Title Page

  • Conducted on

  • Prepared by

  • Location
  • EH Practitioner

  • Community

  • Date

  • House address

  • Number of people living in house at time of inspection

  • Shower taps

  • Hot tap

  • Action

  • Cold tap

  • Action

  • Hot water flow

  • Action

  • Cold water flow

  • Action

  • Shower rose works

  • Action

  • Shower drain works

  • Action

  • Grate

  • Action

  • Shower Soap holder

  • Action

  • Hand basin

  • Action

  • Basin is safe

  • Action

  • Basin taps

  • Hot tap

  • Action

  • Cold tap

  • Action

  • Hot water flow

  • Action

  • Cold water flow

  • Action

  • Basin cabinet is present

  • Cabinet is functional

  • Action

  • Basin drain works

  • Action

  • Floor surface

  • Floor waste

  • Action

  • Grate

  • Action

  • Floor waste works

  • Action

  • Mirror present

  • Action

  • Mirror is safe

  • Kids can see their face

  • Towel rail / hooks

  • Action

  • Towels can be hung up

  • Towels can be hung seperately

  • Is there a shower screen

  • Action

  • Does it work

  • Action

  • It is clean

Soap was present

  • In the Shower

  • At the Basin

  • How many people use this bathroom ?

  • Does everyone have their own towel ?

  • Can each towel be hung up in the bathroom ?

  • Did you install towel hangers or towel rails ?

  • How many towels given to this house ?

  • How many bars of soap given to this house ?

  • Are soap holders installed

  • How many soap holders

  • New mirror installed ?

  • Face and Hand washing sticker in place?

  • Did you replace the Face and Hand washing sticker?

  • Did you have a conversation about Face and Hand washing?

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