Title Page

  • Willingboro Urgent Care

  • Date and Time of Inspection

  • Inspected by

Offices, Waiting Area, Patient Rooms, Vestibule

  • Stock towels, tissue, and hand soap

  • Empty all trash receptacles and replace liners as needed

  • Remove trash to a collection point

  • Clean and polish drinking fountain/water cooler

  • Thoroughly dust all horizontal surfaces, including desktops, files, windowsills, chairs, tables, pictures, and all manner of furnishings

  • Damp wipe all horizontal surfaces to remove coffee rings and spillage

  • Dust telephones

  • Dust mop hard surface floors with a treated dust mop

  • Damp mop hard surface floors to remove any spillage from soiled areas

  • Damp wipe entryway and clean fingerprints from entrance glass

  • Spot clean partition glass

  • Inspect building entrance area

Restrooms

  • Stock towels, tissue, and hand soap

  • Empty sanitary napkin receptacles and wipe with a disinfectant

  • Empty trash receptacles and wipe

  • Clean and polish mirrors

  • Wipe towel cabinet covers

  • Toilets and urinals are cleaned and sanitized inside and outside

  • Toilet seats are cleaned on both sides using a disinfectant

  • Scour and sanitize all basins

  • Dust partitions, top of mirrors and frames

  • Remove splash marks from walls around basins

  • Mop and rinse restroom floors with a disinfectant

Lunchroom

  • Stock towels, tissue, and hand soap

  • All trash receptacles are emptied and trash removed to a collection point

  • Dust mop hard surface floors with a treated dust mop

  • Damp mop hard surface floors to remove spillage from soiled areas

  • Clean and wipe tables and chairs

  • Spot clean walls near trash receptacles

  • Clean fronts, tops, and sides of trash receptacles with a disinfectant

  • Clean and polish drinking fountain/water cooler

  • Damp wipe countertops to remove coffee rings and spillage

  • Clean and sanitize sink

  • Spot clean cabinets and exterior of appliances to present a neat appearance

Completion

  • Recommendations

  • Inspector's Full Name and Signature

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