Deda Hospital Public Area Toilet Checklist

• Site conducted

  Select

• Section

• Shift

  8:00 AM

  11:00 AM

  2:00 PM

  5:00 PM

• Conducted on

  Date

• Prepared by

• Location
  Address

• 1 IS THE ENTRANCE DOOR CLEAN, FREE FROM STAINS.

  Yes

  No

  N/A

• 2 IS THE WASH HAND BASIN AND STOPPER CLEAN,FREE FROM HAIRS

  Yes

  No

  N/A

• 3 IS THERE LIQUID SOAP IN THE DISPENSER

  Yes

  No

  N/A

• 4 IS THE MIRROR CLEAN,FREE FROM WATER MARKS AND DIRTS

  Yes

  No

  N/A

• 5 ARE THE TIOLETS CLEAN,FREE FROM DIRTS,LIMESCALE

  Yes

  No

  N/A

• 6 ARE ALL THE TOILET FLUSHING

  Yes

  No

  N/A

• 7 IS THE TOILET ROLLS AVAILABLE

  Yes

  No

  N/A

• 8 IS THERE HAND TISSUE AVAILABLE

  Yes

  No

  N/A

• 9 IS THE TOILET ROLL FOLDED IN V SHAPE

  Yes

  No

  N/A

• 10 ARE ALL BULBS WORKING

  Yes

  No

  N/A

• 11 ARE ALL THE TOILET CORNERS CLEAN AND FREE FROM DIRTS/WATER

  Yes

  No

  N/A

• 12 IS THE HAND DRYER WORKING

  Yes

  No

  N/A

• 13 ARE ALL VENTS,EXAUSTS CLEAN,FREE FROM DUST

  Yes

  No

  N/A

• 14 IS THE CEILING FREE FROM COBWEBS

  Yes

  No

  N/A

• 15 IS TOILET SMELLING FRESH AND CLEAN

  Yes

  No

  N/A

• 16 IS FLOOR WELL MOPPED

  Yes

  No

  N/A

• 17 WAS THE TRASH BIN EMPTY AND WITH LINNER

  Yes

  No

  N/A

• 18 IS THE WINDOW CLEAN AND THE BLINDS FREE FROM DUST

  Yes

  No

  N/A

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