Title Page

  • Document No.

  • Audit Title

  • Site

  • Conducted on

  • Conducted by

  • Conducted with

General Safety

  • Are correct cleaning chemicals used, diluted and labelled correctly ?

  • Is personal protective equipment (PPE) available and being used?

  • Are chemicals stored correctly with MSDS sheets available?

  • Does the storeroom have adequate supply of equipment and supplies, and in good condition

  • Is the cleaner in the correct uniform?

  • Please check your equipment asset list, all accounted for?

Offices and work stations

  • What office or work station are you auditing today?

  • Skirtings, ledges, furniture and fittings - no visible dust

  • Telephone and handsets - no visible marks/dirt

  • Walls and doors - no visible marks/stains

  • Rubbish bins - not full/ overflow

  • New bin liner

  • Carpeted areas - no visible dirt

Entry/ Reception Areas

  • What entry or reception area are you auditing today?

  • Skirtings, ledges, furniture and fittings - no visible dust

  • Walls - no visible marks/stains

  • Glass door - no visible dirt/marks

  • Tiled/Vinyl entry - no visible marks/ dirt

  • Carpeted areas - no visible dirt

Staff rooms

  • What staff room are you auditing today?

  • Sink and bench - no visible marks/ dirt/ food waste

  • Furniture - no visible dust

  • Skirtings, ledges, furniture and fittings - no visible dust

  • Walls - no visible marks/stains

  • Vinyl floor - no visible marks/ dirt

  • Rubbish bins - not full

  • Carpeted areas - no visible dirt

Audit either a resident lounge, dining room or kitchenette

  • Please specify what area you are auditing today?

  • Kitchen sinks, benches and cupboard fronts - no visible marks/ dirt/ food waste

  • Furniture - no visible dust

  • Skirtings and ledges - no visible dust

  • Walls - no visible marks/stains

  • Internal glass doors - no visible marks/ dirt

  • Carpet - no visible dirt

  • Vinyl floors - no visible dirt

Audit at least one bedroom

  • What room number are you auditing today?

  • Hand basins - no visible marks/ dirt

  • Skirtings, ledges, furniture and fittings - no visible dust

  • Paper towel dispenser - at least half filled

  • Curtain rails, tops of wardrobes and beds - no visible dust

  • Rubbish bins - not full

  • Walls and doors - no visible marks/ dirt

  • Carpet - no visible dirt

  • Vinyl floor - no visible marks/ dirt

Ensuite / resident bathroom

  • What resident bathroom are you auditing today?

  • Toilet bowls, seats and lids - no visible dirt

  • Doors, walls, ledges and partitions - no visible marks/ dirt

  • Dispensers (paper towel, toilet paper) - at least half filled

  • Hand basins, taps, mirrors, fittings, dispensers, driers - no visible marks/ dirt

  • Rubbish bins - not full

  • Floor - no visible marks and dirt

Sluice rooms

  • What sluice room are you auditing today?

  • Hand basins, taps, mirrors, fittings, dispensers, driers - no visible marks/ dirt

  • Dispensers (paper towel, toilet paper) - at least half filled

  • Walls, doors and cupboards - no visible marks/ dirt

  • Rubbish bins - not full

  • Floors - no visible marks/ dirt

Visitors toilets

  • What visitor bathroom are you auditing today?

  • Toilet bowls, seats and lids - no visible dirt

  • Doors, walls, ledges and partitions - no visible marks/ dirt

  • Hand basins, taps, mirrors, fittings, dispensers, driers - no visible marks/ dirt

  • Dispensers (paper towel, toilet paper) - at least half filled

  • Rubbish bins - not full

  • Floor - no visible marks and dirt

Staff toilets, showers and locker rooms

  • What staff bathroom/locker room will you be auditing today?

  • Toilet bowls, seats and lids - no visible dirt

  • Doors, walls, ledges and partitions - no visible marks/ dirt

  • Hand basins, taps, mirrors, fittings, dispensers, driers - no visible marks/ dirt

  • Dispensers (paper towel, toilet paper) - at least half filled

  • Shower - no visible marks/ dirt

  • Floors - no visible marks/ dirt

  • Rubbish bins - not full

Corridors and stairs

  • What corridor or stairs are you auditing today?

  • Internal glass doors - no visible marks/ dirt

  • Ledges, skirting so, handrails - no visible dust

  • Handrails - no visible marks/ dirt

  • Carpeted - no visible dirt

  • Picture frames - no visible dust

  • Fire doors - no visible dirt behind doors

Physio / OT rooms

  • What physio or OT room are you auditing today?

  • Skirtings, ledges, furniture and fittings - no visible dust

  • Walls and doors - no visible marks/ dirt

  • Carpet - no visible dirt

  • Rubbish bins - not full

  • New bin liner

  • Floors - no visible marks/ dirt

Hairdresser / Treatment room

  • What hairdresser or treatments room are you auditing today?

  • Ledges and skirting so - no visible dust

  • Walls and cupboards - no visible marks/ dirt

  • Sink and bench - no visible marks/ dirt

  • Rubbish bins - not full

  • Floors - no visible marks/ dirt

Resident Satisfaction

  • Please ask 5 residents, on a scale of 1 to 5 (one being very bad, 5 being very good) - how would you rate the cleanliness of the facilities. Resident One...

  • Please ask 5 residents, on a scale of 1 to 5 (one being very bad, 5 being very good) - how would you rate the cleanliness of the facilities. Resident Two...

  • Please ask 5 residents, on a scale of 1 to 5 (one being very bad, 5 being very good) - how would you rate the cleanliness of the facilities. Resident Three...

  • Please ask 5 residents, on a scale of 1 to 5 (one being very bad, 5 being very good) - how would you rate the cleanliness of the facilities. Resident Four...

  • Please ask 5 residents, on a scale of 1 to 5 (one being very bad, 5 being very good) - how would you rate the cleanliness of the facilities. Resident Five...

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.