Title Page
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
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Property/ building
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Inspector:
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Restroom location:
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Date:
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Ratings
Rate each item below 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 clean
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Comments
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Lights clean/ free of dust
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Comments
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Vent free of dust
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Comments
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Ceiling free of dust
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Comments
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Walls clean
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Comments
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Mirrors clean
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Comments
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Towel Holders fully stocked
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Comments
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Sinks/Fixtures clean and working
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Comments
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Soap Dispensers working and full.
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Comments
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Stalls clean
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Comments
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Urinals clean.
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Comments
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Floor clean / free of debris
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Comments
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Waste Receptacle clean/ empty
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Comments
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Total Yes
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Total No
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Score:
(Yes Rating Total✖️100)➗(Yes Rating Total➕No Rating Total) = Score (%) -
Score =
