Information
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Assessment Location
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Building:
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Inspection conducted by:
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Inspector Signature
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Document No.
Cleanness
Courtyard / Patio
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Ready to Inspect?
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Outside walks free of litter?
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Entrance glass clean?
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Entrance floor mats clean?
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Waste baskets and liners clean?
Building Exterior / Perimeter
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Ready to Inspect?
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Outside walk-way free of litter?
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Waste baskets and liners clean?
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Light fixtures bug free?
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Clean of cob webs?
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Clean of wasp nest?
Exterior Seating (i.e. Bleachers, picnic tables, dugout, etc)
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Ready to Inspect?
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Outside walk-way free of litter?
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Waste baskets and liners clean?
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Seating clean?
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Clean of wasp nest/cob webs?
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Exterior signage is clean?
Main Entrance
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Ready to Inspect?
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Enter the room number
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Outside walks free of litter?
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Entrance glass clean?
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Entrance floor mats clean?
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Inside floors clean?
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Inside Walls clean?
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Waste baskets and liners clean?
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Picture frames on walls clean?
Waiting area / Reception area
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Ready to Inspect?
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Enter the room number
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Floors clean?
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Walls clean?
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Area free of dust?
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Waste baskets and liners clean?
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Furniture clean?
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White boards clean?
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Air vents clean?
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Windows and sills clean?
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Blinds clean?
Restroom #1
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Ready to Inspect?
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Enter the room number
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Toilets clean?
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Urinal clean?
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Partitions clean?
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Sinks clean and free of soap buildup?
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Fixtures and drain pipes clean?
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Mirrors clean?
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Stainless steel polished?
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Waste baskets and liners clean?
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Floor clean?
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Corners are clean?
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Air vents clean?
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Walls clean?
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Supply adequately stock?
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Shower walls and tile clean?
Restroom #2
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Ready to Inspect?
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Enter the room number
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Toilets clean?
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Urinal clean?
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Partitions clean?
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Sinks clean and free of soap buildup?
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Fixtures and drain pipes clean?
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Mirrors clean?
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Stainless steel polished?
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Waste baskets and liners clean?
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Floor clean?
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Air vents clean?
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Walls clean?
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Supply adequately stock?
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Shower walls and tile clean?
Hallways
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Ready to Inspect?
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Floors clean?
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Walls clean?
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Area free of dust?
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Waste baskets and liners clean?
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Air vents clean?
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Windows and sills clean?
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Blinds clean?
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Water fountain clean?
Lounge
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Ready to Inspect?
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Floors clean?
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Walls clean?
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Area free of dust?
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Waste baskets and liners clean?
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Air vents clean?
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Windows and sills clean?
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Blinds clean?
Kitchenette / Pantry
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Ready to Inspect?
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Floors clean?
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Walls clean?
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Area free of dust?
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Waste baskets and liners clean?
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Air vents clean?
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Appliances clean?
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Sink and drains clean?
Stairs
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Ready to Inspect?
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Steps clean?
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Landing clean?
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Railings clean?
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Walls clean?
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Free of cob webs?
Elevator
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Ready to Inspect?
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Floors clean?
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Walls clean?
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Ceiling & light fixtures (lenses) clean?
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Area free of dust?
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Air vents clean?
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Elevator tracks clean?
Office # 1
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Ready to inspect?
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Enter the room number
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Floors clean?
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Walls clean?
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Area free of dust?
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Waste baskets and liners clean?
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Furniture clean?
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Air vents clean?
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Windows and sills clean?
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Blinds clean?
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Telephone clean?
Office # 2
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Ready to inspect?
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Enter the room number
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Floors clean?
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Walls clean?
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Area free of dust?
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Waste baskets and liners clean?
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Furniture clean?
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Air vents clean?
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Windows and sills clean?
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Blinds clean?
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Telephone clean?
Office # 3
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Ready to inspect?
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Enter the room number
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Floors clean?
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Walls clean?
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Area free of dust?
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Waste baskets and liners clean?
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Furniture clean?
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Air vents clean?
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Windows and sills clean?
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Blinds clean?
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Telephone clean?
Classrooms #1
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Ready to Inspect?
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Enter the room number
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Floors clean?
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White boards clean?
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Walls clean?
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Area free of dust?
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Waste baskets and liners clean?
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Furniture clean?
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Air vents clean?
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Windows and sills clean?
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Blinds clean?
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Door knobs clean / disinfected?
Classrooms #2
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Ready to Inspect?
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Enter the room number
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Floors clean?
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White boards clean?
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Walls clean?
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Area free of dust?
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Waste baskets and liners clean?
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Furniture clean?
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Air vents clean?
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Windows and sills clean?
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Blinds clean?
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Door knobs clean / disinfected?
Classrooms #3
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Ready to Inspect?
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Enter the room number
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Floors clean?
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White boards clean?
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Walls clean?
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Area free of dust?
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Waste baskets and liners clean?
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Furniture clean?
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Air vents clean?
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Windows and sills clean?
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Blinds clean?
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Door knobs clean / disinfected?
Conference Room
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Ready to Inspect?
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Enter the conference room number or name
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Floors clean?
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White boards clean?
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Walls clean?
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Area free of dust?
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Waste baskets and liners clean?
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Furniture clean?
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Air vents clean?
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Windows and sills clean?
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Blinds clean?
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Door knobs clean / disinfected?
Auditorium
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Ready to Inspect?
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Floors clean?
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Are steps clean?
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Railings clean?
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White boards clean?
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Walls clean?
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Area free of dust?
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Waste baskets and liners clean?
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Furniture clean?
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Air vents clean?
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Windows and sills clean?
Study / Practice room #1
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Ready to Inspect?
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Floors clean?
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White boards clean?
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Walls clean?
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Area free of dust?
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Waste baskets and liners clean?
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Furniture clean?
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Air vents clean?
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Windows and sills clean?
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Blinds clean?
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Door knobs clean / disinfected?
Study / Practice room #2
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Ready to Inspect?
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Floors clean?
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White boards clean?
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Walls clean?
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Area free of dust?
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Waste baskets and liners clean?
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Furniture clean?
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Air vents clean?
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Windows and sills clean?
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Blinds clean?
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Door knobs clean / disinfected?
Labs #1
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Ready to Inspect?
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Enter the room number
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Floors clean?
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White boards clean?
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Walls clean?
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Area free of dust?
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Waste baskets and liners clean?
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Furniture clean?
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Counter top sinks clean?
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Air vents clean?
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Windows and sills clean?
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Blinds clean?
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Door knobs clean / disinfected?
Labs #2
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Ready to Inspect?
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Enter the room number
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Floors clean?
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White boards clean?
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Walls clean?
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Area free of dust?
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Waste baskets and liners clean?
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Furniture clean?
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Counter top sinks clean?
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Air vents clean?
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Windows and sills clean?
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Blinds clean?
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Door knobs clean / disinfected?
Stacks (library)
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Ready to Inspect?
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Floors clean?
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Walls clean?
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Windows and sills?
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Furniture clean?
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Area free of dust?
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Air vents clean?
Serving area
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Ready to Inspect?
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Floors clean?
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Walls clean?
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Windows and sills?
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Area free of dust?
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Air vents clean?
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Drains clean?
Dining area
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Ready to Inspect?
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Floors clean?
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Walls clean?
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Windows and sills?
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Furniture clean?
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Area free of dust?
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Air vents clean?
Fitness Centers & Gym
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Ready to Inspect?
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Floors clean?
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Walls clean?
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Windows and sills?
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Furniture clean?
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Fitness equipment?
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Area free of dust?
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Air vents clean?
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Water fountain clean?
Custodial Closet
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Ready to Inspect?
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Floors clean?
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Deep sink and drain clean?
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Equipment stored properly?
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Shelves organized adequately stocked?
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Walls clean?
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All chemicals stored below eye level?
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All chemicals are properly label?
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Area free of dust?
Custodial Equipment?
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Ready to Inspect?
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Brute and caddy clean and organized?
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Vacuum clean?
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Buffer clean?
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Mop bucket and wringer clean?
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Dust mop clean?
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Safety goggles ready and accessible?
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Safety gloves readily accessible?
Safety elements and compliance
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Ready to Inspect?
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Floor care: wet floor signs in use
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Proper foot wear for job task?
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Slips, Trips & Fall hazards?
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Eye/face protection: safety glasses, goggles?
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Hand protection: Disposable gloves, chemical resistant gloves
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Proper labeling of containers?
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Uniform: appearance & in compliance?
Maintenance related issues
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Ready to Procced?
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Lighting: Any light fixtures not working?
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Ceiling: Any ceiling tiles to be replaced (Due to stains or other issues) ?
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Walls: Any wall damage to be repaired?
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Other maintenance related items to be addressed?
Notes: Please indicate anything else not covered through the inspection.
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Your notes