Cleaning Performance Rating Inspection Report

• Document No.

• Building

• Address

• 1. Not Cleaned
  2. Poorly Cleaned
  3. Some improvement needed
  4. Good
  5. Excellent

A. Toilets

• Floors, Walls, Partitions

  1

  2

  3

  4

  5

• Remedial Action Required

• Basins, Counters, Fittings, Mirrors

  1

  2

  3

  4

  5

• Remedial Action Required

• Toilet Bowls, Seats, Lids, Urinals

  1

  2

  3

  4

  5

• Remedial Action Required

• Showers

  1

  2

  3

  4

  5

• Remedial Action Required

• Rubbish Removal, Refill Dispensers

  1

  2

  3

  4

  5

• Remedial Action Required

• Door and Ceiling Grills

  1

  2

  3

  4

  5

• Remedial Action Required

• Total Points Item A

B. OFFICE/ROOMS

• Empty Bins, Replace Liners

  1

  2

  3

  4

  5

• Remedial Action Required

• Carpets

  1

  2

  3

  4

  5

• Remedial Action Required

• Walls, Doors, Glass, Windows

  1

  2

  3

  4

  5

• Remedial Action Required

• Skills, Ledges, etc.

  1

  2

  3

  4

  5

• Remedial Action Required

• Air Conditioning Diffusers, Vents,

  1

  2

  3

  4

  5

• Remedial Action Required

• Furniture, Desks, Cabinets

  1

  2

  3

  4

  5

• Remedial Action Required

• Total Points Item B

C. Staffroom/Kitchen/Pantry

• Empty Bins, Rubbish Removal

  1

  2

  3

  4

  5

• Remedial Action Required

• Carpets

  1

  2

  3

  4

  5

• Remedial Action Required

• Hard Flooring

  1

  2

  3

  4

  5

• Remedial Action Required

• Walls, Doors, Glass

  1

  2

  3

  4

  5

• Remedial Action Required

• Appliance, Table Tops

  1

  2

  3

  4

  5

• Remedial Action Required

• Sinks, Bench Tops, Tiles

  1

  2

  3

  4

  5

• Remedial Action Required

• Total Points Item C

D. Lobbies, Public Areas

• Carpets

  1

  2

  3

  4

  5

• Remedial Action Required

• Hard Floors

  1

  2

  3

  4

  5

• Remedial Action Required

• Lifts

  1

  2

  3

  4

  5

• Remedial Action Required

• Rubbish Removal, Debris, Litter

  1

  2

  3

  4

  5

• Remedial Action Required

• Internal Stairs

  1

  2

  3

  4

  5

• Remedial Action Required

• Sills, Ledges, etc.

  1

  2

  3

  4

  5

• Remedial Action Required

• Air Con Diffusers, Vents, Grills

  1

  2

  3

  4

  5

• Remedial Action Required

• Walls, Doors, Glass, Windows

  1

  2

  3

  4

  5

• Remedial Action Required

• Total Points Item D

E. External

• Walkways, Paved Areas

  1

  2

  3

  4

  5

• Remedial Action Required

• Walls, Under Roof, Eaves

  1

  2

  3

  4

  5

• Remedial Action Required

• Rubbish Removal, Debris, Litter

  1

  2

  3

  4

  5

• Remedial Action Required

• Total Points Item E

Total Score Items A to E

• Assessment Rating % = Total Score Above X 100 = (Max possible Score 145)

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