Form 1819COWCKN_Housekeeping Inspection Checklist

• Conducted on

  Date

• Prepared by

• Location
  Address

Employees

• Employees wearing uniforms and adhering to company dress code.

  Yes

  No

  N/A

• Employees following safety procedures and cleaning plan as instructed.

  Yes

  No

  N/A

Trash/Compost/Recycling

• Trash, compost, recycling receptacles emptied and relined as required.

  Yes

  No

  N/A

• Receptacles, lids, cabinets, and surrounding walls wiped. Floors underneath and behind vacuumed/cleaned.

  Yes

  No

  N/A

• All waste disposed of properly and loading docks left clean and free of trash.

  Yes

  No

  N/A

• Additional Comments

Galleys/HUBS

• Waste emptied. Receptacles, lids, and cabinets wiped and relined.

  Yes

  No

  N/A

• Dispensers tested, wiped, and restocked.

  Yes

  No

  N/A

• Coffee pots rinsed and appliances wiped including underneath microwaves.

  Yes

  No

  N/A

• Surfaces dusted and wiped. Sinks washed and polished. Floors swept and mopped. Furniture reset.

  Yes

  No

  N/A

• Additional Comments

Restrooms/Locker rooms

• Waste emptied. Receptacles disinfected, polished, and relined.

  Yes

  No

  N/A

• Dispensers tested, replenished and polished.

  Yes

  No

  N/A

• Fixtures washed and disinfected (interior and exterior).

  Yes

  No

  N/A

• Surfaces, countertops, partition doors, mirrors, hair dryers, and vents sanitized.

  Yes

  No

  N/A

• Floors swept and mopped.

  Yes

  No

  N/A

• Additional Comments

Offices/Workstations

• Traffic lanes vacuumed nightly and other areas vacuumed as per schedule.

  Yes

  No

  N/A

• Countertops, top of file cabinets, window sills, interior glass, and surfaces dusted and wiped.

  Yes

  No

  N/A

• Chairs realigned.

  Yes

  No

  N/A

• Additional Comments

Conference Rooms

• Waste emptied. Receptacles, lids, and cabinets wiped and relined.

  Yes

  No

  N/A

• Surfaces dusted and wiped to include tables, credenzas, and whiteboards.

  Yes

  No

  N/A

• Carpets vacuumed included under tables.

  Yes

  No

  N/A

• Chairs cleaned and realigned.

  Yes

  No

  N/A

• Additional Comments

Stairs/Elevators/Entrances

• Elevator floors and track vacuumed. Panels and call button sanitized and polished.

  Yes

  No

  N/A

• Stairs swept, mopped and dusted. Handrails, ledges, interior glass, and surfaces dusted and wiped.

  Yes

  No

  N/A

• Doors, push bars, kick plates sanitized and polished.

  Yes

  No

  N/A

• Additional Comments

Corridors

• Floors swept and mopped including corners and ledges.

  Yes

  No

  N/A

• Surfaces and wall fixtures dusted.

  Yes

  No

  N/A

• Water fountains sanitized and polished.

  Yes

  No

  N/A

• Mats and rugs vacuumed.

  Yes

  No

  N/A

Building Exterior

• Waste receptacles emptied and relined. Receptacles and lids wiped.

  Yes

  No

  N/A

• Floor surfaces free of leaves and debris.

  Yes

  No

  N/A

• Windows and doors free of cobwebs and insects.

  Yes

  No

  N/A

• Additional Comments

Cafeteria/Patios

• Waste receptacles emptied. Receptacles, cabinets and lids wiped. Receptacles relined.

  Yes

  No

  N/A

• Tables, chairs, countertops and surfaces dusted and wiped. All tables and chairs realigned.

  Yes

  No

  N/A

• Floors swept/vacuumed and mopped including underneath furniture.

  Yes

  No

  N/A

• Glass doors, revolving doors, and door handles wiped. Floor mats vacuumed. Windowsills dusted.

  Yes

  No

  N/A

• Patios/outdoor seating areas cleaned and reset.

  Yes

  No

  N/A

• Additional Comments

Other Building Areas

• Mother Rooms vacuumed and sanitized.

  Yes

  No

  N/A

• Copy areas and phone booths vacuumed and sanitized.

  Yes

  No

  N/A

• Showers & Locker Rooms sanitized.

• Medical Center areas dusted and sanitized.

• Other

• Other

Janitor’s Closets

• Areas free of clutter and cleaned.

  Yes

  No

  N/A

• Equipment and tools wiped, organized and in good working condition.

  Yes

  No

  N/A

• Safety: Chemicals properly labeled. SDSs available. PPE available. No tripping hazard. Floors dried. No storing of boxes above shoulder length.

  Yes

  No

  N/A

• Additional Comments

Additional Remarks

• What area/floor/section was detailed this evening?

• Do you have any maintenance issues to report?

• Please add any closing remarks you may have.

• Deficiencies corrected on:

  Date

• Please sign

  Sign