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Title Page
Cleaning Inspection Site
Location
Date and Time of Inspection
Inspected By
INSTRUCTIONS: ------------------------------------- 1. Answer the applicable questions. 2. Click Add photos and notes. 3. To add a Corrective Measure click on "Add Action", provide a description, assign to a member, set priority and due date. 4. Complete audit by providing digital signature. 5. Share your report by exporting as PDF, Word, Excel or Web Link.
What area are you going to inspect?
Administration
Dementia Level 2
Level 2 South Rm
Level 2 North Rm
Level 3 South Rm
Level 3 South Continued
Level 3 North Rm
Level 1
General Safety and Environment
ADMINISTRATION
Entry
Inspected
Floors
Walls
Doors
Sills
Railings
Skirts
Furnishings
Vents/Fans
Glass
Safety Environment
Trip Hazards
Wet Floors/Spills
Lounge
Inspected
Floors
Walls
Doors
Sills
Railings
Skirts
Furnishings
Vents/Fans
Glass
Bins
Safety Environment
Trip Hazards
Wet Floors/Spills
Offices (3)
Inspected
Floors
Walls
Doors
Sills
Railings
Skirts
Furnishings
Vents/Fans
Bins
Safety Environment
Trip Hazards
Wet Floors/Spills
Reception
Inspected
Floors
Walls
Doors
Sills
Railings
Skirts
Furnishings
Vents/Fans
Bins
Safety Environment
Trip Hazards
Wet Floors/Spills
Copy Room
Inspected
Floors
Walls
Doors
Skirts
Furnishings
Vents/Fans
Bins
Safety Environment
Trip Hazards
Wet Floors/Spills
Visitors Toilets
Inspected
Floors
Walls
Doors
Furnishings
Vents/Fans
Bins
Sinks
Toilet
Mirror
Safety Environment
Trip Hazards
Wet Floors/Spills
Lift
Inspected
Floors
Walls
Doors
Railings
Safety Environment
Trip Hazards
Wet Floors/Spills
Courtyard
Inspected
Floors
Safety Environment
Trip Hazards
Wet Floors/Spills
Passageways
Inspected
Floors
Walls
Doors
Railings
Skirts
Furnishings
Vents/Fans
Safety Environment
Trip Hazards
Wet Floors/Spills
DEMENTIA LEVEL 2
Passageways
Inspected
Floors
Walls
Doors
Railings
Skirts
Furnishings
Vents/Fans
Bins
Safety Environment
Trip Hazards
Wet Floors/Spills
Dining Room
Inspected
Floors
Walls
Sills
Skirts
Furnishings
Vents/Fans
Bins
Safety Environment
Trip Hazards
Wet Floors/Spills
Nurses Station
Inspected
Floors
Walls
Doors
Skirts
Furnishings
Vents/Fans
Safety Environment
Trip Hazards
Wet Floors/Spills
Pan Room
Inspected
Floors
Walls
Doors
Furnishings
Vents/Fans
Bins
Sinks
Safety Environment
Trip Hazards
Wet Floors/Spills
Lounge
Inspected
Floors
Walls
Doors
Sills
Skirts
Furnishings
Vents/Fans
Glass
Safety Environment
Trip Hazards
Wet Floors/Spills
Servery No
Inspected
Safety Environment
Trip Hazards
Wet Floors/Spills
Courtyard
Inspected
Floors
Safety Environment
Trip Hazards
Wet Floors/Spills
Room
Click "Add Room Number"
Room Number
Inspected
Floors
Walls
Doors
Sills
Furnishings
Skirts
Vents/Fans
Bins
Sinks
Toilet
Shower
Mirror
Safety Environment
Trip Hazards
Wet Floors/Spills
LEVEL 2 SOUTH ROOM
Passageways
Inspected
Floors
Walls
Doors
Sills
Railings
Skirts
Furnishings
Vents/Fans
Glass
Bins
Sinks
Safety Environment
Trip Hazards
Wet Floors/Spills
Dining Room
Inspected
Floors
Walls
Sills
Skirts
Furnishings
Vents/Fans
Bins
Safety Environment
Trip Hazards
Wet Floors/Spills
Servery No
Inspected
Safety Environment
Trip Hazards
Wet Floors/Spills
Bathroom
Inspected
Floors
Walls
Doors
Skirts
Vents/Fans
Bins
Sinks
Toilet
Safety Environment
Trip Hazards
Wet Floors/Spills
Room
Click "Add Room Number"
Room Number
Inspected
Floors
Walls
Doors
Sills
Furnishings
Skirts
Vents/Fans
Bins
Sinks
Toilet
Shower
Mirror
Safety Environment
Trip Hazards
Wet Floors/Spills
LEVEL 2 NORTH ROOM
Passageways
Inspected
Floors
Walls
Doors
Sills
Railings
Skirts
Furnishings
Vents/Fans
Glass
Bins
Sinks
Toilet
Safety Environment
Trip Hazards
Wet Floors/Spills
Treatment Room
Inspected
Floors
Walls
Doors
Skirts
Furnishings
Vents/Fans
Bins
Sinks
Safety Environment
Trip Hazards
Wet Floors/Spills
Nurses Station
Inspected
Floors
Walls
Doors
Railings
Skirts
Furnishings
Vents/Fans
Bins
Safety Environment
Trip Hazards
Wet Floors/Spills
Dining Room
Inspected
Floors
Walls
Doors
Sills
Skirts
Furnishings
Vents/Fans
Glass
Bins
Safety Environment
Trip Hazards
Wet Floors/Spills
Servery No
Inspected
Safety Environment
Trip Hazards
Wet Floors/Spills
Lift
Inspected
Floors
Walls
Doors
Railings
Furnishings
Vents/Fans
Safety Environment
Trip Hazards
Wet Floors/Spills
Balconies
Inspected
Floors
Safety Environment
Trip Hazards
Wet Floors/Spills
Public Toilet
Inspected
Floors
Walls
Doors
Furnishings
Vents/Fans
Bins
Sinks
Toilet
Mirror
Safety Environment
Trip Hazards
Wet Floors/Spills
Store
Inspected
Floors
Walls
Doors
Safety Environment
Trip Hazards
Wet Floors/Spills
Lounge
Inspected
Floors
Walls
Doors
Sills
Railings
Skirts
Furnishings
Vents/Fans
Glass
Bins
Safety Environment
Trip Hazards
Wet Floors/Spills
Pan Room
Inspected
Floors
Walls
Doors
Skirts
Furnishings
Vents/Fans
Glass
Bins
Sinks
Toilet
Shower
Mirror
Safety Environment
Trip Hazards
Wet Floors/Spills
Office
Inspected
Floors
Walls
Doors
Railings
Skirts
Furnishings
Vents/Fans
Glass
Bins
Safety Environment
Trip Hazards
Wet Floors/Spills
Room
Click "Add Room Number"
Room Number
Inspected
Floors
Walls
Doors
Sills
Furnishings
Skirts
Vents/Fans
Bins
Sinks
Toilet
Shower
Mirror
Safety Environment
Trip Hazards
Wet Floors/Spills
LEVEL 3 SOUTH ROOM
Passageways
Inspected
Floors
Walls
Doors
Sills
Railings
Skirts
Furnishings
Vents/Fans
Glass
Bins
Sinks
Safety Environment
Trip Hazards
Wet Floors/Spills
Dining Room
Inspected
Floors
Walls
Sills
Skirts
Furnishings
Vents/Fans
Bins
Safety Environment
Trip Hazards
Wet Floors/Spills
Lounge
Inspected
Floors
Walls
Sills
Skirts
Furnishings
Vents/Fans
Safety Environment
Trip Hazards
Wet Floors/Spills
Lift O/S
Inspected
Walls
Doors
Safety Environment
Trip Hazards
Wet Floors/Spills
Physio Room
Inspected
Floors
Walls
Doors
Safety Environment
Trip Hazards
Wet Floors/Spills
Servery No
Inspected
Safety Environment
Trip Hazards
Wet Floors/Spills
Treatment Room
Inspected
Floors
Walls
Doors
Furnishings
Vents/Fans
Bins
Sinks
Safety Environment
Trip Hazards
Wet Floors/Spills
Nurses Station (2)
Inspected
Floors
Walls
Skirts
Furnishings
Vents/Fans
Bins
Safety Environment
Trip Hazards
Wet Floors/Spills
Bathroom (2)
Inspected
Floors
Walls
Doors
Skirts
Vents/Fans
Glass
Bins
Sinks
Toilet
Safety Environment
Trip Hazards
Wet Floors/Spills
Stairs (2)
Inspected
Floors
Walls
Doors
Sills
Railings
Glass
Toilet
Safety Environment
Trip Hazards
Wet Floors/Spills
LEVEL 3 SOUTH CONTINUED
Pan Room
Inspected
Floors
Walls
Doors
Vents/Fans
Bins
Sinks
Safety Environment
Trip Hazards
Wet Floors/Spills
Store Room
Inspected
Floors
Walls
Doors
Safety Environment
Trip Hazards
Wet Floors/Spills
Room
Click "Add Room Number"
Room Number
Inspected
Floors
Walls
Doors
Sills
Furnishings
Skirts
Vents/Fans
Bins
Sinks
Toilet
Shower
Mirror
Safety Environment
Trip Hazards
Wet Floors/Spills
LEVEL 3 NORTH ROOM
Passageways
Inspected
Floors
Walls
Doors
Sills
Railings
Skirts
Furnishings
Vents/Fans
Glass
Bins
Sinks
Safety Environment
Trip Hazards
Wet Floors/Spills
Dining Room
Inspected
Floors
Walls
Sills
Skirts
Furnishings
Vents/Fans
Bins
Safety Environment
Trip Hazards
Wet Floors/Spills
Lounge
Inspected
Floors
Walls
Sills
Skirts
Furnishings
Vents/Fans
Bins
Safety Environment
Trip Hazards
Wet Floors/Spills
Pan Room
Inspected
Floors
Walls
Doors
Vents/Fans
Safety Environment
Trip Hazards
Wet Floors/Spills
Salon
Inspected
Floors
Walls
Doors
Sills
Skirts
Vents/Fans
Glass
Safety Environment
Trip Hazards
Wet Floors/Spills
Lift O/S
Inspected
Walls
Doors
Skirts
Safety Environment
Trip Hazards
Wet Floors/Spills
Physio Room
Inspected
Floors
Walls
Doors
Safety Environment
Trip Hazards
Wet Floors/Spills
Balconies (2)
Inspected
Floors
Safety Environment
Trip Hazards
Wet Floors/Spills
Servery No
Inspected
Safety Environment
Trip Hazards
Wet Floors/Spills
Bathroom
Inspected
Floors
Walls
Doors
Skirts
Vents/Fans
Bins
Sinks
Toilet
Safety Environment
Trip Hazards
Wet Floors/Spills
Store Room
Inspected
Floors
Walls
Doors
Safety Environment
Trip Hazards
Wet Floors/Spills
Room
Click "Add Room Number"
Room Number
Inspected
Floors
Walls
Doors
Sills
Furnishings
Skirts
Vents/Fans
Bins
Sinks
Toilet
Shower
Mirror
Safety Environment
Trip Hazards
Wet Floors/Spills
LEVEL 1
Passageways
Inspected
Floors
Walls
Doors
Sills
Railings
Skirts
Furnishings
Vents/Fans
Glass
Safety Environment
Trip Hazards
Wet Floors/Spills
Staff Room
Inspected
Floors
Walls
Doors
Sills
Skirts
Furnishings
Vents/Fans
Glass
Bins
Sinks
Safety Environment
Trip Hazards
Wet Floors/Spills
Outside Kitchen
Inspected
Floors
Walls
Doors
Sills
Safety Environment
Trip Hazards
Wet Floors/Spills
Smokers Area
Inspected
Floors
Walls
Doors
Sills
Furnishings
Glass
Bins
Safety Environment
Trip Hazards
Wet Floors/Spills
Loading Dock
Inspected
Floors
Walls
Doors
Safety Environment
Trip Hazards
Wet Floors/Spills
Holding Room
Inspected
Floors
Walls
Doors
Safety Environment
Trip Hazards
Wet Floors/Spills
Store Rooms (3)
Inspected
Floors
Walls
Doors
Safety Environment
Trip Hazards
Wet Floors/Spills
Male Toilet
Inspected
Floors
Walls
Doors
Furnishings
Vents/Fans
Bins
Sinks
Toilet
Shower
Mirror
Safety Environment
Trip Hazards
Wet Floors/Spills
Female Toilet
Inspected
Floors
Walls
Doors
Furnishings
Vents/Fans
Bins
Sinks
Toilet
Shower
Mirror
Safety Environment
Trip Hazards
Wet Floors/Spills
Locker Room
Inspected
Floors
Walls
Doors
Furnishings
Vents/Fans
Safety Environment
Trip Hazards
Wet Floors/Spills
Lift O/S
Inspected
Walls
Doors
Furnishings
Safety Environment
Trip Hazards
Wet Floors/Spills
Carpets All Levels
Inspected
Floors
Safety Environment
Trip Hazards
Wet Floors/Spills
GENERAL SAFETY AND ENVIRONMENT
Chemical Management
Stored correctly (In ventilated area) away from drains
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