TC Audit

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

KITCHEN AREA

• Bins

  Yes

  No

  N/A

• Sinks, Taps and Work Surfaces

  Yes

  No

  N/A

• Inside Cupboards

  Yes

  No

  N/A

• Doors

  Yes

  No

  N/A

• Walls

  Yes

  No

  N/A

• Floor including Edges and Corners

  Yes

  No

  N/A

RECEPTION AND MEETING ROOMS

• Bins

  Yes

  No

  N/A

• Workspace/Desks

  Yes

  No

  N/A

• Telephones/Computers/Light Switches/Picture Frames/

  Yes

  No

  N/A

• Tables and Chairs including Legs

  Yes

  No

  N/A

• Doors

  Yes

  No

  N/A

• Windows & Frames

  Yes

  No

  N/A

• Walls

  Yes

  No

  N/A

• Floor including Edges and Corners

  Yes

  No

  N/A

• Inside Cupboards (As Requested Only)

  Yes

  No

  N/A

SURGERIES AND DECONTAMINATION ROOM

• Bins (Not Medical Waste Bin)

  Yes

  No

  N/A

• General Surfaces (Not Medical Equipment)

  Yes

  No

  N/A

• Telephones/Computers/Light Switches/Picture Frames/

  Yes

  No

  N/A

• Sinks and Taps

  Yes

  No

  N/A

• Doors

  Yes

  No

  N/A

• Windows & Frames

  Yes

  No

  N/A

• Walls

  Yes

  No

  N/A

• Floor including Edges and Corners

  Yes

  No

  N/A

• Inside Cupboards (As Requested Only)

  Yes

  No

  N/A

• Auditor Signature

  Sign

• Customer Signature

  Sign