Capwell Grange Test

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Reception, Lobby and Reception

• Is the environment clean, tidy and free of clutter?

  Yes

  No

  N/A

• Is furniture clean?

  Yes

  No

  N/A

• Are all furniture and fittings in a good state of repair?

  Yes

  No

  N/A

• Are all surfaces smooth, impervious, and with coved, sealed edges?

  Yes

  No

  N/A

• Is the floor clean?

  Yes

  No

  N/A

• Is the floor in a good state of repair?

  Yes

  No

  N/A

• Are curtains clean and in a good state of repair?

  Yes

  No

  N/A

Reception toilet

• Is the toilet and washbasin clean and in a good state of repair?

  Yes

  No

  N/A

• Is the sink plug and overflow free?

  Yes

  No

  N/A

• Is the environment clean, tidy and free of clutter?

  Yes

  No

  N/A

• Is the waste offset so water does not flow directly into it?

  Yes

  No

  N/A

• Are the fittings clean and dust free?

  Yes

  No

  N/A

• Is the floor clean and in a good state of repair?

  Yes

  No

  N/A

• Is there soap and hand towels available ?

  Yes

  No

  N/A

• Is there hand sanitizer available?

  Yes

  No

  N/A

• Is there a pedal bin available?

  Yes

  No

  N/A

• Is there appropriate signage including hand washing instructions?

  Yes

  No

  N/A

Communal Areas

• Is the environment clean, tidy and free of clutter?

  Yes

  No

  N/A

• Is furniture clean?

  Yes

  No

  N/A

• Are all furniture and fittings in a good state of repair?

  Yes

  No

  N/A

• Is David sane?

  Safe

  At Risk

  N/A

• Are all surfaces smooth, impervious, and with coved, sealed edges?

  Yes

  No

  N/A

• Is the floor clean?

  Yes

  No

  N/A

• Is the floor in a good state of repair?

  Yes

  No

  N/A

• Are curtains clean and in a good state of repair?

  Yes

  No

  N/A

Communal Toilets 1

• Is the environment clean, tidy and free of clutter?

  Yes

  No

  N/A

• Is the toilet and washbasin clean and in a good state of repair?

  Yes

  No

  N/A

• Is the sink plug and overflow free?

  Yes

  No

  N/A

• Is the waste offset so water does not flow directly into it?

  Yes

  No

  N/A

• Are the fittings clean and dust free?

  Yes

  No

  N/A

• Is the floor clean and in a good state of repair?

  Yes

  No

  N/A

• Is there soap and hand towels available ?

  Yes

  No

  N/A

• Is there hand sanitizer available?

  Yes

  No

  N/A

• Is there a pedal bin available?

  Yes

  No

  N/A

• Is there appropriate signage including hand washing instructions?

  Yes

  No

  N/A

Communal Toilets 2

• Is the environment clean, tidy and free of clutter?

  Yes

  No

  N/A

• Is the toilet and washbasin clean and in a good state of repair?

  Yes

  No

  N/A

• Is the sink plug and overflow free?

  Yes

  No

  N/A

• Is the waste offset so water does not flow directly into it?

  Yes

  No

  N/A

• Are the fittings clean and dust free?

  Yes

  No

  N/A

• Is the floor clean and in a good state of repair?

  Yes

  No

  N/A

• Is there soap and hand towels available ?

  Yes

  No

  N/A

• Is there hand sanitizer available?

  Yes

  No

  N/A

• Is there a pedal bin available?

  Yes

  No

  N/A

• Is there appropriate signage including hand washing instructions?

  Yes

  No

  N/A

Communal Toilets 3

• Is the environment clean, tidy and free of clutter?

  Yes

  No

  N/A

• Is the toilet and washbasin clean and in a good state of repair?

  Yes

  No

  N/A

• Is the sink plug and overflow free?

  Yes

  No

  N/A

• Is the waste offset so water does not flow directly into it?

  Yes

  No

  N/A

• Are the fittings clean and dust free?

  Yes

  No

  N/A

• Is the floor clean and in a good state of repair?

  Yes

  No

  N/A

• Is there soap and hand towels available ?

  Yes

  No

  N/A

• Is there hand sanitizer available?

  Yes

  No

  N/A

• Is there a pedal bin available?

  Yes

  No

  N/A

• Is there appropriate signage including hand washing instructions?

  Yes

  No

  N/A

Communal Toilets 4

• Is the environment clean, tidy and free of clutter?

  Yes

  No

  N/A

• Is the toilet and washbasin clean and in a good state of repair?

  Yes

  No

  N/A

• Is the sink plug and overflow free?

  Yes

  No

  N/A

• Is the waste offset so water does not flow directly into it?

  Yes

  No

  N/A

• Are the fittings clean and dust free?

  Yes

  No

  N/A

• Is the floor clean and in a good state of repair?

  Yes

  No

  N/A

• Is there soap and hand towels available ?

  Yes

  No

  N/A

• Is there hand sanitizer available?

  Yes

  No

  N/A

• Is there a pedal bin available?

  Yes

  No

  N/A

• Is there appropriate signage including hand washing instructions?

  Yes

  No

  N/A

Bathroom 1

• Is the environment clean, tidy and free of clutter?

  Yes

  No

  N/A

• Is the toilet and washbasin clean and in a good state of repair?

  Yes

  No

  N/A

• Is the sink plug and overflow free?

  Yes

  No

  N/A

• Are the fittings clean and dust free?

  Yes

  No

  N/A

• Is the floor clean and in a good state of repair?

  Yes

  No

  N/A

• Is there a pedal bin available?

  Yes

  No

  N/A

• Is the bath / shower visibly clean?

  Yes

  No

  N/A

• Is there appropriate signage?

  Yes

  No

  N/A

• Is there a clean privacy curtain in place?

  Yes

  No

  N/A

Bathroom 2

• Is the environment clean, tidy and free of clutter?

  Yes

  No

  N/A

• Is the toilet and washbasin clean and in a good state of repair?

  Yes

  No

  N/A

• Is the sink plug and overflow free?

  Yes

  No

  N/A

• Are the fittings clean and dust free?

  Yes

  No

  N/A

• Is the floor clean and in a good state of repair?

  Yes

  No

  N/A

• Is there a pedal bin available?

  Yes

  No

  N/A

• Is the bath / shower visibly clean?

  Yes

  No

  N/A

• Is there appropriate signage?

  Yes

  No

  N/A

• Is there a clean privacy curtain in place?

  Yes

  No

  N/A

Bathroom 3

• Is the environment clean, tidy and free of clutter?

  Yes

  No

  N/A

• Is the toilet and washbasin clean and in a good state of repair?

  Yes

  No

  N/A

• Is the sink plug and overflow free?

  Yes

  No

  N/A

• Are the fittings clean and dust free?

  Yes

  No

  N/A

• Is the floor clean and in a good state of repair?

  Yes

  No

  N/A

• Is there a pedal bin available?

  Yes

  No

  N/A

• Is the bath / shower visibly clean?

  Yes

  No

  N/A

• Is there appropriate signage?

  Yes

  No

  N/A

• Is there a clean privacy curtain in place?

  Yes

  No

  N/A

Bathroom 4

• Is the environment clean, tidy and free of clutter?

  Yes

  No

  N/A

• Is the toilet and washbasin clean and in a good state of repair?

  Yes

  No

  N/A

• Is the sink plug and overflow free?

  Yes

  No

  N/A

• Are the fittings clean and dust free?

  Yes

  No

  N/A

• Is the floor clean and in a good state of repair?

  Yes

  No

  N/A

• Is there a pedal bin available?

  Yes

  No

  N/A

• Is the bath / shower visibly clean?

  Yes

  No

  N/A

• Is there appropriate signage?

  Yes

  No

  N/A

• Is there a clean privacy curtain in place?

  Yes

  No

  N/A

Bedrooms x 4 chosen at Random

• Bedroom Number

• Is the bed frame clean?

  Yes

  No

  N/A

• Is the mattress and overlay clean. Is the pump (if applicable) clean?

  Yes

  No

  N/A

• Is the washbasin clean and in a good state of repair?

  Yes

  No

  N/A

• Is the sink plug and overflow free?

  Yes

  No

  N/A

• Are the fittings clean and dust free?

  Yes

  No

  N/A

• Is the floor clean and in a good state of repair?

  Yes

  No

  N/A

• Is there a pedal bin available?

  Yes

  No

  N/A

Toilet

• Is the environment clean, tidy and free of clutter?

  Yes

  No

  N/A

• Is the toilet clean?

  Yes

  No

  N/A

• Is the floor clean and in a good state of repair?

  Yes

  No

  N/A