Hourly Restroom Cleaning Log

• Site

• Conducted on

  Date

• Prepared by

• Location
  Address

Log

• Time

  Date

• Cleaned the toilet and hand washing facilities

  ✔

  ✖

  N/A

• Filled the hand soap

  ✔

  ✖

  N/A

• Filled the single-use paper towels

  Select ✔ ✖ N/A

  • ✔
  • ✖
  • N/A

• Filled the toilet papers

  ✔

  ✖

  N/A

• Emptied the trash can

  ✔

  ✖

  N/A

• Name and Signature

  Sign

Management Review

• Reviewed By (Name and Signature)

  Sign