Information
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Document No.
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Monthly Walk-Through Report:
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Conducted on
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Prepared by
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Hit the "Start" button.
Education
Sanitation
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Is area properly stocked, I.e. paper towels, soap, sanitizer?
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Are windows, window sills, etc. clean/dust free?
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Are vents free of dust/grime? Are surrounding areas dust free?
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Has trash been taken out? Are trash cans clean inside/out?
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Are the floors clean?
Safety/Fire Safety
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Is safety equipment easily accessible? Fire extinguishers, pull stations, PPE, first aid kit, etc.
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Are wet floor signs and other safety measures being utilized? (Mats, spills immediately cleaned, etc.)
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Is the 18" rule being followed?
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Are means of egress clear to exit?
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Is the area clear of slips, trips, and fall hazards?
Maintenance
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Are there any obvious maintenance issues?
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Who will be submitting the maintenance request form?
Security
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Is the main door secured?
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Are containers (cleaning supplies) properly labeled and secured?
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Have unnecessary security threats been removed from the area?
Kitchen
Sanitation
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Is area properly stocked, I.e. paper towels, soap, sanitizer?
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Are windows, window sills, doors, etc. clean/dust free?
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Are vents free of dust/grime? Are surrounding areas dust free?
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Has trash been taken out? Are trash cans clean inside/out?
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Are the floors clean?
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Have appliances been wiped down?
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Are work areas clean, decontaminated?
Safety/Fire Safety
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Is safety equipment easily accessible? Fire extinguishers, pull stations, PPE, first aid kit, etc.
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Are wet floor signs and other safety measures being utilized? (Mats, spills immediately cleaned, etc.)
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Is the 18" rule being followed?
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Are means of egress clear to exit?
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Is the area clear of slips, trips, and fall hazards?
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Are food temperatures within "safe" range?
Maintenance
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Are there any obvious maintenance issues?
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Who will be submitting the maintenance request form?
Security
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Are containers (cleaning supplies) properly labeled and secured?
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Have unnecessary security threats been removed from the area?
Transportation
Sanitation
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Is area properly stocked, I.e. paper towels, soap, sanitizer?
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Are vents free of dust/grime? Are surrounding areas dust free?
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Has trash been taken out? Are trash cans clean inside/out?
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Are the floors clean?
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Area not evaluated.
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Critical Issue.
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Needs Attention.
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Keep at this standard or better.
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Showers are exemplary.
Safety/Fire Safety
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Is safety equipment easily accessible? Fire extinguishers, pull stations, PPE, first aid kit, etc.
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Are wet floor signs and other safety measures being utilized? (Mats, spills immediately cleaned, etc.)
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Is the 18" rule being followed?
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Are means of egress clear to exit?
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Is the area clear of slips, trips, and fall hazards?
Maintenance
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Are there any obvious maintenance issues?
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Who will be submitting the maintenance request form?
Security
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Are containers (cleaning supplies) properly labeled and secured?
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Are security doors secured?
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Have unnecessary security threats been removed from the area?
Medical
Sanitation
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Is area properly stocked, I.e. paper towels, soap, sanitizer?
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Are cell bars, windows, window sills, doors, etc. clean/dust free?
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Are vents free of dust/grime? Are surrounding areas dust free?
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Has trash been taken out? Are trash cans clean inside/out?
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Are the floors clean?
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Have appliances been wiped down?
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Are work areas clean, decontaminated?
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Area not evaluated.
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Critical Issue.
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Needs Attention.
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Keep at this standard or better.
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Showers are exemplary.
Safety/Fire Safety
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Is safety equipment easily accessible? Fire extinguishers, pull stations, PPE, first aid kit, etc.
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Are wet floor signs and other safety measures being utilized? (Mats, spills immediately cleaned, etc.)
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Is the 18" rule being followed?
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Is area free of clutter?
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Are means of egress clear to exit?
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Is the area clear of slips, trips, and fall hazards?
Maintenance
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Are there any obvious maintenance issues?
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Who will be submitting the maintenance request form?
Security
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Are containers (cleaning supplies) properly labeled and secured?
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Are inmates in cells visible? (Nothing should be hanging over the bottom bunk or over toilet area obstructing the view).
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Is anything hanging from the bars, i.e., clothes lines, trash bags, clothing, etc.?
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Is the main Security door secure? Are cell doors secure?
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Have unnecessary security threats been removed from the area?
Common Areas
Sanitation
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Are areas properly stocked, I.e. paper towels, soap, sanitizer?
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Are windows, window sills, doors, etc. clean/dust free?
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Are vents free of dust/grime? Are surrounding areas dust free?
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Has trash been taken out? Are trash cans clean inside/out?
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Are the floors clean?
Safety/Fire Safety
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Is safety equipment easily accessible? Fire extinguishers, pull stations, PPE, first aid kit, etc.
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Are wet floor signs and other safety measures being utilized? (Mats, spills immediately cleaned, etc.)
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Is the 18" rule being followed?
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Are means of egress clear to exit?
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Is the area clear of slips, trips, and fall hazards?
Maintenance
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Are there any obvious maintenance issues?
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Who will be submitting the maintenance request form?
Security
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Are containers (cleaning supplies) properly labeled and secured?
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Are security doors secure?
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Have unnecessary security threats been removed from the area?
Administration
Sanitation
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Is area properly stocked, I.e. paper towels, soap, sanitizer?
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Are windows, window sills, etc. clean/dust free?
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Are vents free of dust/grime? Are surrounding areas dust free?
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Has trash been taken out? Are trash cans clean inside/out?
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Are the floors clean?
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Have appliances been wiped down?
Safety/Fire Safety
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Is safety equipment easily accessible? Fire extinguishers, pull stations, PPE, first aid kit, etc.
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Are wet floor signs and other safety measures being utilized? (Mats, spills immediately cleaned, etc.)
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Is the 18" rule being followed?
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Are means of egress clear to exit?
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Is the area clear of slips, trips, and fall hazards?
Maintenance
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Are there any obvious maintenance issues?
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Who will be submitting the maintenance request form?
Security
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Are containers (cleaning supplies) properly labeled and secured?
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Are security doors secured?
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Have unnecessary security threats been removed from the area?
Commissary
Sanitation
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Is area properly stocked, I.e. paper towels, soap, sanitizer?
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Are vents free of dust/grime? Are surrounding areas dust free?
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Has trash been taken out? Are trash cans clean inside/out?
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Are the floors clean?
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Have appliances been wiped down?
Safety/Fire Safety
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Is safety equipment easily accessible? Fire extinguishers, pull stations, PPE, first aid kit, etc.
-
Are wet floor signs and other safety measures being utilized? (Mats, spills immediately cleaned, etc.)
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Is the 18" rule being followed?
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Are means of egress clear to exit?
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Is there any unnecessary clutter?
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Is the area clear of slips, trips, and fall hazards?
Maintenance
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Are there any obvious maintenance issues?
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Who will be submitting the maintenance request form?
Security
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Are containers (cleaning supplies) properly labeled and secured?
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Have unnecessary security threats been removed from the area?
D2
Sanitation
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Are cell bars, windows, window sills, doors, etc. clean/dust free?
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Are vents free of dust/grime? Are surrounding areas dust free?
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Has trash been taken out? Are trash cans clean inside/out?
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Are the floors clean?
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Have appliances been wiped down?
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Area not evaluated.
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Critical Issue.
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Needs Attention.
-
Keep at this standard or better.
-
Showers are exemplary.
Safety/Fire Safety
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Is safety equipment easily accessible? Fire extinguishers, pull stations, PPE, first aid kit, etc.
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Are wet floor signs and other safety measures being utilized? (Mats, spills immediately cleaned, 18" rule, etc.)
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Are living areas free of clutter?
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Are means of egress clear to exit?
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Is the area clear of slips, trips, and fall hazards?
Maintenance
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Are there any obvious maintenance issues?
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Who will be submitting the maintenance request form?
Security
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Are containers (cleaning supplies) properly labeled and secured?
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Are inmates in cells visible? (Nothing should be hanging over the bottom bunk or over toilet area obstructing the view).
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Is the main Pod door secure? Are cell doors secure?
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Have unnecessary security threats been removed from the area?
D3
Sanitation
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Are cell bars, windows, window sills, etc. clean/dust free?
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Are vents free of dust/grime? Are surrounding areas dust free?
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Has trash been taken out? Are trash cans clean inside/out?
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Are the floors clean?
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Have appliances been wiped down?
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Area not evaluated.
-
Critical Issue.
-
Needs Attention.
-
Keep at this standard or better.
-
Showers are exemplary.
Safety/Fire Safety
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Is safety equipment easily accessible? Fire extinguishers, pull stations, PPE, first aid kit, etc.
-
Are wet floor signs and other safety measures being utilized? (Mats, spills immediately cleaned, 18" rule, etc.)
-
Are living areas free of clutter?
-
Are means of egress clear to exit?
-
Is the area clear of slips, trips, and fall hazards?
Maintenance
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Are there any obvious maintenance issues?
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Who will be submitting the maintenance request form?
Security
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Are containers (cleaning supplies) properly labeled and secured?
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Are inmates in cells visible? (Nothing should be hanging over the bottom bunk or over toilet area obstructing the view).
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Is the main Pod door secure? Are cell doors secure?
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Have unnecessary security threats been removed from the area?
4B
Sanitation
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Are cell bars, windows, window sills, etc. clean/dust free?
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Are vents free of dust/grime? Are surrounding areas dust free?
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Has trash been taken out? Are trash cans clean inside/out?
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Are the floors clean?
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Have appliances been wiped down?
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Area not evaluated.
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Critical Issue.
-
Needs Attention.
-
Keep at this standard or better.
-
Showers are exemplary.
Safety/Fire Safety
-
Is safety equipment easily accessible? Fire extinguishers, pull stations, PPE, first aid kit, etc.
-
Are wet floor signs and other safety measures being utilized? (Mats, spills immediately cleaned, 18" rule, etc.)
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Are cells free of clutter?
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Are means of egress clear to exit?
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Is the area clear of slips, trips, and fall hazards?
Maintenance
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Are there any obvious maintenance issues?
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Who will be submitting the maintenance request form?
Security
-
Are containers (cleaning supplies) properly labeled and secured?
-
Are inmates in cells visible? (Nothing should be hanging over the bottom bunk or over toilet area obstructing the view).
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Is anything hanging from the bars, i.e., clothes lines, trash bags, clothing, etc.?
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Is the main Pod door secure? Are cell doors secure?
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Have unnecessary security threats been removed from the area?
4C
Sanitation
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Are cell bars, windows, window sills, etc. clean/dust free?
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Are vents free of dust/grime? Are surrounding areas dust free?
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Has trash been taken out? Are trash cans clean inside/out?
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Are the floors clean?
-
Have appliances been wiped down?
-
Area not evaluated.
-
Critical Issue.
-
Needs Attention.
-
Keep at this standard or better.
-
Showers are exemplary.
Safety/Fire Safety
-
Is safety equipment easily accessible? Fire extinguishers, pull stations, PPE, first aid kit, etc.
-
Are wet floor signs and other safety measures being utilized? (Mats, spills immediately cleaned, 18" rule, etc.)
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Are cells free of clutter?
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Are means of egress clear to exit?
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Is the area clear of slips, trips, and fall hazards?
Maintenance
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Are there any obvious maintenance issues?
-
Who will be submitting the maintenance request form?
Security
-
Are containers (cleaning supplies) properly labeled and secured?
-
Are inmates in cells visible? (Nothing should be hanging over the bottom bunk or over toilet area obstructing the view).
-
Is anything hanging from the bars, i.e., clothes lines, trash bags, clothing, etc.?
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Is the main Pod door secure? Are cell doors secure?
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Have unnecessary security threats been removed from the area?
3B
Sanitation
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Are cell bars, windows, window sills, etc. clean/dust free?
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Are vents free of dust/grime? Are surrounding areas dust free?
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Has trash been taken out? Are trash cans clean inside/out?
-
Are the floors clean?
-
Have appliances been wiped down?
-
Area not evaluated.
-
Critical Issue.
-
Needs Attention.
-
Keep at this standard or better.
-
Showers are exemplary.
Safety/Fire Safety
-
Is safety equipment easily accessible? Fire extinguishers, pull stations, PPE, first aid kit, etc.
-
Are wet floor signs and other safety measures being utilized? (Mats, spills immediately cleaned, 18" rule, etc.)
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Are cells free of clutter?
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Are means of egress clear to exit?
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Is the area clear of slips, trips, and fall hazards?
Maintenance
-
Are there any obvious maintenance issues?
-
Who will be submitting the maintenance request form?
Security
-
Are containers (cleaning supplies) properly labeled and secured?
-
Are inmates in cells visible? (Nothing should be hanging over the bottom bunk or over toilet area obstructing the view).
-
Is anything hanging from the bars, i.e., clothes lines, trash bags, clothing, etc.?
-
Is the main Pod door secure? Are cell doors secure?
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Have unnecessary security threats been removed from the area?
3C
Sanitation
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Are cell bars, windows, window sills, etc. clean/dust free?
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Are vents free of dust/grime? Are surrounding areas dust free?
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Has trash been taken out? Are trash cans clean inside/out?
-
Are the floors clean?
-
Have appliances been wiped down?
-
Area not evaluated.
-
Critical Issue.
-
Needs Attention.
-
Keep at this standard or better.
-
Showers are exemplary.
Safety/Fire Safety
-
Is safety equipment easily accessible? Fire extinguishers, pull stations, PPE, first aid kit, etc.
-
Are wet floor signs and other safety measures being utilized? (Mats, spills immediately cleaned, 18" rule, etc.)
-
Are cells free of clutter?
-
Are means of egress clear to exit?
-
Is the area clear of slips, trips, and fall hazards?
Maintenance
-
Are there any obvious maintenance issues?
-
Who will be submitting the maintenance request form?
Security
-
Are containers (cleaning supplies) properly labeled and secured?
-
Are inmates in cells visible? (Nothing should be hanging over the bottom bunk or over toilet area obstructing the view).
-
Is anything hanging from the bars, i.e., clothes lines, trash bags, clothing, etc.?
-
Is the main Pod door secure? Are cell doors secure?
-
Have unnecessary security threats been removed from the area?
2B
Sanitation
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Are cell bars, windows, window sills, etc. clean/dust free?
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Are vents free of dust/grime? Are surrounding areas dust free?
-
Has trash been taken out? Are trash cans clean inside/out?
-
Are the floors clean?
-
Have appliances been wiped down?
-
Area not evaluated.
-
Critical Issue.
-
Needs Attention.
-
Keep at this standard or better.
-
Showers are exemplary.
Safety/Fire Safety
-
Is safety equipment easily accessible? Fire extinguishers, pull stations, PPE, first aid kit, etc.
-
Are wet floor signs and other safety measures being utilized? (Mats, spills immediately cleaned, 18" rule, etc.)
-
Are cells free of clutter?
-
Are means of egress clear to exit?
-
Is the area clear of slips, trips, and fall hazards?
Maintenance
-
Are there any obvious maintenance issues?
-
Who will be submitting the maintenance request form?
Security
-
Are containers (cleaning supplies) properly labeled and secured?
-
Are inmates in cells visible? (Nothing should be hanging over the bottom bunk or over toilet area obstructing the view).
-
Is anything hanging from the bars, i.e., clothes lines, trash bags, clothing, etc.?
-
Is the main Pod door secure? Are cell doors secure?
-
Have unnecessary security threats been removed from the area?
2C
Sanitation
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Are cell bars, windows, window sills, etc. clean/dust free?
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Are vents free of dust/grime? Are surrounding areas dust free?
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Has trash been taken out? Are trash cans clean inside/out?
-
Are the floors clean?
-
Have appliances been wiped down?
-
Area not evaluated.
-
Critical Issue.
-
Needs Attention.
-
Keep at this standard or better.
-
Showers are exemplary.
Safety/Fire Safety
-
Is safety equipment easily accessible? Fire extinguishers, pull stations, PPE, first aid kit, etc.
-
Are wet floor signs and other safety measures being utilized? (Mats, spills immediately cleaned, 18" rule, etc.)
-
Are cells free of clutter?
-
Are means of egress clear to exit?
-
Is the area clear of slips, trips, and fall hazards?
Maintenance
-
Are there any obvious maintenance issues?
-
Who will be submitting the maintenance request form?
Security
-
Are containers (cleaning supplies) properly labeled and secured?
-
Are inmates in cells visible? (Nothing should be hanging over the bottom bunk or over toilet area obstructing the view).
-
Is anything hanging from the bars, i.e., clothes lines, trash bags, clothing, etc.?
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Is the main Pod door secure? Are cell doors secure?
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Have unnecessary security threats been removed from the area?
Sign Off
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Inspector's Signature