Information

  • Room Number

  • Conducted on

  • Prepared by

  • Personnel

GCPM - CY

ZONE 1 - BATH

  • Tub Stopper

  • Accessible Grab Bars

  • Shower Tile and Soap Dish

  • Shower / Tub Caulking

  • Shower / Tub Grout

  • Shower Curtain Rod

  • Shower Curtain (like new)

  • Exhaust Vent

  • Toilet Flushes

  • Toilet Seat

  • Toilet Caulking

  • Toilet Paper Holder

  • Towel Racks

  • Sink Faucet

  • Sink Faucet Aerator

  • Sink Stopper

  • Vanity and Sink Caulking

  • Vanity Counter, Fixtures, and Sink spotless

  • GFCI Receptacle

  • Light Bulbs and Fixture

  • Mirror

  • Walls

  • Ceiling Paint

  • Bathroom Floor and Base

  • Door Frame Paint

ZONE 2 - LIVING

  • TV Remote

  • TV Channels

  • TV Reception and Sound

  • TV Connections

  • Telephone - Dial Tone

  • Telephone - Signage/Faceplate

  • Alarm Clock Radio Time

  • HVAC/PTAC Clean

  • HVAC/PTAC - Heat and AC Function

  • HVAC/PTAC - Thermostat Set Point

  • Sheers/Blackout Drape Hardware

  • Connecting Door Lock

  • Smoke Detector

  • "No Hanger" Sticker is present on Smoke Detector

  • Switch / Outlet Covers

  • Mirror(s)

  • Artwork

  • Carpet

  • Carpet Edges Free of Dust

  • Walls

  • Table and Desk - Wood

  • Night Stands - Wood

  • Upholstery

  • Lamps / Shades / Bulbs

  • Bed Skirt

  • Headboard

ZONE 3 - BALCONY

  • Sliding Glass Doors

  • Door Hardware / Security Bar / and Door Lock

  • Balcony Condition

  • Balcony Furniture

ZONE 4 - HALL

  • Closet Doors

  • Ironing Board Condition

  • Iron Holder

ZONE 5 - ENTRY

  • Welcome Light

  • Entry Door Lock

  • Night Latch and Door Protector

  • Door Locks / Handles / Hinges

  • Door Security Viewer

  • Door Bumpers / Seals

  • Entry / Connecting Door Finish

  • Entry / Connecting Door Stopper

  • Door Closer and Operation

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.