Daily/Weekly Residents Gym - Equipment Safety and Cleaning Checks - TEMPLATE

• Audit Title

• Document No.

• Site name

• Location
  Address

• Attendees

• Conducted on

  Date

• Prepared by

• Has the gym clean been conducted and to a high standard?

  Good

  Fair

  Poor

  N/A

• Who was the contractor for the gym clean?

• Is the gym sanitation station correctly stocked with no missing items?

  Yes

  No

  N/A

• Will any of the gym sanitary products/items need replenishing?

  Yes

  No

  N/A

• Which date was the gym cleaned?

  Date

Inspection report requirements and metrics

• Cleaning/H&S inspection shall be performed Daily by the Gym manager (or authorized representative).

• Key:
  
  Good = 10 points
  Fair = 5 points
  Poor = 0 points
  
  Yes = 10 points
  No = 0 points
  NA = 10 points

Equipment Safety Checks

• Dumbbell Trolley

  Safe

  At Risk

  N/A

• Leg Extension & Leg Curl

  Safe

  At Risk

  N/A

• Pec Fly & Rear Delt Machine

  Safe

  At Risk

  N/A

• Adjacent Flat/Incline Bench

  Safe

  At Risk

  N/A

• Matt Hanger

  Safe

  At Risk

  N/A

• Hip Abductor/Adductor

  Safe

  At Risk

  N/A

• Cross Trainer

  Safe

  At Risk

  N/A

• Dumbells/Plates

  Safe

  At Risk

  N/A

• Exercise Bike

  Safe

  At Risk

  N/A

• Bars/Clips

  Safe

  At Risk

  N/A

• Exercise Matt

  Safe

  At Risk

  N/A

• Rowing Machine

  Safe

  At Risk

  N/A

• Benches

  Safe

  At Risk

  N/A

• Kettle Bells

  Safe

  At Risk

  N/A

• Exercise Ball/Bosu Ball

  Safe

  At Risk

  N/A

• Skill Bikes

  Safe

  At Risk

  N/A

• Treadmills

  Safe

  At Risk

  N/A

• Matted Streching Area

  Good

  Fair

  Poor

  N/A

• Weight Area

  Good

  Fair

  Poor

  N/A

• Desk and Sink Area

  Good

  Fair

  Poor

  N/A

• Cleaning Stations

  Good

  Fair

  Poor

  N/A

• Main Walkway and Stairwell

  Good

  Fair

  Poor

  N/A

• Weights Room and Foyer Area

  Good

  Fair

  Poor

  N/A

• Gym Office

  Good

  Fair

  Poor

  N/A

Assessors signatures

• Gym Manager or authorized representative

  Sign