Title Page
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Name of Establishment
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Room #
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Room Type
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Conducted on
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Inspected by
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Instructions:
1. Take a photo of the room being inspected.
2. Answer "Yes", "No", "N/A" on the items below.
3. In the event of items in need of maintenance or repair, add a note and image evidence by tapping on notes and image.
4. Add a Corrective Action for identified failed items. Tap on "Action", provide a description, assign to a member, set priority and due date.
5. Provide your overall comments or recommendations (if any)
6. Complete audit by providing digital signature.
Room Checklist
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Take a photo of the room
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Doors working properly
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Door is Clean and Scratch Free
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Emergency evacuation plan back of door
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Current Poster on back of door (Take Photo)
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Light switches work
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Window glass are clean and damage free
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Drapes are straight and are in good condition
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Heater working
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Heater is clean
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Lamp shades are clean and straight
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Beds are properly made
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Mattress(es) firm
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Bedspread is free of rips and stains
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Furnitures are free from scratches or stains
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Walls are clean and free of cobwebs
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Walls are free from scratches and nicks
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Bins Clean
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Pictures and mirrors are in pristine condition
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Locker in good condition
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Bunk Beds is secuied
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Power Point working
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Private Room Kettle and Mug are in good condition
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Private Room Clothing Hang in good condition
Bathroom Checklist
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Take a photo of bathroom(s)
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Clean toilet seat (both sides)
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Underside of lavatory clean
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Shower rod in good condition
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Toilet flushes correctly
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Bathroom free of odors
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Pop up stopper clean ( flush button)
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Free of water spots on tiles
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Shower free of grout
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Clean supply of towels prepared
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Floor Clean
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Heater Working
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Towel Rank Securied
Completion
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Comments and Recommendations
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Inspector's Name and Signature