Title Page

  • Site conducted

  • Conducted on

  • Prepared by

  • Location

Cleanliness

  • Is the Room Clean?

Walls, Ceiling & Flooring - Kitchen

  • Wall 1 Condition

  • Wall 2 Condition

  • Wall 3 Condition

  • Wall 4 Condition

  • Ceiling Condition

  • Skirting Condition

  • Flooring Condition

Walls, Ceiling & Flooring - Lounge

  • Wall 1 Condition

  • Wall 2 Condition

  • Wall 3 Condition

  • Wall 4 Condition

  • Ceiling Condition

  • Skirting Condition

  • Flooring Condition

Doors, Windows & Lighting

  • Windows - Are the Windows Safe, Secure and Free from Damage? Check Glazing, Frame, Handles and Hinges.

  • Door Stop - In place and Secure?

  • Fire signage on door and Correct for location?

  • Door Closure - Fully Operational

  • All Lighting Working?

Furniture

  • Kitchen Stools - In place and free from Damage or Wear and Tear? Confirm number of stools.

  • Dining Chairs - In place and free from Damage or Wear and Tear? Confirm number of chairs.

  • Lounge Sofas - In place and free from Damage or Wear and Tear? Confirm number of sofa seats.

Appliances

  • Toaster - In place and working?

  • Kettle - In place and working?

  • Microwave - In place and working?

  • Oven - Working with knobs and decals in place?

  • Hob - Working with knobs and decals in place?

  • Fridge - Check clear of food and fully functioning?

  • Freezer - Check clear of food and fully functioning?

  • Fridge/Freezer Shelving - Any missing or cracked shelving?

Sink Area

  • Taps working and secure? Check pressure.

  • Washing bowl in place?

  • Sink plug drainer in place?

  • Drying board in place?

  • Sink Area - Any Other Issues?

  • Kitchen Cupboards - Check all are in fully working order. Report any Damage or Wear and Tear.

Waste

  • Excessive Waste to remove?

  • Personal Belongings to Store/Report to Uni?

  • Personal Belongings to dispose via Charity Bins?

Any Other Issues

  • Additional Issue 1?

  • Additional Issue 2?

  • Additional Issue 3?

  • Additional Issue 4?

  • Additional Issue 5?

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.