Information

  • Audit Title

  • Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Exterior and Entry Areas

  • Dumpster areas and exterior trash / ash receptacles litter free and clean?

  • Exterior Entry area, thresholds, vestibule flooring and walk off mats clean and presentable?

  • Glass doors clean?

  • Carpeting clean and in acceptable condition?

  • Hard floors clean, free of water mopping spots?

  • Vertical surfaces, corners, baseboards clean and free of cobwebs?

  • Lobby Furniture / tables / security desk / files clean, free from smudges and toe marks?

  • Low and high Dusting acceptable?

  • Rate area cleanliness on a scale of 1 - 10

Restrooms / Gyms / Locker Rooms

  • Sinks, drains, dispensers, and counters clean - <br>Including chrome fixtures?

  • Check box if counters have permanent stains or water damage and are ready for replacement

  • Under counter drain piping free from excessive dust?

  • Mirrors clean?

  • Paper towels, Soap, seat covers, sanitary napkins, and Toilet paper stocked?

  • Check box if it appears we are not getting 100% usage

  • Partitions clean and graffiti free and other Vertical wall surfaces clean (including grout if applicable)?

  • Floors clean and presentable (including grout)?

  • Toilet fixtures clean inside and out, shut off valves clean and leak free, and dispenser surfaces clean?

  • Air Vents and registers clean and free from dust?

  • Trash cans - liners in place, surfaces clean and presentable?

  • Check box if receptacle capacity seems insufficient

  • Floor drains clean and odor free?

  • Rate restroom area cleanliness on a scale of 1 - 10

  • Is there a gym, locker room, or showers on site?

  • Gym, locker, shower section
  • Fitness equipment being cleaned and dusted?

  • Flooring condition acceptable?

  • Shower stalls clean? (Walls, grout, fixtures, curtains, etc...)

  • Any odors in any of these areas?

  • Any signs of mold or mildew?

Corridors / stairs / elevators

  • Flooring condition acceptable?

  • Doors, Handrails, drinking fountains, etc... wiped down and clean?

  • Baseboards, corners, vertical surfaces clean?

  • High and vent dusting in good condition?

  • Any damage noticed due to janitorial carts or staff?

  • Elevator doors, floor track, handrails, buttons, lights and ceiling vents clean and polished as needed?

  • Water fountains clean and polished?

Kitchen, Dining, Coffee Bar, and vending areas

    Dynamic field. Does location have a kitchen
  • Are food prep area counters and floors clean and presentable?

  • Are kitchen exhaust hoods grease free and clean?

  • Dish machine area acceptable?

  • All floors clean - open areas, around, and under equipment?

  • Vertical walls clean, free of grease and dust?

  • Ceilings and vents clean and dust free?

  • Serving line areas, counters, sneeze guards, tray lines, etc...clean?

  • Rate kitchen area cleanliness on a scale of 1 - 10

  • Dining or Seating area Table tops / counters clean?

  • Equipment and appliances provided for Employees clean inside and out? (coffee makers / vending / ice / ovens / microwaves / refrigerators / etc.)

  • Coffee station area clean? (Counters, sinks, flooring, etc...)

  • Vending area clean? Including top and underneath machines?

  • Any other comments?

General office areas

  • Furniture / cabinets / window ledges / horizontal surfaces dust free (or acceptable)?

  • Edges, Baseboards, corners, and vertical surfaces clean?

  • Equipment (PC's, Copiers, Fire extinguishers, etc...) being dusted sufficiently?

  • Trash cans being emptied per schedule and liner bags clean and dry?

  • Conference / Meeting room areas clean? (Table fingerprints or marks, white boards, wall switches, floor/ chairs/furniture)

  • Carpet - cubicle and office areas acceptable?

  • Carpet - traffic lanes acceptable?

  • Hard floors clean, with adequate sealer/wax?

  • High and vent dusting in good condition?

  • Vacant areas cleaned and prepped for new occupants?

Restricted or Secured office areas

  • Furniture / cabinets / window ledges / horizontal surfaces dust free (or acceptable)?

  • Edges, Baseboards, corners, and vertical surfaces clean?

  • Equipment (PC's, Copiers, Fire extinguishers, etc...) being dusted sufficiently?

  • Trash cans being emptied per schedule and liner bags clean and dry?

  • Conference / Meeting room areas clean? (Table fingerprints or marks, white boards, wall switches, floor/ chairs/furniture)

  • Carpet - cubicle and office areas acceptable?

  • Carpet - traffic lanes acceptable?

  • Hard floors clean, with adequate sealer/wax?

  • High and vent dusting in good condition?

  • Other areas

Executive or Prestige office areas

  • Board room or Executive meeting areas clean? (Table fingerprints or marks, white boards, wall switches, floor/ chairs/furniture, catering areas)

  • Furniture / cabinets / window ledges / horizontal surfaces dust free (or acceptable)?

  • Edges, Baseboards, corners, and vertical surfaces clean?

  • Equipment (PC's, Copiers, Fire extinguishers, etc...) being dusted sufficiently?

  • Trash cans being emptied per schedule and liner bags clean and dry?

  • Carpet - cubicle and office areas acceptable?

  • High, Vertical surfaces, and vent dusting in good condition?

Janitorial areas

  • Loading dock/delivery areas clean and free of food/trash/clutter?

  • Storage areas, mop sinks, supplies, and equipment clean and in good repair- all being properly stored?

  • Equipment has grounded plugs and cords in good condition? Minimal use of extension cords?

  • Hazard labels and warnings on chemical containers- proper concentration / dispensing of chemicals?

  • MSDS available to their staff as well as provided to Facilities (and entered into our 3E database)?

  • Staff appearance and uniforms in use and presentable

Authorization signatures

  • Facilities Representative signature

  • Janitorial Representative 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.