Title Page
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Name of ward/department
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Conducted on
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Prepared by
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Location
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Please note that this inspection template is intended to provide guidance on the tasks that should be carried out and areas that should be examined. It is in no way intended to provide prescriptive rules on what must be done.
Reception/Waiting Room
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Room/Location
Estates Tasks
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Fans
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Walls
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Ceiling
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All external glazing
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Ventilation grilles
Cleaning Tasks
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Switches, sockets, data points
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Walls
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All doors
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All internal glazing (including partitions)
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Mirrors
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Radiators
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Floor (Polished)
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Floor (Non-slip)
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Floor (Soft floor)
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Electrical items
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Low surfaces
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High surfaces
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Chairs
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Tables
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Hand hygiene/alcohol rub dispensers
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Waste receptacles
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Curtains/Blinds
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Replenishment
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Sinks/Hand-wash basins
Treatment Room
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Treatment room description
Nursing Tasks
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Weighing scales, manual handling equipment
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Drip stands
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Other medical equipment (NOT CONNECTED TO PATIENT)
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Medical gas equipment
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Notes and drugs trolley
Estates Tasks
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Fans
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Walls
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Ceiling
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All external glazing
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Ventilation grilles
Cleaning Tasks
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Bedside alcohol, clipboards and noticeboards
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Switches, sockets, data points
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Walls
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All doors
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All internal glazing (including partitions)
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Mirrors
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Radiators
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Floor (Polished)
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Floor (Non-slip)
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Electrical items
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Low surfaces
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High surfaces
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Chairs
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Beds
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Lockers
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Tables
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Hand wash/toilet roll/hand towel dispenser
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Hand hygiene/alcohol rub dispensers
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Waste receptacles
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Curtains/Blinds
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Replenishment
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Sinks/hand-wash basins
Storeroom
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Name/location of storeroom
Nursing Tasks
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Weighing scales, manual handling equipment
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Drip stands
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Other medical equipment (NOT CONNECTED TO PATIENT)
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Medical gas equipment
Estates Tasks
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Fans
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Walls
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Ceiling
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All external glazing
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Ventilation grilles
Cleaning Tasks
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Switches, sockets and data points
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Walls
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All doors
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All internal glazing (including partitions)
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Radiators
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Floor (Non-slip)
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Floor (Soft floor)
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Electrical items
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Cleaning equipment
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Low surfaces
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High surfaces
Stairwell
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Stairwell description/location
Estates Tasks
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Walls
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Ceiling
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All external glazing
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Ventilation grilles
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Low surfaces
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High surfaces
Cleaning Tasks
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Switches, sockets, data points
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Walls
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All doors
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All internal glazing (including partitions)
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Radiators
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Floor (Polished)
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Floor (Non-slip)
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Low surfaces
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High surfaces
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Hand hygiene/alcohol rub dispensers
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Curtains and blinds
Staff Room
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Description/Location of staff room
Estates Tasks
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Walls
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Ceiling
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All external glazing
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Ventilation grilles
Cleaning Tasks
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Switches, sockets, data points
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Walls
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All doors
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All internal glazing (including partitions)
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Mirrors
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Radiators
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Floor (Polished)
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Floor (Non-slip)
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Floor (Soft floor)
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Electrical items
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Low surfaces
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High surfaces
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Chairs
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Tables
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Lockers
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Hand wash/toilet roll/hand towel dispenser
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Hand hygiene/alcohol rub dispensers
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Waste receptacles
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Curtains and blinds
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Fridges and freezers
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Ice machines and hot water boilers
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Kitchen/Storage cupboards
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Microwaves
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Replenishment
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Sinks/hand-wash basins
Nurse Station
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Location/Description of nurse station
Nursing Tasks
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Weighing scales, manual handling equipment
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Other medical equipment (NOT CONNECTED TO PATIENT)
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Notes and drugs trolley
Estates Tasks
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Fans
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Walls
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Ceiling
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All external glazing
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Ventilation grilles
Cleaning Tasks
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Switches, sockets, data points
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Walls
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All doors
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All internal glazing (including partitions)
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Mirrors
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Radiators
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Floor (Polished)
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Electrical items
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Low surfaces
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High surfaces
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Chairs
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Tables
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Hand wash/toilet tissue/hand towel dispenser
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Hand hygiene/alcohol rub dispensers
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Waste receptacles
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Curtains and blinds
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Replenishment
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Sinks/hand-wash basins
Office
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Office description/location
Nursing Tasks
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Electrical Items
Estates Tasks
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Fans
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Walls
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Ceiling
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All external glazing
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Ventilation grilles extract and inlets
Cleaning Tasks
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Switches, sockets, data points
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Walls
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All doors
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All internal glazing (including partitions)
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Mirrors
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Radiators
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Floor (Polished)
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Floor (Non-slip)
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Floor (Soft floor)
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Electrical items
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Low surfaces
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High surfaces
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Chairs
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Tables
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Hand wash/toilet roll/hand towel dispenser
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Hand hygiene/alcohol rub dispensers
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Waste receptacles
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Curtains and blinds
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Replenishment
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Sinks/hand-wash basins
Kitchen
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Location/Description of kitchen
Estates Tasks
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Ceiling
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All external glazing
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Ventilation grilles
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Pest control devices
Cleaning Tasks
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Switches, sockets, data points
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Walls
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All doors
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All internal glazing including partitions
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Radiators
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Floor (Polished)
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Floor (Non-slip)
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Electrical items
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Low surfaces
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High surfaces
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Hand wash/toilet roll/hand towel dispenser
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Waste receptacles
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Dishwashers
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Fridges and freezers
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Kitchen/Storage cupboards
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Microwaves
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Replenishment
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Sinks/hand-wash basins
Waste Cupboard
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Waste cupboard location
Estates Tasks
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Walls
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Ceiling
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Ventilation grilles extract and inlets
Cleaning Tasks
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Switches, sockets, data points
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Walls
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All doors
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All internal glazing (including partitions)
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Floor (Non-slip)
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Low surfaces
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High surfaces
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Waste receptacles
Entrance
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Entrance location
Estates Tasks
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Walls
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Ceiling
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All external glazing
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Ventilation grilles
Cleaning Tasks
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Switches, sockets, data points
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Walls
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All doors
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All internal glazing (including partitions)
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Mirrors
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Radiators
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Floor (Polished)
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Floor (Non-slip)
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Floor (Soft floor)
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Low surfaces
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High surfaces
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Chairs
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Tables
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Hand wash containers
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Hand hygiene/alcohol rub dispensers
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Replenishments
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Sinks
Domestic Cupboard
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Description/Location of domestic cupboard
Estates Tasks
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Walls
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Ceiling
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All external glazing
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Ventilation grilles
Cleaning Tasks
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Switches, sockets, data points
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Walls
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All doors
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All internal glazing (including partitions)
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Radiators
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Floor (Polished)
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Floor (Non-slip)
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Floor (Soft floor)
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Electrical items
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Cleaning equipment
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Low surfaces
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High surfaces
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Hand wash/toilet tissue/hand towel dispenser
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Waste receptacles
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Curtains and blinds
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Kitchen/Storage cupboards
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Replenishment
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Sinks/hand-wash basins
Dirty Utility
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Description
Estates Tasks
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Walls
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Ceiling
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All external glazing
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Ventilation grilles
Cleaning Tasks
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Commodes
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Switches, sockets, data points
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Walls
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All doors
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All internal glazing (including partitions)
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Radiators
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Floor (Polished)
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Floor (Non-slip)
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Floor (Soft floor)
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Low surfaces
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High surfaces
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Tables
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Hand wash/toilet roll/hand towel dispenser
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Hand hygiene/alcohol rub dispensers
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Waste receptacles
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Curtains and blinds
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Kitchen/Storage cupboards
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Replenishment
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Sinks/hand-wash basins
Clean Utility
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Description/Location
Nursing Tasks
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Weighing scales, manual handling equipment
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Notes and drugs trolley
Estates Tasks
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Walls
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Ceiling
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All external glazing
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Ventilation grilles
Cleaning Tasks
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Commodes
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Switches, sockets, data points
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Walls
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All doors
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All internal glazing (including partitions)
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Radiators
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Floor (Polished)
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Floor (Non-slip)
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Floor (Soft floor)
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Low surfaces
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High surfaces
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Hand wash/toilet roll/hand towel dispenser
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Hand hygiene/alcohol rub dispensers
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Waste receptacles
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Curtains and blinds
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Kitchen/Storage cupboards
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Replenishment
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Sinks/hand-wash basins
W/C
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WC Location
Estates Tasks
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Walls
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Ceiling
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Ventilation grilles
Cleaning Tasks
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Switches, sockets, data points
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Walls
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All doors
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Mirrors
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Radiators
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Floor (Polished)
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Floor (Non-slip)
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Low surfaces
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High surfaces
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Chairs
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Hand wash/toilet roll/hand towel dispenser
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Waste receptacles
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Curtains and blinds
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Toilets and bidets
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Replenishment
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Sinks/Hand-wash basins
Bathroom/Shower
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Bathroom/Shower location
Estates Tasks
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Walls
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Ceiling
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Ventilation grilles
Cleaning Tasks
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Switches, sockets, data points
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Walls
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All doors
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Mirrors
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Radiators
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Floor (Polished)
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Floor (Non-slip)
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Low surfaces
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High surfaces
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Chairs
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Hand wash/toilet roll/hand towel dispenser
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Waste receptacles
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Curtains and blinds
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Showers
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Toilets and bidets
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Replenishment
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Sinks/hand-wash basins
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Baths
Bed area
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Description/Location of bed area
Nursing Tasks
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Drip stands
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Medical equipment (CONNECTED TO PATIENT)
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Other medical equipment (NOT CONNECTED TO PATIENT)
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Medical gas equipment
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Notes and drugs trolley
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12. Patient personal items e.g. cards, suitcase
Estates Tasks
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Fans
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Walls
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Ceiling
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All external glazing
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Ventilation grilles
Cleaning Tasks
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Bedside alcohol, clipboards and notice boards
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Switches, sockets, data points
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Walls
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All doors
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All internal glazing (including partitions)
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Mirrors
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Patient entertainment in bay
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Radiators
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Floor (Polished)
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Floor (Non-slip)
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Electrical items
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Cleaning equipment
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Low surfaces
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High surfaces
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Chairs
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Beds
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Lockers
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Tables
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Hand wash/toilet roll/hand towel dispenser
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Hand hygiene/alcohol rub dispensers
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Waste receptacles
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Curtains and blinds
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Replenishment
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Sinks/Hand-wash basins
Consultation/Examination Room
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Name/Description of consultation/examination room
Nursing Tasks
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Weighing scales, manual handling equipment
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Other medical equipment (NOT CONNECTED TO PATIENT)
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Notes and drugs trolley
Estates Tasks
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Fans
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Walls
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Ceiling
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All external glazing
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Ventilation grilles
Cleaning Tasks
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Switches, sockets, data points
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Walls
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All doors
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All internal glazing (including partitions)
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Mirrors
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Radiators
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Floor (Polished)
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Floor (Non-slip)
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Floor (Soft floor)
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Electrical items
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Low surfaces
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High surfaces
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Chairs
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Tables
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Hand wash/toilet tissue/hand towel dispenser
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Hand hygiene/alcohol rub dispensers
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Waste receptacles
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Curtains and blinds
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Replenishment
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Sinks/hand-wash basins
Corridors
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Corridor location
Estates Tasks
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Walls
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Ceiling
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All external glazing
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Ventilation grilles
Cleaning Tasks
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Switches, sockets, data points
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Walls
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All doors
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All internal glazing (including partitions)
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Radiators
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Floor (Polished)
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Floor (Non-slip)
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Floor (Soft floor)
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Electrical items
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Cleaning equipment
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Low surfaces
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High surfaces
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Chairs
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Hand wash/toilet roll/hand towel dispenser
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Hand hygiene/alcohol rub dispensers
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Curtains and blinds
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Replenishment
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Sinks/hand-wash basins
Approach Corridor
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Corridor location
Estates Tasks
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Walls
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Ceiling
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All external glazing
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Ventilation grilles
Cleaning Tasks
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Switches, sockets and data points
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Walls
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All doors
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All internal glazing (including partitions)
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Radiators
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Floor (Polished)
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Floor (Non-slip)
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Floor (Soft floor)
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Low surfaces
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High surfaces
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Chairs
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Hand wash/toilet roll/hand towel dispenser
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Hand hygiene/alcohol rub dispensers
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Curtains and blinds
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Replenishment
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Sinks/hand-wash basins
Day/Quiet room
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Location/Description of day/quiet room
Estates Tasks
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Walls
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Ceiling
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All external glazing
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Ventilation grilles
Cleaning Tasks
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Switches, sockets and data points
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Walls
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All doors
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All internal glazing (including partitions)
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Radiators
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Floor (Polished)
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Floor (Soft Floor)
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Electrical items
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Low surfaces
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High surfaces
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Chairs
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Tables
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Hand wash/toilet tissue/hand towel dispenser
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Hand hygiene/alcohol rub dispensers
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Waste receptacles
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Curtains and blinds
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Replenishment
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Sinks/hand-wash basins
Sign-Off
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Closing comments
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Signature (Auditor)
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Signature (Ward/Senior Manager)