Information

  • Proprietor

  • Business Name & address

  • Proprietor email:

  • Council Registration No.

  • Conducted on

  • Prepared by

  • Location
  • Personnel

GENERAL PREMISES PHOTOS

  • Add media

BEDROOMS

  • Do no. of occupants comply re overcrowding?

  • Are bedrooms clean & in good repair?

  • Are bedrooms (and any attached ensuites) cleaned before re-use?

  • Is bed linen provided?

  • Is the bed linen changed at least weekly and after re-use?

AMENITIES

Ensuites

  • Are ensuites clean & in good repair?

Bathrooms

  • Are toilets & bathrooms clean & in good repair?

  • Are toilet & bathing facilities at the premises adequate?

Laundry

  • Is the laundry clean & in good repair?

KITCHEN

  • Is kitchen clean & in good repair?

COMMON AREAS

  • Are common areas clean & in good repair?

WATER/WASTEWATER

  • Is there adequate hot & cold water facilities?

  • Is there adequate clean drinking water?

  • Is all sewage & waste water discharged to sewer?

  • Are stormwater guttering, down pipes etc in good condition and connected to legal point of discharge?

REFUSE/WASTE MANAGEMENT

  • Are refuse receptacles sufficient & clean?

  • Is refuse disposed of regularily?

OUTSIDE AREAS

  • Are lawns & gardens well maintained?

  • Are there any outbuildings, garages, sheds etc?

  • Are these structures in good condition?

  • Are any outbuildings being occupied?

  • Are these outbuildings approved for occupancy?

ADDITIONAL

  • Is there a register of occupants?

  • Other comments

ITEMS REQUIRING ATTENTION

    Item

FOLLOW-UP INSPECTION

  • Is a follow-up inspection required?

  • Follow-up inspection scheduled for:

SIGN OFF

  • On site representative

  • Add drawing

  • Officer's signature

  • Add drawing

  • Public Health Unit ph: 9518 3539

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.