Title Page

  • Date

  • Visit and house status

  • Community Name

  • Address
  • Prepared by

  • Pests evident

  • Power

  • Working washing machine

  • Hot water

  • Yarn about Hygiene

Insert Numbers Given to Tenant

  • Soap bars

  • Towels

  • Mirror

  • Light Bulbs

  • Hygiene Kit

  • 6 Steps Sticker

  • Bathroom
  • Shower Taps

  • Shower water flow/pressure

  • Shower head

  • Shower drain

  • Shower soap holder

  • Bathroom light

  • Hand basin

  • Hand basin taps

  • Hand basin water flow/pressure

  • Hand Basin Spout

  • Hand basin drain

  • Hand basin waste pipe

  • Bath

  • Bath taps

  • Bath safety taps

  • Bath spout

  • Bath water flow/pressure

  • Bath drain

  • Bath plug

  • Bathroom floor drain

  • Bathroom floor

  • Mirror Intact

  • Bathroom door intact

  • Bathroom door can be locked

  • Laundry
  • Washing machine taps

  • Laundry light

  • Laundry trough taps

  • Laundry spout

  • Laundry trough

  • laundry trough drain

  • Laundry floor drain

  • Laundry floor

  • Toilet
  • Toilet cistern

  • Toilet stop tap

  • Toilet pedestal pan

  • Toilet hand basin

  • Toilet hand basin taps

  • Toilet hand basin water flow/pressure

  • Toilet basin spout

  • Toilet basin drain

  • Toilet basin waste pipe

  • Toilet light working

  • Toilet floor drain

  • Toilet floor

  • Toilet roll holder intact

  • Toilet Door Intact

  • Kitchen
  • Kitchen light

  • Kitchen sink drain

  • Kitchen sink taps

  • Kitchen sink spout

  • Kitchen sink drains as it should

  • Kitchen sink able to hold water (has plug)

  • Kitchen clean and free from waste

  • Oven intact & working

  • Oven door

  • Oven clean

  • Stove intact and working

  • Stove elements

  • Stove clean

  • Fridge in house

  • Fridge working

  • Freezer in house

  • Freezer working

  • Kitchen bench tops intact

  • Kitchen bench tops clean

  • Kitchen bench tops damaged

  • Other notes:

Other Issues

    Other Issues
  • Other Issues - Specify

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