Title Page
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Site conducted
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Work Area / Job
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Conducted on
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Conducted by Stanwell Employee
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Conducted by UGL Employee
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Do the works being executed align with details of the corresponding service scope - Refer Scope
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Are urinals, toilets, showers and wash basins clean, disinfected, free of discoloration and debris, and adequately stocked with consumables?
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Are all floors absent of dirt, stains, visible dust & debris, watermarks and streaks from mopping?
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Are all hard surfaces, benches and tables clean, disinfected and free of watermarks, stains and debris?
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Are kitchens & crib rooms, including fittings (benchtops, splashbacks, sinks, taps, etc) free of dirt, stains, watermarks, and debris?
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Are appliances including fridges, microwaves, dispensers, dishwashers, etc clean, free of dirt, stains, and debris?
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Are kitchens adequately stocked with consumables?
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Are windows, window sills, and window tracks clean and free of dust, dirt, cobwebs, watermarks, and debris?
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Are common areas, meeting rooms, and stairwells clean and free of dirt and debris?
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7 "Yes" out of the above 8 questions is considered a pass for scope alignment (if No - provide details)
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Is the work area safe and/or works being conducted safely?
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Is equipment required to complete these works well maintained and appropriate Personal Protective Equipment (PPE) and Safety Data Sheets (SDS) provided?
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Are work orders relating to this service scope being completed on time and closed out with adequate commentary
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Is the outcome of work area and/or works audited to an acceptable standard?
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Are there any audit actions requiring follow up or rectification?
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All identified issues must provide evidence of compliance by agreed date
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Stanwell Employee
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UGL Employee