Title Page

  • Site conducted

  • Store Name

  • Store Number

  • Conducted on

  • Prepared by

  • Location

Customer Toilets

  • Please confirm and take photos showing there are none of the below Initial items on site.

  • Soap dispensers

  • Photo of soap dispensers

  • Toilet roll dispensers

  • Photo of toilet roll dispensers

  • Air fresheners

  • Photo of air fresheners

  • Sanitary bins

  • Photo of sanitary bins

Kitchen

  • Please confirm and take photos showing there are none of the below Initial items on site.

  • Kitchen - paper towel dispensers

  • Photo of paper towel dispensers

Staff Toilets

  • Please confirm and take photos showing there are none of the below Initial items on site.

  • Soap dispensers

  • Photo of soap dispensers

  • Toilet roll dispensers

  • Photo of toilet roll dispensers

  • Air fresheners

  • Photo of air fresheners

  • Sanitary bins

  • Photo of sanitary bins

Sign off

  • Area Manager Signature

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.