Title Page

  • Date Submitted

  • Submitted by

Monday

  • Date

  • Name of Public Area Attendant

  • Signature of Public Area Attendant

  • Name of Public Area Manager

  • Signature of Public Area Manager

Time: 0600H

  • Door Handles

  • Hand Contact Area: Paper Towel Dispenser

  • Soap & Sanitizer Dispenser (loaded, in good order, clean)

  • Switches

  • Toilet Seat, Flush, Splash Wall

  • Trash Bins

  • Water Taps

  • Urinal, Partitions and Walls

Time: 0800H

  • Door Handles

  • Hand Contact Area: Paper Towel Dispenser

  • Soap & Sanitizer Dispenser (loaded, in good order, clean)

  • Switches

  • Toilet Seat, Flush, Splash Wall

  • Trash Bins

  • Water Taps

  • Urinal, Partitions and Walls

Time: 1000H

  • Door Handles

  • Hand Contact Area: Paper Towel Dispenser

  • Soap & Sanitizer Dispenser (loaded, in good order, clean)

  • Switches

  • Toilet Seat, Flush, Splash Wall

  • Trash Bins

  • Water Taps

  • Urinal, Partitions and Walls

Time: 1200H

  • Door Handles

  • Hand Contact Area: Paper Towel Dispenser

  • Soap & Sanitizer Dispenser (loaded, in good order, clean)

  • Switches

  • Toilet Seat, Flush, Splash Wall

  • Trash Bins

  • Water Taps

  • Urinal, Partitions and Walls

Time: 1400H

  • Door Handles

  • Hand Contact Area: Paper Towel Dispenser

  • Soap & Sanitizer Dispenser (loaded, in good order, clean)

  • Switches

  • Toilet Seat, Flush, Splash Wall

  • Trash Bins

  • Water Taps

  • Urinal, Partitions and Walls

Time: 1600H

  • Door Handles

  • Hand Contact Area: Paper Towel Dispenser

  • Soap & Sanitizer Dispenser (loaded, in good order, clean)

  • Switches

  • Toilet Seat, Flush, Splash Wall

  • Trash Bins

  • Water Taps

  • Urinal, Partitions and Walls

Time: 1800H

  • Door Handles

  • Hand Contact Area: Paper Towel Dispenser

  • Soap & Sanitizer Dispenser (loaded, in good order, clean)

  • Switches

  • Toilet Seat, Flush, Splash Wall

  • Trash Bins

  • Water Taps

  • Urinal, Partitions and Walls

Time: 2000H

  • Door Handles

  • Hand Contact Area: Paper Towel Dispenser

  • Soap & Sanitizer Dispenser (loaded, in good order, clean)

  • Switches

  • Toilet Seat, Flush, Splash Wall

  • Trash Bins

  • Water Taps

  • Urinal, Partitions and Walls

Time: 2200H

  • Door Handles

  • Hand Contact Area: Paper Towel Dispenser

  • Soap & Sanitizer Dispenser (loaded, in good order, clean)

  • Switches

  • Toilet Seat, Flush, Splash Wall

  • Trash Bins

  • Water Taps

  • Urinal, Partitions and Walls

Time: 0000H

  • Door Handles

  • Hand Contact Area: Paper Towel Dispenser

  • Soap & Sanitizer Dispenser (loaded, in good order, clean)

  • Switches

  • Toilet Seat, Flush, Splash Wall

  • Trash Bins

  • Water Taps

  • Urinal, Partitions and Walls

Tuesday

  • Date

  • Name of Public Area Attendant

  • Signature of Public Area Attendant

  • Name of Public Area Manager

  • Signature of Public Area Manager

Time: 0600H

  • Door Handles

  • Hand Contact Area: Paper Towel Dispenser

  • Soap & Sanitizer Dispenser (loaded, in good order, clean)

  • Switches

  • Toilet Seat, Flush, Splash Wall

  • Trash Bins

  • Water Taps

  • Urinal, Partitions and Walls

Time: 0800H

  • Door Handles

  • Hand Contact Area: Paper Towel Dispenser

  • Soap & Sanitizer Dispenser (loaded, in good order, clean)

  • Switches

  • Toilet Seat, Flush, Splash Wall

  • Trash Bins

  • Water Taps

  • Urinal, Partitions and Walls

Time: 1000H

  • Door Handles

  • Hand Contact Area: Paper Towel Dispenser

  • Soap & Sanitizer Dispenser (loaded, in good order, clean)

  • Switches

  • Toilet Seat, Flush, Splash Wall

  • Trash Bins

  • Water Taps

  • Urinal, Partitions and Walls

Time: 1200H

  • Door Handles

  • Hand Contact Area: Paper Towel Dispenser

  • Soap & Sanitizer Dispenser (loaded, in good order, clean)

  • Switches

  • Toilet Seat, Flush, Splash Wall

  • Trash Bins

  • Water Taps

  • Urinal, Partitions and Walls

Time: 1400H

  • Door Handles

  • Hand Contact Area: Paper Towel Dispenser

  • Soap & Sanitizer Dispenser (loaded, in good order, clean)

  • Switches

  • Toilet Seat, Flush, Splash Wall

  • Trash Bins

  • Water Taps

  • Urinal, Partitions and Walls

Time: 1600H

  • Door Handles

  • Hand Contact Area: Paper Towel Dispenser

  • Soap & Sanitizer Dispenser (loaded, in good order, clean)

  • Switches

  • Toilet Seat, Flush, Splash Wall

  • Trash Bins

  • Water Taps

  • Urinal, Partitions and Walls

Time: 1800H

  • Door Handles

  • Hand Contact Area: Paper Towel Dispenser

  • Soap & Sanitizer Dispenser (loaded, in good order, clean)

  • Switches

  • Toilet Seat, Flush, Splash Wall

  • Trash Bins

  • Water Taps

  • Urinal, Partitions and Walls

Time: 2000H

  • Door Handles

  • Hand Contact Area: Paper Towel Dispenser

  • Soap & Sanitizer Dispenser (loaded, in good order, clean)

  • Switches

  • Toilet Seat, Flush, Splash Wall

  • Trash Bins

  • Water Taps

  • Urinal, Partitions and Walls

Time: 2200H

  • Door Handles

  • Hand Contact Area: Paper Towel Dispenser

  • Soap & Sanitizer Dispenser (loaded, in good order, clean)

  • Switches

  • Toilet Seat, Flush, Splash Wall

  • Trash Bins

  • Water Taps

  • Urinal, Partitions and Walls

Time: 0000H

  • Door Handles

  • Hand Contact Area: Paper Towel Dispenser

  • Soap & Sanitizer Dispenser (loaded, in good order, clean)

  • Switches

  • Toilet Seat, Flush, Splash Wall

  • Trash Bins

  • Water Taps

  • Urinal, Partitions and Walls

Wednesday

  • Date

  • Name of Public Area Attendant

  • Signature of Public Area Attendant

  • Name of Public Area Manager

  • Signature of Public Area Manager

Time: 0600H

  • Door Handles

  • Hand Contact Area: Paper Towel Dispenser

  • Soap & Sanitizer Dispenser (loaded, in good order, clean)

  • Switches

  • Toilet Seat, Flush, Splash Wall

  • Trash Bins

  • Water Taps

  • Urinal, Partitions and Walls

Time: 0800H

  • Door Handles

  • Hand Contact Area: Paper Towel Dispenser

  • Soap & Sanitizer Dispenser (loaded, in good order, clean)

  • Switches

  • Toilet Seat, Flush, Splash Wall

  • Trash Bins

  • Water Taps

  • Urinal, Partitions and Walls

Time: 1000H

  • Door Handles

  • Hand Contact Area: Paper Towel Dispenser

  • Soap & Sanitizer Dispenser (loaded, in good order, clean)

  • Switches

  • Toilet Seat, Flush, Splash Wall

  • Trash Bins

  • Water Taps

  • Urinal, Partitions and Walls

Time: 1200H

  • Door Handles

  • Hand Contact Area: Paper Towel Dispenser

  • Soap & Sanitizer Dispenser (loaded, in good order, clean)

  • Switches

  • Toilet Seat, Flush, Splash Wall

  • Trash Bins

  • Water Taps

  • Urinal, Partitions and Walls

Time: 1400H

  • Door Handles

  • Hand Contact Area: Paper Towel Dispenser

  • Soap & Sanitizer Dispenser (loaded, in good order, clean)

  • Switches

  • Toilet Seat, Flush, Splash Wall

  • Trash Bins

  • Water Taps

  • Urinal, Partitions and Walls

Time: 1600H

  • Door Handles

  • Hand Contact Area: Paper Towel Dispenser

  • Soap & Sanitizer Dispenser (loaded, in good order, clean)

  • Switches

  • Toilet Seat, Flush, Splash Wall

  • Trash Bins

  • Water Taps

  • Urinal, Partitions and Walls

Time: 1800H

  • Door Handles

  • Hand Contact Area: Paper Towel Dispenser

  • Soap & Sanitizer Dispenser (loaded, in good order, clean)

  • Switches

  • Toilet Seat, Flush, Splash Wall

  • Trash Bins

  • Water Taps

  • Urinal, Partitions and Walls

Time: 2000H

  • Door Handles

  • Hand Contact Area: Paper Towel Dispenser

  • Soap & Sanitizer Dispenser (loaded, in good order, clean)

  • Switches

  • Toilet Seat, Flush, Splash Wall

  • Trash Bins

  • Water Taps

  • Urinal, Partitions and Walls

Time: 2200H

  • Door Handles

  • Hand Contact Area: Paper Towel Dispenser

  • Soap & Sanitizer Dispenser (loaded, in good order, clean)

  • Switches

  • Toilet Seat, Flush, Splash Wall

  • Trash Bins

  • Water Taps

  • Urinal, Partitions and Walls

Time: 0000H

  • Door Handles

  • Hand Contact Area: Paper Towel Dispenser

  • Soap & Sanitizer Dispenser (loaded, in good order, clean)

  • Switches

  • Toilet Seat, Flush, Splash Wall

  • Trash Bins

  • Water Taps

  • Urinal, Partitions and Walls

Thursday

  • Date

  • Name of Public Area Attendant

  • Signature of Public Area Attendant

  • Name of Public Area Manager

  • Signature of Public Area Manager

Time: 0600H

  • Door Handles

  • Hand Contact Area: Paper Towel Dispenser

  • Soap & Sanitizer Dispenser (loaded, in good order, clean)

  • Switches

  • Toilet Seat, Flush, Splash Wall

  • Trash Bins

  • Water Taps

  • Urinal, Partitions and Walls

Time: 0800H

  • Door Handles

  • Hand Contact Area: Paper Towel Dispenser

  • Soap & Sanitizer Dispenser (loaded, in good order, clean)

  • Switches

  • Toilet Seat, Flush, Splash Wall

  • Trash Bins

  • Water Taps

  • Urinal, Partitions and Walls

Time: 1000H

  • Door Handles

  • Hand Contact Area: Paper Towel Dispenser

  • Soap & Sanitizer Dispenser (loaded, in good order, clean)

  • Switches

  • Toilet Seat, Flush, Splash Wall

  • Trash Bins

  • Water Taps

  • Urinal, Partitions and Walls

Time: 1200H

  • Door Handles

  • Hand Contact Area: Paper Towel Dispenser

  • Soap & Sanitizer Dispenser (loaded, in good order, clean)

  • Switches

  • Toilet Seat, Flush, Splash Wall

  • Trash Bins

  • Water Taps

  • Urinal, Partitions and Walls

Time: 1400H

  • Door Handles

  • Hand Contact Area: Paper Towel Dispenser

  • Soap & Sanitizer Dispenser (loaded, in good order, clean)

  • Switches

  • Toilet Seat, Flush, Splash Wall

  • Trash Bins

  • Water Taps

  • Urinal, Partitions and Walls

Time: 1600H

  • Door Handles

  • Hand Contact Area: Paper Towel Dispenser

  • Soap & Sanitizer Dispenser (loaded, in good order, clean)

  • Switches

  • Toilet Seat, Flush, Splash Wall

  • Trash Bins

  • Water Taps

  • Urinal, Partitions and Walls

Time: 1800H

  • Door Handles

  • Hand Contact Area: Paper Towel Dispenser

  • Soap & Sanitizer Dispenser (loaded, in good order, clean)

  • Switches

  • Toilet Seat, Flush, Splash Wall

  • Trash Bins

  • Water Taps

  • Urinal, Partitions and Walls

Time: 2000H

  • Door Handles

  • Hand Contact Area: Paper Towel Dispenser

  • Soap & Sanitizer Dispenser (loaded, in good order, clean)

  • Switches

  • Toilet Seat, Flush, Splash Wall

  • Trash Bins

  • Water Taps

  • Urinal, Partitions and Walls

Time: 2200H

  • Door Handles

  • Hand Contact Area: Paper Towel Dispenser

  • Soap & Sanitizer Dispenser (loaded, in good order, clean)

  • Switches

  • Toilet Seat, Flush, Splash Wall

  • Trash Bins

  • Water Taps

  • Urinal, Partitions and Walls

Time: 0000H

  • Door Handles

  • Hand Contact Area: Paper Towel Dispenser

  • Soap & Sanitizer Dispenser (loaded, in good order, clean)

  • Switches

  • Toilet Seat, Flush, Splash Wall

  • Trash Bins

  • Water Taps

  • Urinal, Partitions and Walls

Friday

  • Date

  • Name of Public Area Attendant

  • Signature of Public Area Attendant

  • Name of Public Area Manager

  • Signature of Public Area Manager

Time: 0600H

  • Door Handles

  • Hand Contact Area: Paper Towel Dispenser

  • Soap & Sanitizer Dispenser (loaded, in good order, clean)

  • Switches

  • Toilet Seat, Flush, Splash Wall

  • Trash Bins

  • Water Taps

  • Urinal, Partitions and Walls

Time: 0800H

  • Door Handles

  • Hand Contact Area: Paper Towel Dispenser

  • Soap & Sanitizer Dispenser (loaded, in good order, clean)

  • Switches

  • Toilet Seat, Flush, Splash Wall

  • Trash Bins

  • Water Taps

  • Urinal, Partitions and Walls

Time: 1000H

  • Door Handles

  • Hand Contact Area: Paper Towel Dispenser

  • Soap & Sanitizer Dispenser (loaded, in good order, clean)

  • Switches

  • Toilet Seat, Flush, Splash Wall

  • Trash Bins

  • Water Taps

  • Urinal, Partitions and Walls

Time: 1200H

  • Door Handles

  • Hand Contact Area: Paper Towel Dispenser

  • Soap & Sanitizer Dispenser (loaded, in good order, clean)

  • Switches

  • Toilet Seat, Flush, Splash Wall

  • Trash Bins

  • Water Taps

  • Urinal, Partitions and Walls

Time: 1400H

  • Door Handles

  • Hand Contact Area: Paper Towel Dispenser

  • Soap & Sanitizer Dispenser (loaded, in good order, clean)

  • Switches

  • Toilet Seat, Flush, Splash Wall

  • Trash Bins

  • Water Taps

  • Urinal, Partitions and Walls

Time: 1600H

  • Door Handles

  • Hand Contact Area: Paper Towel Dispenser

  • Soap & Sanitizer Dispenser (loaded, in good order, clean)

  • Switches

  • Toilet Seat, Flush, Splash Wall

  • Trash Bins

  • Water Taps

  • Urinal, Partitions and Walls

Time: 1800H

  • Door Handles

  • Hand Contact Area: Paper Towel Dispenser

  • Soap & Sanitizer Dispenser (loaded, in good order, clean)

  • Switches

  • Toilet Seat, Flush, Splash Wall

  • Trash Bins

  • Water Taps

  • Urinal, Partitions and Walls

Time: 2000H

  • Door Handles

  • Hand Contact Area: Paper Towel Dispenser

  • Soap & Sanitizer Dispenser (loaded, in good order, clean)

  • Switches

  • Toilet Seat, Flush, Splash Wall

  • Trash Bins

  • Water Taps

  • Urinal, Partitions and Walls

Time: 2200H

  • Door Handles

  • Hand Contact Area: Paper Towel Dispenser

  • Soap & Sanitizer Dispenser (loaded, in good order, clean)

  • Switches

  • Toilet Seat, Flush, Splash Wall

  • Trash Bins

  • Water Taps

  • Urinal, Partitions and Walls

Time: 0000H

  • Door Handles

  • Hand Contact Area: Paper Towel Dispenser

  • Soap & Sanitizer Dispenser (loaded, in good order, clean)

  • Switches

  • Toilet Seat, Flush, Splash Wall

  • Trash Bins

  • Water Taps

  • Urinal, Partitions and Walls

Saturday

  • Date

  • Name of Public Area Attendant

  • Signature of Public Area Attendant

  • Name of Public Area Manager

  • Signature of Public Area Manager

Time: 0600H

  • Door Handles

  • Hand Contact Area: Paper Towel Dispenser

  • Soap & Sanitizer Dispenser (loaded, in good order, clean)

  • Switches

  • Toilet Seat, Flush, Splash Wall

  • Trash Bins

  • Water Taps

  • Urinal, Partitions and Walls

Time: 0800H

  • Door Handles

  • Hand Contact Area: Paper Towel Dispenser

  • Soap & Sanitizer Dispenser (loaded, in good order, clean)

  • Switches

  • Toilet Seat, Flush, Splash Wall

  • Trash Bins

  • Water Taps

  • Urinal, Partitions and Walls

Time: 1000H

  • Door Handles

  • Hand Contact Area: Paper Towel Dispenser

  • Soap & Sanitizer Dispenser (loaded, in good order, clean)

  • Switches

  • Toilet Seat, Flush, Splash Wall

  • Trash Bins

  • Water Taps

  • Urinal, Partitions and Walls

Time: 1200H

  • Door Handles

  • Hand Contact Area: Paper Towel Dispenser

  • Soap & Sanitizer Dispenser (loaded, in good order, clean)

  • Switches

  • Toilet Seat, Flush, Splash Wall

  • Trash Bins

  • Water Taps

  • Urinal, Partitions and Walls

Time: 1400H

  • Door Handles

  • Hand Contact Area: Paper Towel Dispenser

  • Soap & Sanitizer Dispenser (loaded, in good order, clean)

  • Switches

  • Toilet Seat, Flush, Splash Wall

  • Trash Bins

  • Water Taps

  • Urinal, Partitions and Walls

Time: 1600H

  • Door Handles

  • Hand Contact Area: Paper Towel Dispenser

  • Soap & Sanitizer Dispenser (loaded, in good order, clean)

  • Switches

  • Toilet Seat, Flush, Splash Wall

  • Trash Bins

  • Water Taps

  • Urinal, Partitions and Walls

Time: 1800H

  • Door Handles

  • Hand Contact Area: Paper Towel Dispenser

  • Soap & Sanitizer Dispenser (loaded, in good order, clean)

  • Switches

  • Toilet Seat, Flush, Splash Wall

  • Trash Bins

  • Water Taps

  • Urinal, Partitions and Walls

Time: 2000H

  • Door Handles

  • Hand Contact Area: Paper Towel Dispenser

  • Soap & Sanitizer Dispenser (loaded, in good order, clean)

  • Switches

  • Toilet Seat, Flush, Splash Wall

  • Trash Bins

  • Water Taps

  • Urinal, Partitions and Walls

Time: 2200H

  • Door Handles

  • Hand Contact Area: Paper Towel Dispenser

  • Soap & Sanitizer Dispenser (loaded, in good order, clean)

  • Switches

  • Toilet Seat, Flush, Splash Wall

  • Trash Bins

  • Water Taps

  • Urinal, Partitions and Walls

Time: 0000H

  • Door Handles

  • Hand Contact Area: Paper Towel Dispenser

  • Soap & Sanitizer Dispenser (loaded, in good order, clean)

  • Switches

  • Toilet Seat, Flush, Splash Wall

  • Trash Bins

  • Water Taps

  • Urinal, Partitions and Walls

Sunday

  • Date

  • Name of Public Area Attendant

  • Signature of Public Area Attendant

  • Name of Public Area Manager

  • Signature of Public Area Manager

Time: 0600H

  • Door Handles

  • Hand Contact Area: Paper Towel Dispenser

  • Soap & Sanitizer Dispenser (loaded, in good order, clean)

  • Switches

  • Toilet Seat, Flush, Splash Wall

  • Trash Bins

  • Water Taps

  • Urinal, Partitions and Walls

Time: 0800H

  • Door Handles

  • Hand Contact Area: Paper Towel Dispenser

  • Soap & Sanitizer Dispenser (loaded, in good order, clean)

  • Switches

  • Toilet Seat, Flush, Splash Wall

  • Trash Bins

  • Water Taps

  • Urinal, Partitions and Walls

Time: 1000H

  • Door Handles

  • Hand Contact Area: Paper Towel Dispenser

  • Soap & Sanitizer Dispenser (loaded, in good order, clean)

  • Switches

  • Toilet Seat, Flush, Splash Wall

  • Trash Bins

  • Water Taps

  • Urinal, Partitions and Walls

Time: 1200H

  • Door Handles

  • Hand Contact Area: Paper Towel Dispenser

  • Soap & Sanitizer Dispenser (loaded, in good order, clean)

  • Switches

  • Toilet Seat, Flush, Splash Wall

  • Trash Bins

  • Water Taps

  • Urinal, Partitions and Walls

Time: 1400H

  • Door Handles

  • Hand Contact Area: Paper Towel Dispenser

  • Soap & Sanitizer Dispenser (loaded, in good order, clean)

  • Switches

  • Toilet Seat, Flush, Splash Wall

  • Trash Bins

  • Water Taps

  • Urinal, Partitions and Walls

Time: 1600H

  • Door Handles

  • Hand Contact Area: Paper Towel Dispenser

  • Soap & Sanitizer Dispenser (loaded, in good order, clean)

  • Switches

  • Toilet Seat, Flush, Splash Wall

  • Trash Bins

  • Water Taps

  • Urinal, Partitions and Walls

Time: 1800H

  • Door Handles

  • Hand Contact Area: Paper Towel Dispenser

  • Soap & Sanitizer Dispenser (loaded, in good order, clean)

  • Switches

  • Toilet Seat, Flush, Splash Wall

  • Trash Bins

  • Water Taps

  • Urinal, Partitions and Walls

Time: 2000H

  • Door Handles

  • Hand Contact Area: Paper Towel Dispenser

  • Soap & Sanitizer Dispenser (loaded, in good order, clean)

  • Switches

  • Toilet Seat, Flush, Splash Wall

  • Trash Bins

  • Water Taps

  • Urinal, Partitions and Walls

  • Shower Area (if any)

Time: 0000H

  • Door Handles

  • Hand Contact Area: Paper Towel Dispenser

  • Soap & Sanitizer Dispenser (loaded, in good order, clean)

  • Switches

  • Toilet Seat, Flush, Splash Wall

  • Trash Bins

  • Water Taps

  • Urinal, Partitions and Walls

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.