CLP 3e. Cubicle checks - monthly

• Conducted on

  Date

• Select date

  Date

Male toilet cubicle

Toilet door 1 (nearest to the door)

• Door hinges - Is this safe and operational

  Okay

  Needs Attention

  At risk

• Door decor front - Is this presentable

  Okay

  Needs Attention

  At risk

• Door decor back - Is this presentable

  Okay

  Needs Attention

  At risk

• Door handle - Is this safe and operational

  Okay

  Needs Attention

  At risk

• Door Lock - Is this safe and operational

  Okay

  Needs Attention

  At risk

• Cubical lighting - Is this safe and operational

  Okay

  Needs Attention

  At risk

• Toilet roll dispenser - Is this safe, attached to the side and operational

  Okay

  Needs Attention

  At risk

• Toilet Bowl - is this safe and operational

  Okay

  Needs Attention

  At risk

• Toilet lid - is this attached, safe and operational

  Okay

  Needs Attention

  At risk

• Chain Flush - Is this attached, safe and operational

  Okay

  Needs Attention

  At risk

• Toilet cleanliness - Clean and tidy

  Okay

  Needs Attention

  At risk

Toilet door 2 (furthest from door)

• Door hinges - Is this safe and operational

  Okay

  Needs Attention

  At risk

• Door decor front - Is this presentable

  Okay

  Needs Attention

  At risk

• Door decor back - Is this presentable

  Okay

  Needs Attention

  At risk

• Door handle - Is this safe and operational

  Okay

  Needs Attention

  At risk

• Door Lock - Is this safe and operational

  Okay

  Needs Attention

  At risk

• Cubical lighting - Is this safe and operational

  Okay

  Needs Attention

  At risk

• Toilet roll dispenser - Is this safe, attached to the side and operational

  Okay

  Needs Attention

  At risk

• Toilet Bowl - is this safe and operational

  Okay

  Needs Attention

  At risk

• Toilet lid - is this attached, safe and operational

  Okay

  Needs Attention

  At risk

• Chain Flush - Is this attached, safe and operational

  Okay

  Needs Attention

  At risk

• Toilet cleanliness - Clean and tidy

  Okay

  Needs Attention

  At risk

Female toilet cubical

Toilet door 1 (Closest to the door)

• Door hinges - Is this safe and operational

  Okay

  Needs Attention

  At risk

• Door decor front - Is this presentable

  Okay

  Needs Attention

  At risk

• Door decor back - Is this presentable

  Okay

  Needs Attention

  At risk

• Door handle - Is this safe and operational

  Okay

  Needs Attention

  At risk

• Door Lock - Is this safe and operational

  Okay

  Needs Attention

  At risk

• Cubical lighting - Is this safe and operational

  Okay

  Needs Attention

  At risk

• Toilet roll dispenser - Is this safe, attached to the side and operational

  Okay

  Needs Attention

  At risk

• Toilet Bowl - is this safe and operational

  Okay

  Needs Attention

  At risk

• Toilet lid - is this attached, safe and operational

  Okay

  Needs Attention

  At risk

• Chain Flush - Is this attached, safe and operational

  Okay

  Needs Attention

  At risk

• Toilet cleanliness - Clean and tidy

  Okay

  Needs Attention

  At risk

Toilet door 2 (middle)

• Door hinges - Is this safe and operational

  Okay

  Needs Attention

  At risk

• Door decor front - Is this presentable

  Okay

  Needs Attention

  At risk

• Door decor back - Is this presentable

  Okay

  Needs Attention

  At risk

• Door handle - Is this safe and operational

  Okay

  Needs Attention

  At risk

• Door Lock - Is this safe and operational

  Okay

  Needs Attention

  At risk

• Cubical lighting - Is this safe and operational

  Okay

  Needs Attention

  At risk

• Toilet roll dispenser - Is this safe, attached to the side and operational

  Okay

  Needs Attention

  At risk

• Toilet Bowl - is this safe and operational

  Okay

  Needs Attention

  At risk

• Toilet lid - is this attached, safe and operational

  Okay

  Needs Attention

  At risk

• Chain Flush - Is this attached, safe and operational

  Okay

  Needs Attention

  At risk

• Toilet cleanliness - Clean and tidy

  Okay

  Needs Attention

  At risk

Toilet door 3 (furthest from door)

• Door hinges - Is this safe and operational

  Okay

  Needs Attention

  At risk

• Door decor front - Is this presentable

  Okay

  Needs Attention

  At risk

• Door decor back - Is this presentable

  Okay

  Needs Attention

  At risk

• Door handle - Is this safe and operational

  Okay

  Needs Attention

  At risk

• Door Lock - Is this safe and operational

  Okay

  Needs Attention

  At risk

• Cubical lighting - Is this safe and operational

  Okay

  Needs Attention

  At risk

• Toilet roll dispenser - Is this safe, attached to the side and operational

  Okay

  Needs Attention

  At risk

• Toilet Bowl - is this safe and operational

  Okay

  Needs Attention

  At risk

• Toilet lid - is this attached, safe and operational

  Okay

  Needs Attention

  At risk

• Chain Flush - Is this attached, safe and operational

  Okay

  Needs Attention

  At risk

• Toilet cleanliness - Clean and tidy

  Okay

  Needs Attention

  At risk

• Name and sign

  Sign