Title Page

  • Conducted on

  • Location

General Facilities

Restrooms

  • Toilets: add cleaner and scrub with toilet brush, flush, wipe down seat and outside of toilet with cleaner and a clean cloth

  • Sinks: spray with cleaner and wipe clean with a clean cloth;

  • Floors: Sweep floors, Fill scrub bucket with cleaner and water and mop floor with washroom mop stored in utility closet

Lunchroom

  • Table: wipe with cloth and cleaner

  • Sink: spray with cleaner and wipe with cloth Microwave: wipe with cloth

  • Refrigerator: dispose of any old food, wipe any spills with cloth

  • Garbage: remove garbage and clean garbage can,

  • Floors: Sweep floors, Fill scrub bucket with cleaner and water and mop floor with mop stored in utility closet

Door Handles and Light Switches

  • Sanitize all door handles and light switches in the building using a clean cloth and sanitizer spray bottle with CSG 1000 and water in a 1:80 Dilution.

Verification

  • Verified By (Name)

  • Verified On (Date)

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