Audit

WAITING ROOM:

Location:

Overall condition of the waiting room cleaned?

RESTROOM:
Restroom:

Location:

1. Toilet bowl / Plumbing fixtures clean?

2. Sink / Plumbing fixtures clean?

3. Mirriors clean?

4. Walls / Stalls clean?

5. Wastecans clean & freshly lined?

6. Floors clean / mopped?

7. Vents / Cieling clean?

8. Supplies in place?

Restroom:

Location:

1. Toilet bowl / Plumbing fixtures clean?

2. Sink / Plumbing fixtures clean?

3. Mirriors clean?

4. Walls / Stalls clean?

5. Wastecans clean & freshly lined?

6. Floors clean / mopped?

7. Vents / Cieling clean?

8. Supplies in place?

ANCILLARY AREAS:
Area:

Location:

1. Cabinets Cleaned?

2. Counters Cleaned?

3. Sinks Cleaned?

4. Walls Cleaned?

5. Ceiling Cleaned?

6. Ledges Cleaned?

7. Vents Cleaned?

8. Wastecans Cleaned & Freshly Lined?

9. Supplies in Place?

10. Floors Cleaned?

11. Exam Table (Foot Stool)

12. Cubical Curtains (Changed)

Area:

Location:

1. Cabinets Cleaned?

2. Counters Cleaned?

3. Sinks Cleaned?

4. Walls Cleaned?

5. Ceiling Cleaned?

6. Ledges Cleaned?

7. Vents Cleaned?

8. Wastecans Cleaned & Freshly Lined?

9. Supplies in Place?

10. Floors Cleaned?

11. Exam Table (Foot Stool)

12. Cubical Curtains (Changed)

Area:

Location:

1. Cabinets Cleaned?

2. Counters Cleaned?

3. Sinks Cleaned?

4. Walls Cleaned?

5. Ceiling Cleaned?

6. Ledges Cleaned?

7. Vents Cleaned?

8. Wastecans Cleaned & Freshly Lined?

9. Supplies in Place?

10. Floors Cleaned?

11. Exam Table (Foot Stool)

12. Cubical Curtains (Changed)

Area:

Location:

1. Cabinets Cleaned?

2. Counters Cleaned?

3. Sinks Cleaned?

4. Walls Cleaned?

5. Ceiling Cleaned?

6. Ledges Cleaned?

7. Vents Cleaned?

8. Wastecans Cleaned & Freshly Lined?

9. Supplies in Place?

10. Floors Cleaned?

11. Exam Table (Foot Stool)

12. Cubical Curtains (Changed)

FLOORCARE:
Floorcare:

Location:

1. Baseboard Cleaned?

2. Corners Cleaned?

3. Edges Cleaned?

4. Floors Finished / Carpet Clean?

Floorcare:

Location:

1. Baseboard Cleaned?

2. Corners Cleaned?

3. Edges Cleaned?

4. Floors Finished / Carpet Clean?

ENVIRONMENTAL ROUNDS:
Personal Protective Equipment

1. Gloves?

2. Eye Goggles?

Chemical

1. Disinfection wipe container lids closed and labeled correctly?

2. Chemical Dispensing unit in working condition?

3. Disinfectant Wipe/bottle properly Dated?

Hopper Closet

1. Closet cleaned & organized?

2. Eye Wash Station Clean & Checked?

3. Work Charts Available?

4. Housekeeping Cart Clean & Orderly?

Stairwell/Elevator

Elevator Location:

1. Elevator Tracks / Door Clean?

Stairwell Location:

2. Stairwell Clean free of Dust/Litter?

3. Stairwell Ledges / Handrails Clean?

Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.