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• Document No.

• Audit Title

• Add client here

• Conducted on

  Date
• Location
  Address

Main Reception

• Entrance glass

  Excellent

  Acceptable

  Average

  Below Average

  N/A

• Floors and edges

  Excellent

  Acceptable

  Average

  Below Average

  N/A

• Reception desk

  Excellent

  Acceptable

  Average

  Below Average

  N/A

• Internal glass

  Excellent

  Acceptable

  Average

  Below Average

  N/A

• Window ledges & skirting boards

  Excellent

  Acceptable

  Average

  Below Average

  N/A

• Carpets vacuumed and spot cleaned

  Excellent

  Acceptable

  Average

  Below Average

  N/A

• Walls and power points

  Excellent

  Acceptable

  Average

  Below Average

  N/A

• Computer backs phones keyboards lifted

  Excellent

  Acceptable

  Average

  Below Average

  N/A

• Bins emptied, cleaned and have clean liners

  Excellent

  Acceptable

  Average

  Below Average

  N/A

• Cobwebs

  Excellent

  Acceptable

  Average

  Below Average

  N/A

Men's Toilets

• Toilet bowls, seats, urinals & cisterns

  Excellent

  Acceptable

  Average

  Below Average

  N/A

• Doors, vents and behind

  Excellent

  Acceptable

  Average

  Below Average

  N/A

• Windows, ledges, grills

  Excellent

  Acceptable

  Average

  Below Average

  N/A

• High dusting of cubicles

  Excellent

  Acceptable

  Average

  Below Average

  N/A

• Benches, sink, cupboards etc

  Excellent

  Acceptable

  Average

  Below Average

  N/A

• Consumables

  Excellent

  Acceptable

  Average

  Below Average

  N/A

• Showers

  Excellent

  Acceptable

  Average

  Below Average

  N/A

• Walls

  Excellent

  Acceptable

  Average

  Below Average

  N/A

• Grout on tiles

  Excellent

  Acceptable

  Average

  Below Average

  N/A

• Bins emptied, clean and reclined

  Excellent

  Acceptable

  Average

  Below Average

  N/A

• Cobwebs

  Excellent

  Acceptable

  Average

  Below Average

  N/A

Ladies Toilets

• Toilet bowls, seats & cisterns

  Excellent

  Acceptable

  Average

  Below Average

  N/A

• Doors, vents and behind

  Excellent

  Acceptable

  Average

  Below Average

  N/A

• Windows, ledges, grills

  Excellent

  Acceptable

  Average

  Below Average

  N/A

• High dusting of cubicles

  Excellent

  Acceptable

  Average

  Below Average

  N/A

• Benches, sink, cupboards etc

  Excellent

  Acceptable

  Average

  Below Average

  N/A

• Consumables

  Excellent

  Acceptable

  Average

  Below Average

  N/A

• Showers

  Excellent

  Acceptable

  Average

  Below Average

  N/A

• Walls

  Excellent

  Acceptable

  Average

  Below Average

  N/A

• Grout on tiles

  Excellent

  Acceptable

  Average

  Below Average

  N/A

• Bins emptied, clean and relined

  Excellent

  Acceptable

  Average

  Below Average

  N/A

• Cobwebs

  Excellent

  Acceptable

  Average

  Below Average

  N/A

Office Areas

• Carpets vacuumed and spot cleaned

  Excellent

  Acceptable

  Average

  Below Average

  N/A

• Hard floors and edges

  Excellent

  Acceptable

  Average

  Below Average

  N/A

• Computer backs, phones are wiped and key boards lifted (where allowed)

  Excellent

  Acceptable

  Average

  Below Average

  N/A

• Desks and shelves etc (where cleared)

  Excellent

  Acceptable

  Average

  Below Average

  N/A

• Partitions are dust free

  Excellent

  Acceptable

  Average

  Below Average

  N/A

• Window and ledges

  Excellent

  Acceptable

  Average

  Below Average

  N/A

• Doors and handles

  Excellent

  Acceptable

  Average

  Below Average

  N/A

• Walls

  Excellent

  Acceptable

  Average

  Below Average

  N/A

• Bins clean and have clean liners

  Excellent

  Acceptable

  Average

  Below Average

  N/A

• Cobwebs

  Excellent

  Acceptable

  Average

  Below Average

  N/A

• Stairs and lifts are clean

  Excellent

  Acceptable

  Average

  Below Average

  N/A

Kitchen / Staffroom

• Bench tops and splash back

  Excellent

  Acceptable

  Average

  Below Average

  N/A

• Tops and front of fridge & Microwave clean& dust free

  Excellent

  Acceptable

  Average

  Below Average

  N/A

• Sink is clean and free of tea/ coffee stains

  Excellent

  Acceptable

  Average

  Below Average

  N/A

• Cupboards are clean

  Excellent

  Acceptable

  Average

  Below Average

  N/A

• Rubbish bin is clean with clean bin liner if required

  Excellent

  Acceptable

  Average

  Below Average

  N/A

• Hard floors and edges

  Excellent

  Acceptable

  Average

  Below Average

  N/A

• External furniture cleaned

  Excellent

  Acceptable

  Average

  Below Average

  N/A

• Stairs are clean

  Excellent

  Acceptable

  Average

  Below Average

  N/A

Presentation, equipment and commutation

• Equipment in good condition

  Excellent

  Acceptable

  Average

  Below Average

  N/A

• Equipment test and tag is in date

  Excellent

  Acceptable

  Average

  Below Average

  N/A

• SDS booklet

  Excellent

  Acceptable

  Average

  Below Average

  N/A

• Chemicals are used correctly

  Excellent

  Acceptable

  Average

  Below Average

  N/A

• Chemicals are stored correctly

  Excellent

  Acceptable

  Average

  Below Average

  N/A

• Uniforms are clean and tidy

  Excellent

  Acceptable

  Average

  Below Average

  N/A

• Communication book is present and used correctly

  Excellent

  Acceptable

  Average

  Below Average

  N/A

• Have periodicals been completed as outlined in periodical table (if aplicable)

  Excellent

  Acceptable

  Average

  Below Average

  N/A

• Client to Sign

  Sign

• Auditor to sign

  Sign