i-Clean Audit

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Offices

• Bins

  Yes

  No

  N/A

• Soft floors

  Yes

  No

  N/A

• Hard floors

  Yes

  No

  N/A

• Vertical surfaces

  Yes

  No

  N/A

• Furniture / fixtures / fittings / work surfaces

  Yes

  No

  N/A

• Other furniture / fittings

  Yes

  No

  N/A

Washrooms

• Bins

  Yes

  No

  N/A

• Hard floors

  Yes

  No

  N/A

• Vertical surfaces

  Yes

  No

  N/A

• Partition / cubicle walls

  Yes

  No

  N/A

• All surfaces

  Yes

  No

  N/A

• Sanitary surfaces / hand contact areas

  Yes

  No

  N/A

• Furniture / fixtures / fittings

  Yes

  No

  N/A

• Mirrors / dispensers

  Yes

  No

  N/A

• Consumables

  Yes

  No

  N/A

Corridors / stairs / entrances / lifts

• Bins

  Yes

  No

  N/A

• Soft floors

  Yes

  No

  N/A

• Hard floors

  Yes

  No

  N/A

• Vertical surfaces

  Yes

  No

  N/A

• Furniture / fixtures / fittings / work surfaces

  Yes

  No

  N/A

• Other furniture / fittings

  Yes

  No

  N/A

Refreshment / vending facilities

• Bins

  Yes

  No

  N/A

• Hard floors

  Yes

  No

  N/A

• Vertical surfaces

  Yes

  No

  N/A

• Furniture / fixtures / fittings

  Yes

  No

  N/A

• Consumables

  Yes

  No

  N/A

Dining areas / rest rooms

• Bins

  Yes

  No

  N/A

• Soft floors

  Yes

  No

  N/A

• Hard floors

  Yes

  No

  N/A

• Vertical surfaces

  Yes

  No

  N/A

• Furniture / fixtures / fittings

  Yes

  No

  N/A

• Table tops

  Yes

  No

  N/A

• Mirrors / dispensers

  Yes

  No

  N/A

• Provided facilities (ovens / microwaves / etc.)

  Yes

  No

  N/A

• Consumables

  Yes

  No

  N/A

Reception / prestige areas

• Bins

  Yes

  No

  N/A

• Soft floors - traffic lanes

  Yes

  No

  N/A

• Soft floors - other areas

  Yes

  No

  N/A

• Hard floors

  Yes

  No

  N/A

• Vertical surfaces

  Yes

  No

  N/A

• Furniture / fixtures / fittings

  Yes

  No

  N/A

• Other areas

  Yes

  No

  N/A

Authorisation signatures

• Auditor signature

  Sign

• Manager Signature

  Sign