who checked the room prior to guest check in ( full name - title)
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Who dilutes the BathCare 61 ready for use?
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If other, who?
Customer service
Information about general customer service and guest communication
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Are bath mats available at reception upon request?
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Who advised this (full name - title)
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Is there an 'Essentials Guide' leaflet available in the room and does it specifically state the availability of bath mats?
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Picture of 'Essential Guide' in place in room
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Picture of specific text advising of bath mat availability
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Is there a 'Luggage Tag' info advisory hanging in the bathroom including advice on the availability of bath mats on request?
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Picture of 'Luggage Tag' info advisory hanging location
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Picture of specific text advising of bath mat availability