Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

  • Room number:
    Room Entrance Door

  • Door exterior

  • Door frame

  • Door interior

  • Electronic lock

  • Secondary lock

  • Door viewer

  • Door closer

  • Emergency Exit Plan Map

  • Entry light

  • Door Hardware

  • Door Threshold

  • Add signature

  • Select date

Page two

  • Walls

  • Baseboards and Corner Guards

  • Paint/Wallpaper

  • Carpet

  • Ceiling

  • Furniture

  • Dresser/Desk

  • Mirrors

  • Tables

  • Chairs

  • Nightstands

  • Sofa

  • Bed

Page three

  • Luggage racks

  • Pictures

  • Waste Basket

  • Clothes closet

  • Telephone

  • Telephone Check

  • Telephone Cleanliness

  • Telephone cord

  • Telephone Wall Receptacle

  • Select date

  • Add signature

Page four

  • TV/Radio

  • TV cable wall receptacle

  • Antenna/Cable Connectors

  • TV Serial Number

  • TV Channel Check/Radio Check

  • Remote Control

  • TV Cleaning

  • Lamps/Switches/Outlets

  • Wall switches

  • Lamp Switches

  • Lamp Scockets

  • Light Bulbs

  • Lamp Shades

Page five

  • Lamp bases

  • Lamp fixtures

  • Plugs/Wires

  • Switch/Receptacle Cover Plates

  • Add signature

  • Select date

  • Windows

  • Windows Gereral

  • Window tracks

  • Windows second lock

  • Weather stripping/Window seals

  • Window sills/Inside/Outside

Page six

  • Bathroom

  • Wash basin

  • Faucet/Wash basin fixture

  • Shower walls

  • Shower fixtures

  • Overflow cover

  • Drain ring/Pop-up

  • Toilet (lever,lid,seats,bolts,tank)

  • Toilet Caulking

  • Toilet Paper Holder

  • Vanity

  • Vanity Lighting

  • Vanity outlet/plug-in

Page seven

  • Facial tissue holder

  • Towel bars

  • Hair dryer

  • Robe hook

  • Wall switch

  • Art Work

  • Waste basket

  • Shower rod

  • Shower curtain

  • Air vent grill

  • Ceiling wall light fixtures

  • Vanity mirror

  • Bathroom door Front and Back

Page eight

  • Bathroom floor

  • Bathroom walls and ceilings

  • Bathroom windows

  • Select date

  • Add signature

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.