Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

  • YES means items are acceptable. NO means items are unacceptable. If NO is selected photos and comments MUST be provided. A total of 1 point per line items is awarded for a YES mark.

Entrance

  • Entry glass clean and presentable

  • Reception area clean and presentable

Carpet Areas

  • Carpets areas vacuumed and free from debris

  • Carpet corners and ledges free from fluff

Office areas

  • Internal office doors clean and presentable

  • Walkways clean and presentable

  • Ledges and skirting boards free from dust

  • Switches free from dust and finger prints

  • Accessable vents and lights free from dust and marks

  • Accessable walls free from removable marks

  • Accessable areas behind work station computer screens and surrounding areas free from dust

  • Bins emptied and in acceptable sanitary condition including plastic bags

Internal bathrooms and showers

  • Partitions, frames and skirting clean and free from dust, clean and presentable

  • Air conditioning vents free from dust, clean and presentable

  • Walls free from marks, clean and presentable

  • Floors clean and presentable

  • Cisterns clean and presentable

  • Urinals clean and presentable

  • Hand basins, sinks, taps clean and presentable

  • Glass and mirrors clean and presentable

  • Shower screens and doors clean and presentable

  • Bins emptied and in acceptable sanitary condition

Internal kitchen areas

  • Floors clean and presentable

  • Bench surfaces and cupboards clean and presentable

  • Sinks, tape clean and presentable

  • Bins emptied and in acceptable sanitary condition. Plastic bags changed.

Corrective Action

  • Review the items that require corrective action and briefly list here

  • Name the staff member who is responsible for carrying out this corrective action. If multiple people are included itemise the specific task relating to each person requiring corrective action

  • Enter a date when all items requiring corrective action must be completed by

  • Enter a date when an inspection will be carried out to confirm whether or not the items requiring corrective action have been completed

Signatory

  • I hereby acknowledge this report to be a fair and accurate reflection of the inspected site.

Corrective Action Review

  • Have all items requiring corrective action been completed by the specified due date on this inspection report? If the Answer is NO enter a brief description of what has not been completed. Once this report has been finalised proceed to create a Corrective Action Report

  • Enter a date when they were inspected to confirm they had been completed

Signatory

  • I hereby acknowledge this report to be a fair and accurate reflection of the inspected site.

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.