Title Page
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
Entrance
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Floors, edges and corners
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Windows
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Ledges
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High level dusting
Corridors
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Floors, edges and corners
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Low level dusting
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High level dusting
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Walls
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Staircase
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Internal glass
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Lift
Main Lounge
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Floors, edges and corners
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Chairs
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Low level dusting
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High level dusting
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Walls
Laundry
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Floors, edges and corners
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Surfaces
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Walls
Male Toilets
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Toilet bowl, seat and urinals
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Floors, edges and corners
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Walls
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Cubicle walls and doors
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High level dusting
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Sink and taps
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Bins
Female Toilets
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Toilet bowl and seat
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Floors, edges and corners
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Walls
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Cubicle walls and doors
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High level dusting
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Sink and taps
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Bins
Health and Safety
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Equipment in good working order
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Electrical equipment PAT tested
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RAMS onsite and up to date
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COSHH details onsite and available
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Chemicals Stored Correctly
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Cleaners in uniform
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Cleaning store clean and tidy
Action Plan
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Action plan completed
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Action plan required from this inspection
Signatures
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Area Manager Signature
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Client Signature