Title Page

  • Established in 1969, Associated Cleaning Services has a long history of delivering exceptional commercial cleaning services across Queensland. Central to our philosophy in the delivery of service is the incorporation of robust control systems, timely communication and expert industry knowledge to sustain strong relationships with Clients

  • Proper cleaning and sanitising is a key way to protect workers and visitors in workplaces from the risk of exposure to Covid19 and other infectious substances.

  • Regular routine cleaning provides a safer and more pleasing workplace and can contribute to confidence, motivation and pride in the workplace.

  • Conducted on

  • Location
  • Report Number

Declaration and Service Report

Health Declaration

  • Self-declaration records will be used and disclosed for managing site access and as required by law.

  • Are you CURRENTLY experiencing any of the following symptoms? Loss of smell, loss of taste, cough, sore throat, fatigue, aches and pains, shortness of breath, runny or stuffy nose, headaches or raised temperature.

  • Have you been in a declared hotspot area?

  • In the past 14 days have you returned from travel outside of Australia?

  • Have you recently been in contact with someone diagnosed with coronavirus to your knowledge?

  • Are you, or someone you are living with, awaiting a Covid19 test result?

  • Have you been in close contact with someone awaiting the results of COVID-19 testing within the past 14 days?

Attendance

  • What is the site name?

  • What time did you start the service?

  • What time did you finish the service?

Sanitising Cleaning Process

  • Have you read the Safe Work Method Statement 014 Sanitising Cleaning?

  • Did you wear gloves while conducting the sanitising work?

  • Do you use clean disposable cloths to sanitise surfaces?

  • To sanitise correctly, the surface must be cleaned immediately before applying sanitising chemical. Have you cleaned the surfaces to be sanitised?

  • Effective sanitisation requires the use of approved chemical, used in the correct dilution rate and allowed to dwell on the surface for the correct amount of time. Have you used the sanitising chemical correctly according to the manufacturers instructions for sanitising?

  • Did you either dispose of or wash out (with warm water) cleaning cloths at the completion of service?

  • Did you remove all waste at the completion of service?

Sanitising Requirements

  • Cleaning and sanitising to prevent the spread of disease requires routine environmental cleaning. It is good practice to routinely clean surfaces. Frequently touched surfaces should be cleaned daily or more frequently depending on the nature of the workplace (e.g. shift changes, shared facilities). Minimally touched surfaces (floors, ceilings, walls, blinds etc) should be routinely cleaned. In addition, surfaces should be cleaned immediately after any spillage or where visibly soiled.

  • Have you cleaned and sanitised frequently touched surfaces?

  • With reference to the Worksheet, have you completed all the duties requested?

Declaration

  • By signing this report I declare that I have followed the procedures for sanitising cleaning, that I have completed the work requested in the Worksheet and that I have truthfully answered all questions herein.

  • Name and signature of Cleaner

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.