Title Page

  • Site conducted

  • Conducted on

  • Prepared by

  • Location
  • Picture of Front of Site

RECEPTION

  • Is entrance way free from dust, cobwebs and dirt?

  • Have all desktops, counters and shelves been dusted or wiped down WEEKLY if paperwork has been removed?

  • Are all bins being emptied, wiped down and lined with a new liner daily?

  • Has carpet been vacuumed?

  • Have hard surface areas been mopped?

GYM FLOOR (GENERAL)

  • Have floors mopped using chemical floor cleaners on all non-carpeted areas daily?

  • Have floors been vacuumed?

  • Has a feather duster been used to go over all non-equipment surfaces (eg. windowsills / pillars) on a fortnightly basis? (lockers not included)

  • Has all internal glass below 2-metre been cleaned and free of marks and smudges?

EQUIPMENT

  • Have the machine seating, handles, frames and plates been wiped and disinfected WEEKLY on a FRIDAY?

  • Have the weight plates, trees, dumbbells fixed bars and racks been wiped and disinfected WEEKLY on a FRIDAY?

  • Have the medicine balls, kettlebells and racks been wiped and disinfected WEEKLY on a FRIDAY?

  • Have the non-powered cardio equipment (eg. assault bikes / rowers) been wiped and disinfected WEEKLY on a FRIDAY?

  • Has the carpet / vinyl under cardio equipment been vacuumed weekly , free of dust, dirt and any rubbish?

BATHROOMS AND SHOWERS

  • Are toilets / urinals and waterless urinals clean and sanitised?

  • Are mirrors and glass clean and free from streaks?

  • Are showers cleaned thoroughly, tiles clean and all surfaces (including doors)?

  • Are shower grates free from hair and build up?

  • Are floors clean including free from mould, grease, grime and hair?

  • Are shower curtains clean and free of grime?

  • Are vanities, basins, sinks clean and free of soap scum and hair?

  • Are all the soap, shampoo and conditioner dispensers, toilet roll holders and hand towel dispensers fully stocked daily?

CLEANERS ROOM

  • Are the WH&S Guidelines displayed?

  • Are all chemicals placed in bottles that are labelled and stored safely?

  • Are Material Safety Data Sheets (MSDS) visible?

  • Are stock levels sufficient?

  • Are coloured mops / buckets being used?

  • Are all equipment stored neatly or put away?

  • Is area free of rubbish?

  • Photo of the Evacuation Site Plan

Client Sign Off

  • FLG Representative Sign Off

  • FLG Representative Name and Signature

  • Dimeo Area Manager Name and Signature

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.