Title Page

  • Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Location

Scoring

  • Presentation Standards:

    P: Pass = 1 Point

    IR: Improvement Required = -1

    F: Failed = -2 Points

    Yes = 2 Points

    No = -2 Points

Toilets

Male Toilets

  • Toilet bowls, seats, lids, urinals clean and sanitised

  • Partitions & doors clean

  • All grills, drains and vents clean

  • Hand basins clean

  • Mirrors clean and free of marks & doors to mirrors locked

  • Toilet floor surfaces clean and free of marks

Female Toilets

  • Toilet bowls, seats, lids, urinals clean and sanitised

  • Partitions & doors clean

  • All grills, drains and vents clean

  • Hand basins clean

  • Mirrors clean and free of marks & doors to mirrors locked

  • Toilet floor surfaces clean and free of marks

Parents Room

  • Toilet

  • Common Area

Disable Toilet

  • Toilet

Entries

Deli Sushi Entry

  • Ground surfaces & walkways

  • Entry Mats

  • Entry glass & window ledges

  • Walls, handrails, signs and light fittings to 3 metres

Post Office Entry

  • Ground surfaces & walkways

  • Entry mats <br>

  • Walls, handrails, signs and light fittings, cobwebs to 3 metres

Centre's Common Area

Centre's Common Area

  • Walls, doors, ceilings and corners

  • Flooring

Loading Dock

Loading Dock

  • Loading dock area clean

  • Compactor area's clean

Car Park

Car park

  • Car park area clean

KPI's

  • Last Inspection 100% Completed To Do Task

  • Spill Register Complete

  • Lop times been met <20mins, identify areas not been met & create an action for them

  • Entrance - Aus Post

  • Loop Time - Mall Newsagent

  • Loop Time - Main Public Toilets

  • Loop Time - Mall Millers

  • Loop Time - Mall Woolworths

  • Loop Time - Female Toilets

  • Loop Time - Male Toilets

  • Loop Time - Parents Room

  • Strip & seal due twice a year - May & November

OH&S

  • Cleaning storage clean & organised

  • All OH&S safety & code of conduct information is displayed

  • All equipment tested & tagged

  • All staff wearing the correct uniforms

  • All staff are following the organisation’s safe work practices

  • Tool Box Talks, if yes provide a photo of the document for evidence

Sign Off

  • Comments, Requests and Additional Service Requirements

  • Vicinity's Representative Signage

  • Contractors Representative Signature

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.