Congress Men's Health

• Document No.

• Conducted on

  Date
• Location
  Address

• Personnel

• Auditor

  Sign

Chemicals

• Pink Panther Disinfectant
  Used for dusting, wiping and mopping

• Brilliant
  Used for cleaning of glass, mirrors and stainless steel

• Toilet and Bathroom cleaner
  Used neat for inside of toilet bowl and urinals

• Eucalyptus oil
  Used for air freshening, mopping if odour is high and for spraying in bins

• Fresh
  Air freshener

• Ocean
  Used for rescaling of bathrooms

Mop head colour coding

• Red
  Bodily fluids blood and vomit

• Yellow
  Toilets and bathrooms

• Green
  General use

Cloths and rags

• Red
  Bodily Fluids

• Yellow
  Bathrooms

• Green
  General Use

• Blue
  Glass and mirrors

Safe Work Method Statement

• Have you viewed all safe work method statement and agree that they reflect work to be preformed?

  Yes

  No

  N/A

Start work

• Check trolley has enough:

• Chemical

  Yes

  No

  N/A

• Toilet paper and hand towel

  Yes

  No

  N/A

• Cleaning cloths

  Yes

  No

  N/A

• Gloves

  Yes

  No

  N/A

• Comments

Offices

• Wipe all benches, tables and telephones using Pink Panther Disinfectant and a Green cloth<br>NOTE: DO NOT wipe desks apart from reception desks<br>

  Yes

  No

  N/A

• Wipe all light switches and power points using Pink Panther Disinfectant and a Green cloth

  Yes

  No

  N/A

• Wipe all door handles, doors, door vents, door frames and all door hardware using Pink Panther Disinfectant and a Green cloth

  Yes

  No

  N/A

• Wipe and spot clean all walls, window ledgers, signs, fire extinguishers, fire hoses, TV’s and all equipment on walls using Pink Panther Disinfectant and a Green cloth

  Yes

  No

  N/A

• Wipe all skirting boards Pink Panther Disinfectant and a green cloth

  Yes

  No

  N/A

• Wipe all chair vinyl/plastic or leather chairs using Pink Panther Disinfectant and a red cloth

  Yes

  No

  N/A

• Wipe over all water fountains using Pink Panther Disinfectant and a green cloth

  Yes

  No

  N/A

• Scrub inside sink using Pink Panther Disinfectant and a sourer then rinse with clean water and wipe dry using Brilliant and a dry green cloth

  Yes

  No

  N/A

• Spot clean internal glass using Brilliant and a blue cloth

  Yes

  No

  N/A

• Check all corners for cobwebs and remove if visible using a cobweb broom

  Yes

  No

  N/A

• Empty all waste paper bins and replace bag if required and spray 1 squirt of Eucalyptus oil into bin

  Yes

  No

  N/A

• Vacuum and mop all floors using Pink Panther Disinfectant and a green mop head and bucket.

  Yes

  No

  N/A

• Before locking room spray 1 squirt of Fresh into room and if end of day lock room

  Yes

  No

  N/A

• Overall condition of area

• Comments

Kitchen

• Spot clean internal glass using Brilliant and a blue cloth

  Yes

  No

  N/A

• Check all corners for cobwebs and remove if visible using a cobweb broom

  Yes

  No

  N/A

• Empty all waste paper bins and replace bag if required and spray 1 squirt of Eucalyptus oil into bin

  Yes

  No

  N/A

• Vacuum and mop all floors using Pink Panther Disinfectant and a green mop head and bucket.

  Yes

  No

  N/A

• <br>Before locking room spray 1 squirt of Fresh into room and if end of day lock room

  Yes

  No

  N/A

• Wipe all benches, tables and telephones using Pink Panther Disinfectant and a clean Green cloth

  Yes

  No

  N/A

• Wipe all light switches and power points using Pink Panther Disinfectant and a Green cloth

  Yes

  No

  N/A

• Wipe all door handles, doors, door vents, door frames and all door hardware using Pink Panther Disinfectant and a Green cloth

  Yes

  No

  N/A

• Wipe and spot clean all walls, window ledgers, signs, fire extinguishers, fire hoses, TV’s and all equipment on walls using Pink Panther Disinfectant and a Green cloth

  Yes

  No

  N/A

• Wipe all skirting boards Pink Panther Disinfectant and a green cloth

  Yes

  No

  N/A

• Wipe all chair using Pink Panther Disinfectant and a red cloth

  Yes

  No

  N/A

• Scrub inside sink using Pink Panther Disinfectant and a scorer then rinse with clean water and wipe dry using Brilliant and a dry green cloth

  Yes

  No

  N/A

• Overall Condition of area

• Comments

Toilets

• Apply neat Toilet and Bathroom cleaner to internal of toilet bowl rim and scrub using a toilet brush.

  Yes

  No

  N/A

• Wipe and scrub external of toilet bowl including all pipe work, cistern, toilet seats both top and bottom, base of toilet bowl up to 1 meter from toilet base including behind and under bowl using Pink Panther Disinfectant and a yellow cloth

  Yes

  No

  N/A

• Flush toilet and apply 5 drops of Toilet and Bathroom cleaner into water of toilet to tint water blue

  Yes

  No

  N/A

• Apply neat Toilet and Bathroom cleaner to face of urinal and scrub urinal with a scorer ensuring to not use same scorer in any other area apart from toilets.

  Yes

  No

  N/A

• Wipe over whole of urinal including wipe work, ledgers, step and floor up to 1 meter from step of urinal using Pink Panther Disinfectant and a yellow cloth

  Yes

  No

  N/A

• Scrub basin and vanity using Pink Panther Disinfectant and a scorer and wipe dry using a yellow cloth

  Yes

  No

  N/A

• Clean mirrors to a streak free finish using Brilliant and a blue cloth

  Yes

  No

  N/A

• Wipe all light switches and power points using Pink Panther Disinfectant and a yellow cloth

  Yes

  No

  N/A

• Wipe all door handles, doors, door vents, door frames and all door hardware using Pink Panther Disinfectant and a yellow cloth

  Yes

  No

  N/A

• Wipe and spot clean all walls, window ledgers, signs, fire extinguishers, fire hoses, TV’s and all equipment on walls using Pink Panther Disinfectant and a yellow cloth

  Yes

  No

  N/A

• Wipe all skirting boards Pink Panther Disinfectant and a yellow cloth

  Yes

  No

  N/A

• Replenish all toilet paper, hand towel and soap if required

  Yes

  No

  N/A

• Empty all waste paper bins and replace bag if required and spray 1 squirt of Eucalyptus oil into bin

  Yes

  No

  N/A

• Vacuum and mop all floors using Pink Panther Disinfectant and a green mop head and bucket.

  Yes

  No

  N/A

• Before locking room spray 1 squirt of Fresh into room and if end of day lock room

  Yes

  No

  N/A

• Overall condition of area

• Comments

Clinic Room

• Wipe all benches, tables and telephones using Pink Panther Disinfectant and a green cloth<br>NOTE: DO NOT wipe doctors desk<br>

  Yes

  No

  N/A

• Wipe all light switches and power points using Pink Panther Disinfectant and a green cloth

  Yes

  No

  N/A

• Wipe all door handles, doors, door vents, door frames and all door hardware using Pink Panther Disinfectant and a green cloth

  Yes

  No

  N/A

• Wipe and spot clean all walls, window ledgers, signs, fire extinguishers, fire hoses, TV’s and all equipment on walls using Pink Panther Disinfectant and a green cloth

  Yes

  No

  N/A

• Wipe all skirting boards Pink Panther Disinfectant and a green cloth

  Yes

  No

  N/A

• Wipe all patient beds and chair using Pink Panther Disinfectant and a red cloth

  Yes

  No

  N/A

• Scrub inside sink using Pink Panther Disinfectant and a sourer then rinse with clean water and wipe dry using Brilliant and a dry green cloth

  Yes

  No

  N/A

• Spot clean internal glass using brilliant and a blue cloth

  Yes

  No

  N/A

• Check all corners for cobwebs and remove if visible using a cobweb broom

  Yes

  No

  N/A

• Empty all waste paper bins and replace bag if required and spray 1 squirt of eucalyptus oil into bin

  Yes

  No

  N/A

• Empty all medical waste bins and replace with a yellow bio hazard liner while following all medical waste procedures.

  Yes

  No

  N/A

• Vacuum and mop all floors using Pink Panther Disinfectant and a red mop head and bucket.

  Yes

  No

  N/A

• Before locking room spray 1 squirt of fresh into room and if end of day lock room

  Yes

  No

  N/A

• Overall condition of area

• Comments

Breezway, laundry & Showers

• Wipe all benches, tables and telephones using Pink Panther Disinfectant and a Green cloth

  Yes

  No

  N/A

• Wipe all light switches and power points using Pink Panther Disinfectant and a Green cloth

  Yes

  No

  N/A

• Wipe all door handles, doors, door vents, door frames and all door hardware using Pink Panther Disinfectant and a Green cloth

  Yes

  No

  N/A

• Wipe and spot clean all walls, window ledgers, signs, fire extinguishers, fire hoses, TV’s and all equipment on walls using Pink Panther Disinfectant and a Green cloth

  Yes

  No

  N/A

• Wipe all skirting boards Pink Panther Disinfectant and a green cloth

  Yes

  No

  N/A

• Wipe all chair vinyl/plastic or leather chairs using Pink Panther Disinfectant and a red cloth

  Yes

  No

  N/A

• Wipe over all water fountains using Pink Panther Disinfectant and a green cloth

  Yes

  No

  N/A

• Wipe over all hand banisters and rails using Pink Panther Disinfectant and a green cloth

  Yes

  No

  N/A

• Wipe over all washing machines and dryers using Pink Panther Disinfectant and a green cloth

  Yes

  No

  N/A

• Scrub showers using ocean and a scorer

  Yes

  No

  N/A

• Polish tiles and chrome fittings using Brilliant and a blue cloth

  Yes

  No

  N/A

• Spot clean internal glass using Brilliant and a blue cloth

  Yes

  No

  N/A

• Check all corners for cobwebs and remove if visible using a cobweb broom

  Yes

  No

  N/A

• Empty all waste paper bins and replace bag if required and spray 1 squirt of Eucalyptus oil into bin

  Yes

  No

  N/A

• Vacuum and mop all floors using Pink Panther Disinfectant and a green mop head and bucket.

  Yes

  No

  N/A

• Before locking area spray 1 squirt of Fresh into room and if end of day lock room

  Yes

  No

  N/A

• Overall condition of area

• Comments

Finish of shift

• Clean store room including mopping and vacuuming of room

  Yes

  No

  N/A

• Charge Ipad

  Yes

  No

  N/A

• Put all cloths on washing machine for day shift to place in dryer

  Yes

  No

  N/A

• Empty dust bag in vacuum if full

  Yes

  No

  N/A

• Clean vacuum filter

  Yes

  No

  N/A

• Coil vacuum cord and ensure that cord is in good working condition with no kinks or cuts

  Yes

  No

  N/A

• Ensure all doors are locked, air conditioners and lights are off and that alarm is armed.

  Yes

  No

  N/A

• Rinse and wash mop heads in hot water and wring dry

  Yes

  No

  N/A

• Restock trolley for next day

  Yes

  No

  N/A

• Take all medical waste to medical waste bins

  Yes

  No

  N/A

• Take all rubbish to external skip

  Yes

  No

  N/A

• Overall condition of area

• Comments