Information
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Conducted on
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Prepared by
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Client name
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Branch name
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Location map
Staffing details
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Authorised strength
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Total number of strength
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Picture of the staff
Uniform grooming standard
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Staff presented in full uniform
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Remarks
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Picture of the staff
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Vaccination double dose certificate
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Vaccinated badge and mask
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Availablity of SOP
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Picture of SOP
Office area
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Entrance Glass clean and free from smudges
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Office floors are free of stains and marks
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Tables, printers are free from dust
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The meeting room is clean and odorless
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Meeting room tables and chairs are cleaned and organised
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Walls clean and free of spots and stains
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Window glass free of finger prints and spots
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Ledges, window sils and shelves are free of dust and debris
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Floors are free of slip/trip/fall hazards
Bathroom
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Bathroom is cleaned and odourless
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Floors free of dirt, dust, litter including corners
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Bathroom mirror is free of debris and streaking
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Bathroom ventilation is working
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The bathroom commode is clean and free of stains
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The bathroom is stocked with soap, paper towels, and toilet tissue
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The sink is clean, free of soap and another buildup including any exposed piping
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Cubicles are present, clean, and secure
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Commode chairs are clean and in good repair
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Washroom checklist is presented and maintained regularly
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Sufficient materials available at the site
Pantry
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Is pantry without obstruction
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The water dispenser is cleaned and away from wastebin
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The micro oven is free from food particles and clean state
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Refrigerator is clean and without odor
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Walls clean and free of spots and stains
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Flooring clean of dirt, dust, and litter including corners
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The washbasin is free of debris and cleaned
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Floors are free of slip/trip/fall hazards
Fine & Rewards
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Fine or Rewards
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Reason for Fine or Rewards
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MAX ID of the Staff
Conversation and signature
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Name of the staff with max ID
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Signature of the staff
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Name of the client representative with employee ID
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Signature of the client representative
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Feedback and recommendations
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Signature of the assessor
