Title Page

  • Date Submitted

  • Submitted By

Monday

  • Date

  • Location of Front Desk & Lobby

  • Name of Front Office Agent / Receptionist

  • Signature of Front Office Agent / Receptionist

  • Name of Front Office Supervisor / Manager

  • Signature of Front Office Supervisor / Manage

Time: 0600H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

Time: 0800H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

Time: 1000H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

Time: 1200H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

Time: 1400H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

Time: 1600H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

Time: 1800H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

Time: 2000H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

Time: 2200H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

Time: 0000H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

Tuesday

  • Date

  • Location of Front Desk & Lobby

  • Name of Front Office Agent / Receptionist

  • Signature of Front Office Agent / Receptionist

  • Name of Front Office Supervisor / Manager

  • Signature of Front Office Supervisor / Manage

Time: 0600H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

Time: 0800H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

Time: 1000H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

Time: 1200H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

Time: 1400H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

Time: 1600H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

Time: 1800H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

Time: 2000H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

Time: 2200H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

Time: 0000H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

Wednesday

  • Date

  • Location of Front Desk & Lobby

  • Name of Front Office Agent / Receptionist

  • Signature of Front Office Agent / Receptionist

  • Name of Front Office Supervisor / Manager

  • Signature of Front Office Supervisor / Manage

Time: 0600H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

Time: 0800H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

Time: 1000H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

Time: 1200H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

Time: 1400H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

Time: 1600H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

Time: 1800H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

Time: 2000H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

Time: 2200H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

Time: 0000H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

Thursday

  • Date

  • Location of Front Desk & Lobby

  • Name of Front Office Agent / Receptionist

  • Signature of Front Office Agent / Receptionist

  • Name of Front Office Supervisor / Manager

  • Signature of Front Office Supervisor / Manage

Time: 0600H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

Time: 0800H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

Time: 1000H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

Time: 1200H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

Time: 1400H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

Time: 1600H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

Time: 1800H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

Time: 2000H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

Time: 2200H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

Time: 0000H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

Friday

  • Date

  • Location of Front Desk & Lobby

  • Name of Front Office Agent / Receptionist

  • Signature of Front Office Agent / Receptionist

  • Name of Front Office Supervisor / Manager

  • Signature of Front Office Supervisor / Manage

Time: 0600H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

Time: 0800H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

Time: 1000H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

Time: 1200H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

Time: 1400H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

Time: 1600H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

Time: 1800H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

Time: 2000H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

Time: 2200H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

Time: 0000H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

Saturday

  • Date

  • Location of Front Desk & Lobby

  • Name of Front Office Agent / Receptionist

  • Signature of Front Office Agent / Receptionist

  • Name of Front Office Supervisor / Manager

  • Signature of Front Office Supervisor / Manage

Time: 0600H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

Time: 0800H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

Time: 1000H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

Time: 1200H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

Time: 1400H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

Time: 1600H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

Time: 1800H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

Time: 2000H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

Time: 2200H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

Time: 0000H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

Sunday

  • Date

  • Location of Front Desk & Lobby

  • Name of Front Office Agent / Receptionist

  • Signature of Front Office Agent / Receptionist

  • Name of Front Office Supervisor / Manager

  • Signature of Front Office Supervisor / Manage

Time: 0600H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

Time: 0800H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

Time: 1000H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

Time: 1200H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

Time: 1400H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

Time: 1600H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

Time: 1800H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

Time: 2000H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

Time: 2200H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

Time: 0000H

  • Door Handles

  • Switches

  • Dispensers (Loaded, In Good Order, Clean)

  • Tables and Counter Tops

  • Chairs and armrests

  • Telephone

  • Hand Contact Areas (PC, keyboard, mouse, etc.)

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.