Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Action plans

  • Has previous identified actions been submitted and closed out

Safety

  • No smoking sticker present?

  • Evacuation plan and procedure installed and current?

  • No evidence of smoking. Any damage has been reported to supervisor?

Safety comments

Operations

  • Bed has been made well?

  • All floor area has been swept, moped and scrubbed where necessary?

  • Clean hand basin?

  • Shower curtain changed as required?

  • Toilet has been cleaned well, including S bend and seat?

  • Ensure all breezeways/balcony/hallways/rubbish collection points and pathways are clean, maintained and free from debris?

  • Rubbish bin has been emptied, bin liner replaced?

  • Air freshener has been used?

  • Has back of door sign off sheet been completed correctly?

  • Toilet paper/paper towelling has been refilled with spares available?

  • External ashtrays emptied as required?

Operations comments

Other / Overall Comments

Sign off

  • ESS representative

  • Bechtel representative

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.