Pre-clean general condition?

  • Please enter arrival time

  • Internal conditions?

  • Add media

  • External conditions?

  • Add media

  • Are the specified works able to be completed without obstructions?

2.0 - Health and Safety in the working Enviroment.

  • Are adequate precautions taken to prevent injury through manual handling?

  • Are adequate precautions taken to prevent injury through slips trips and falls?

  • 2.1 - Evacuation plan displayed and understood?

  • 2.8 - Adequate direction notices for fire exits?

  • 2.10 - Are Fire Exits clear of obstructions?

  • Have all reasonable precautions been taken to protect staff/contractors?

3.0 - General Lighting

  • 3.1 - Good natural lighting?

  • 3.3 - is lighting adequate to complete works?

4.0 - Building Condition

  • Are all areas to be worked on free from pre- existing damage?

  • Stair and storage areas kept clear?

Scope of works

  • Are works to site as specified?

  • Additional works requested by site staff?

  • Specify works requested

  • Can we continue with additional works within time constraints?

  • Additional works completed to site

  • Add media

Post clean results

  • Add media

Sign Off

  • On site representative

  • Technicians Signature

  • Please enter departure time

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. Any ratings or scores displayed in our Public Library have not been verified by SafetyCulture for accuracy. Users of our platform may provide a rating or score that is incorrect or misleading. You should independently determine whether the template is suitable for your circumstances. You can use our Public Library to search based on criteria such as industry and subject matter. Search results are based on their relevance to your search and other criteria. We may feature checklists based on subject matters we think may be of interest to our customers.