Information
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
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Room #
- 201
- 202
- 203
- 204
- 205
- 206
- 207
- 208
- 209
- 210
- 211
- 212
- 213
- 214
- 215
- 216
- 217
- 218
- 219
- 220
- 221
- 222
- 223
- 224
- 225
- 301
- 302
- 303
- 304
- 305
- 306
- 307
- 308
- 309
- 310
- 311
- 312
- 313
- 314
- 315
- 316
- 317
- 318
- 319
- 320
- 321
- 323
- 324
- 325
- 401
- 402
- 403
- 404
- 405
- 406
- 407
- 408
- 409
- 410
- 411
- 412
- 413
- 414
- 415
- 416
- 417
- 418
- 419
- 420
- 421
- 422
- 423
- 424
- 425
- 501
- 502
- 503
- 504
- 505
- 506
- 507
- 508
- 509
- 510
- 511
- 512
- 513
- 514
- 515
- 516
- 517
- 518
- 519
- 520
- 521
- 522
- 523
- 524
- 525
Entry
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1.Entry door / 2. Deadbolt / 3.Viewer , <br>Working and free from defects?
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Date repaired
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4. Security lock <br>Working and free from defects?
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Date repaired
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5. Emergency evac. Sign in place?<br>Free from defects?
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Date repaired
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6. Entry light <br>Working and free from defects?
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Date repaired
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7. Closet doors<br>Working and free from defects?
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Date repaired
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18. Iron and board<br>Working and free from defects?
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Date repaired
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8. Coat rack secure<br>Working and free from defects?
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Date repaired
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9. Luggage rack<br>Working and free from defects?
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Date repaired
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10. Closet walls / 11. Carpet<br>Free from defects?
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Date repaired
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12. Coffee station secure / 13. Electrical outlet <br>Working and free from defects?<br>
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Date repaired
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14. Full length mirror in place<br>Working and free from defects?
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Date repaired
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15. Corner guards in place<br>Working and free from defects?
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Date repaired
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80. Conecting Door<br>Free from defects, working dead bult,
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Date repaired
Bedroom
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16. Luggage bench<br>Free from scratches and defects?
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Date repaired
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17. TV cabinet and backboard <br>Free from scratches and defects? Do cabinet doors open correctly?
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Date repaired
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23. Mini-fridge <br>Freezer working, free from scratches and defects?<br>
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Date repaired
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Mini-fridge ice build-up
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Date repaired
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24. Microwave <br>Working and free from defects?
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Date repaired
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25. Safe<br>Working and free from defects? Battery level ok?
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Date repaired
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20. Dresser <br>Working and free from defects?
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Date repaired
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21. Desk<br>Free from scratches and defects?
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Date repaired
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22. Desk chair<br>Arms and fabric tight and free from defects? All adjustments working?
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Date repaired
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26. Desk phone / 27. Desk lamp<br>Both working and free from defects?
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Date repaired
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28. Ethernet jack and Wi-Fi<br>Working and good signal?
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Date repaired
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29. Sofa chair<br>Free from defects?
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Date repaired
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30. HVAC and Thermostat <br>Working, Case free from defects, filters cleaned?
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Date repaired
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31. Window and drapes <br>Window free from leaks? Both drapes open & close? Free from stains or cuts?
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Date repaired
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32. Small round table<br>Legs tight and free from defects?
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Date repaired
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33. Bed 1 <br>Frame secure free from defects?
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Date repaired
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34. Bed 2<br>Frame secure free from defects?
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Date repaired
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35. Headboard<br>Secure and free from defects?
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Date repaired
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36. Nightstand 1<br>Drawer opens correct? Free from defects?
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Date repaired
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37. Nightstand 2<br>Drawer opens correct? Free from defects?
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Date repaired
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38. Nightstand lamp 1<br>Working and free from defects?
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Date repaired
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39. Nightstand lamp 2<br>Working and free from defects?
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Date repaired
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40. Nightstand Phone<br>Working and free from defects?
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Date repaired
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41. Nightstand Clock<br>Working, Alarm working, Time adjusted? Battery in place?
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Date repaired
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42. Tall lamp<br>Working and free from defects?
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Date repaired
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43. Artwork <br>Secure and free from defects?
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Date repaired
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44. TV / 45. Remote<br>Working with clear channels, batteres in remote? Secure coards and base?
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Date repaired
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46. Ceiling / 47. Walls / 79. Carpet<br>Free from scratches, stains and waterspots or defects?
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Date repaired
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48. Electrical outlets <br>Working and secure, free from defects?
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Date repaired
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78. Smoke detector<br>Working and secure?
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Date repaired
Bathroom
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49. Vanity <br>Secure, caulked and free from defects?
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Date repaired
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50. Vanity sink<br>Working, chrome looks good? No leaks or cracks?
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Date repaired
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51. Vanity Mirror<br>Secure and free from defects?
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Date repaired
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52. Vanity lights <br>Working, secure and free from defects?
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Date repaired
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53. Toilet<br>Working, calked, secure and free from defects?
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Date repaired
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77. Toilet Seat<br>Secure and free from defects?
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Date repaired
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54. Toilet paper holder<br>Working and secure?
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Date repaired
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55. Towel bar<br>Secure and free from defects?
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Date repaired
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70. Exhaust fan<br>Working and clean?
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Date repaired
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71. Bathroom door and hardware<br>Coat hook, locks and free from defects?
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Date repaired
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72. Walls and cileing <br>Free from scratches, defects and waterspots?
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Date repaired
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75. Hairdryer <br>Working and free from defects?
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Date repaired
Bathtub
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56. Bathtub / 57. Bath fauset <br>Tub caulked, free from scraches and defects? Fauset secure free from defects?
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Date repaired
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58. Grab-bar / 59. Soap-dish / 60. Drain<br>Working, caulked and secure, free from defects?
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Date repaired
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61. Shower head<br>Working and free from defects?
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Date repaired
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76. Bathtub walls<br>Caulk looks good? Free from defects?
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Date repaired
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62. Curtain rod<br>Secure and free from defects?
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Date repaired
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Handicap accessible?
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Date repaired
Shower
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63. Shower surround / 64. Shower handle <br>Shower caulked, free from defects, shower handle secure and free from defects?
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Date repaired
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65. Grab-bar / 66. Soap-dish / 67. Drain<br>Secure caulked and free from defects?
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Date repaired
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68. Shower head<br>Working and free from defects?
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Date repaired
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69. Shower door<br>Door handles secure, track correct, caulked and free from defects?
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Date repaired
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Handicap accessible?
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Date repaired
Suite
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73. Sofa bed<br>Working, fabric free from stains and cuts, free from defects?
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Date repaired
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74. Table and chairs<br>Legs secure, free from scratches, defects and stains?
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Date repaired
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Select date
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Completed by