Community Centres - MBRC

• Document No.

• Audit Title

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Site Name and Number

• Joint Inspection

Matrix - 1 = Not Cleaned, 2 = Poorly Cleaned, 3 = Acceptable, 4 = Good, 5 = Exceeds Expectations

External Grounds

• Are the entrances clean and free of litter?

  1

  2

  3

  4

  5

• Is the external concrete paths and hard stand areas clean and clear of leaves and leaf litter?

  1

  2

  3

  4

  5

• Are the Glass/Windows clean and free of smears and marks?

  1

  2

  3

  4

  5

• Additional Information or comments

Common / Hall Areas / Meeting and Computer Rooms

• Are the Skirting boards and window ledges clean and free from dirt, dust, marks, stains and cobwebs?

  1

  2

  3

  4

  5

• Are the floor coverings clean and free from dirt, grit, marks etc?

  1

  2

  3

  4

  5

• Are the walls, doors and door frames free from dirt, dust, marks, stains and cobwebs?

  1

  2

  3

  4

  5

• Are the ceiling tiles and air conditioning vents free from dirt, dust, marks stains and cobwebs?

  1

  2

  3

  4

  5

• Additional Information or Comments

Kitchen

• Cleanliness of kitchen basins, taps, bench tops, cupboard surfaces and exterior cupboard doors?

  1

  2

  3

  4

  5

• Cleanliness of external appliances (Refrigerator, Microwave)

  1

  2

  3

  4

  5

• Are the soap and paper towel dispensers cleaned and stocked?

  1

  2

  3

  4

  5

• Are Rubbish bins emptied and cleaned?

  1

  2

  3

  4

  5

• Cleanliness of floors, walls, doors, door handles, skirting boards and window ledges?

  1

  2

  3

  4

  5

• Additional Information or comments

Toilets / Urinals (Male, Female and Disabled)

• Is the Urinal clean and free from odours?

  1

  2

  3

  4

  5

• Are the toilets bowls, seats, lids and urinals clean and odour free?

  1

  2

  3

  4

  5

• Are the Hand basins, counters, tap fittings, mirrors clean?

  1

  2

  3

  4

  5

• Cleanliness of floors, walls and cubicle doors and handles free from dirt, dust, marks, stains and cobwebs?

  1

  2

  3

  4

  5

• Are Rubbish bins emptied and cleaned?

  1

  2

  3

  4

  5

• Are the soap and paper towel dispensers cleaned and stocked?

  1

  2

  3

  4

  5

• Additional Information or comments

Cleaners Cupboards

• Cleanliness of Cleaners Cupboards?

  Yes

  No

  N/A

• Are Chemicals labelled?

  Yes

  No

  N/A

• Is equipment tagged?

  Yes

  No

  N/A

• Is the MSDS wall chart and frequency chart displayed?

  Yes

  No

  N/A

Building Maintenance

• Add media

  Media

• Additional Information or Comments

CONCLUSION

• Inspection Period?

  Morning

  Afternoon

  Evening

  Night Shift

• General Score 0 = Poor, 5 = Average, 10 = Excellent

• Sketch or write additional information if required

  Drawing

• Additional comments or information

Please sign off the report to complete the inspection

• MBRC Representative Signature (If Available):

  Sign

• Service Provider SXFS Signature :

  Sign

• Date and Time of Audit

  Date