Title Page
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Document No.
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Client / Site
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Conducted on
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Prepared by
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Location
Scoring
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Presentation Standards:
P: Pass = 1 Point
IR: Improvement Required = -1
F: Failed = -2 Points
Yes = 2 Points
No = -2 Points
Toilets
Male Toilets
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Toilet bowls, seats, lids, urinals clean and sanitised
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Partitions & doors clean
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All grills, drains and vents clean
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Hand basins clean
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Mirrors clean and free of marks & doors to mirrors locked
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Toilet floor surfaces clean and free of marks
Female Toilets
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Toilet bowls, seats, lids, urinals clean and sanitised
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Partitions & doors clean
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All grills, drains and vents clean
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Hand basins clean
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Mirrors clean and free of marks & doors to mirrors locked
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Toilet floor surfaces clean and free of marks
Parents Room
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Toilet
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Common Area
Disable Toilet
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Toilet
Entries
Deli Sushi Entry
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Ground surfaces & walkways
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Entry Mats
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Entry glass & window ledges
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Walls, handrails, signs and light fittings to 3 metres
Post Office Entry
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Ground surfaces & walkways
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Entry mats <br>
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Walls, handrails, signs and light fittings, cobwebs to 3 metres
Centre's Common Area
Centre's Common Area
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Walls, doors, ceilings and corners
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Flooring
Loading Dock
Loading Dock
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Loading dock area clean
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Compactor area's clean
Car Park
Car park
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Car park area clean
KPI's
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Last Inspection 100% Completed To Do Task
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Spill Register Complete
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Lop times been met <20mins, identify areas not been met & create an action for them
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Strip & seal due twice a year - May & November
OH&S
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Cleaning storage clean & organised
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All OH&S safety & code of conduct information is displayed
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All equipment tested & tagged
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All staff wearing the correct uniforms
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All staff are following the organisation’s safe work practices
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Tool Box Talks, if yes provide a photo of the document for evidence
Sign Off
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Comments, Requests and Additional Service Requirements
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Vicinity's Representative Signage
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Contractors Representative Signature