Title Page

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

  • Building:

  • Inspector:

  • Room #:

  • Date:

  • Ratings

    Rate each item bell yes or no based on whether or not it's condition meets the standards. For items that are not applicable for a particular area, leave that rating blank.

  • Entry Door

  • Comments

  • Door Hardware

  • Comments

  • Lights

  • Comments

  • HVAC DIffusers

  • Comments

  • Ceiling

  • Comments

  • Walls

  • Comments

  • Windows

  • Comments

  • Blinds/Drapes

  • Comments

  • Pictures

  • Comments

  • Baseboard

  • Comments

  • Floor

  • Comments

  • Chairs/Couches

  • Comments

  • Furniture

  • Comments

  • Ash Trays

  • Comments

  • Waste Receptacle

  • Comments

  • Total Yes

  • Total No

  • Score: (Yes Rating Total✖️100)➗(Yes Rating Total➕No Rating Total) = Score (%)

  • Score =

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.