Ashfield Healthcare Charter Point

• Audit Title

• Prepared by

• Document No.

• Site name

• Conducted on

  Date
• Location
  Address

• Attendees

Reception

• Partition Glass / Internal Glazing

  Good

  Fair

  Poor

  N/A

• Furniture/ Counter Tops

  Good

  Fair

  Poor

  N/A

• Carpet and Hard Flooring

  Good

  Fair

  Poor

  N/A

• Waste Bins

  Good

  Fair

  Poor

  N/A

• Seating

  Good

  Fair

  Poor

  N/A

• Skirting Boards/ Window Sill

  Good

  Fair

  Poor

  N/A

Corridors and Stairs

• Flooring

  Good

  Fair

  Poor

  N/A

• Handrails

  Good

  Fair

  Poor

  N/A

• Handrails

  Good

  Fair

  Poor

  N/A

• Fire Extinguisher

  Good

  Fair

  Poor

  N/A

• Lifts

  Good

  Fair

  Poor

  N/A

• Skirting Boards and Window Cills

  Good

  Average

  Poor

  N/A

Canteen

• Floor surfaces

  Good

  Fair

  Poor

  N/A

• Waste Bins

  Good

  Fair

  Poor

  N/A

• Tables and Chairs

  Good

  Fair

  Poor

  N/A

• Doors and Door Furniture

  Good

  Fair

  Poor

  N/A

• Kitchen Appliances

  Good

  Fair

  Poor

  N/A

• Work Surfaces

  Good

  Fair

  Poor

  N/A

• Sink and Tap

  Good

  Fair

  Poor

  N/A

Ground Floor Meeting Room

• Flooring

  Good

  Fair

  Poor

  N/A

• Furniture

  Good

  Fair

  Poor

  N/A

• Skirting Boards and Window Cills

  Good

  Fair

  Poor

  N/A

• Glazing

  Good

  Fair

  Poor

  N/A

• Waste Bins

  Good

  Average

  Poor

  N/A

Male Washrooms

• Toilet bowls

  Good

  Fair

  Poor

  N/A

• Urinals

  Good

  Fair

  Poor

  N/A

• Rubbish bins

  Good

  Fair

  Poor

  N/A

• Surfaces (including tops of cubicles)

  Good

  Fair

  Poor

  N/A

• Mirrors

  Good

  Fair

  Poor

  N/A

• Hand basins

  Good

  Fair

  Poor

  N/A

• Pipe Work

  Good

  Fair

  Poor

  N/A

• Dryers and dispensers

  Good

  Fair

  Poor

  N/A

• Floor surfaces and floor mats

  Good

  Fair

  Poor

  N/A

• Taps

  Good

  Fair

  Poor

  N/A

Female Washrooms

• Toilet bowls

  Good

  Fair

  Poor

  N/A

• Waste Bins

  Good

  Fair

  Poor

  N/A

• Surfaces (including tops of cubicles)

  Good

  Fair

  Poor

  N/A

• Mirrors

  Good

  Fair

  Poor

  N/A

• Hand basins

  Good

  Fair

  Poor

  N/A

• Pipe work

  Good

  Fair

  Poor

  N/A

• Dryers and dispensers

  Good

  Fair

  Poor

  N/A

• Floor surfaces and floor mats

  Good

  Fair

  Poor

  N/A

• Taps

  Good

  Fair

  Poor

  N/A

Ground Floor Office Space

• Flooring

  Good

  Fair

  Poor

  N/A

• Furniture

  Good

  Fair

  Poor

  N/A

• Skirting Boards and Window Cills

  Good

  Fair

  Poor

  N/A

• Glazing

  Good

  Fair

  Poor

  N/A

• Waste Bins

  Good

  Fair

  Poor

  N/A

First Floor Office

• Flooring

  Good

  Fair

  Poor

  N/A

• Furniture

  Good

  Fair

  Poor

  N/A

• Waste Bins

  Good

  Fair

  Poor

  N/A

• Skirting Boards and Window Cills

  Good

  Fair

  Poor

  N/A

• Glazing

  Good

  Fair

  Poor

  N/A

First Floor Meeting Room

• Flooring

  Good

  Fair

  Poor

  N/A

• Furniture

  Good

  Fair

  Poor

  N/A

• Skirting Boards and Window Cills

  Good

  Fair

  Poor

  N/A

• Waste Bins

  Good

  Fair

  Poor

  N/A

• Glazing

  Good

  Fair

  Poor

  N/A

Cleaning Cupboard

• Tidy

  Good

  Fair

  Poor

  N/A

• COSHH Compliant

  Good

  Fair

  Poor

  N/A

Site Compliance

• Uniform

  Yes

  No

• Site File

  Yes

  No

• General comments and discussions

Assessors signatures

• Property Manager or authorized representative

  Sign

• Contractors representative

  Sign