Title Page
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Site conducted
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Conducted on
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Prepared by
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Location
NC Quality Control Inspection Score For Total Facility
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General dusting & disinfecting
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Hard surface floors
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Vacuuming
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Trash
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Restrooms
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Overall
General Cleaning-Entry and Offices
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Entry Doors Clean Inside and Outside
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Furniture Clean
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Free of Cobwebs
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Are Floors Clean
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Offices/Entry free of Dust
Rest Rooms
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Floors Clean
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Toilets/Urinals Cleaned
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Mirrors Clean
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Counters and Sinks Clean
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Supplies Filled
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Partitions Clean
Conference and/or Board Room
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Conference table Clean
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Floors are Clean
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Free of Dust/cobwebs
Break/Lunch Room/Kitchen
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Refrigerator Clean
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Microwave Clean
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Tables and Chairs Clean
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Floors Clean
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Counters and sinks Clean
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Free of Dust
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Supplies filled
Stairwells & halls
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Floors Clean in halls
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Free of Dust/Cobwebs
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Floors clean in stairwells
Elevators
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Steel and walls clean and no Handprints
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Floors Clean
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Tracks Clean