Employee Name:

Restroom Location:

Date Marked:
Time Marked:

Cleaning Type

Date Inspected:
Time Inspected:
Yes = Completely Removed / No = Appeared Untouched

1. Bathroom Light Switch

2. Bathroom Door Handle

3. Counter Top

4. Faucet Handle

5. Bathroom Handhold

6. Baby Changing Station

7. Stall Handle

8. Toilet Plumbing

9. Toilet Seat

10. Auto Hand Dryer

Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.