Title Page
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Site
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Conducted on (Date and Time)
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Employee's Full Name
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Manager/Supervisor's Full Name
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Location
General
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Sweep and mop floor
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Wipe dry the sink, faucet, and countertop
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Dust baseboards, wall tile, and wainscoting
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Remove all items from the countertop
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Clean mirrors, remove spots and streaks
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Dust the frames
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Wipe light switches, door knobs and the areas around them
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Dust corners and check the ceiling for cobwebs
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Empty trash bins
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Check grout lines and scrub any grungy spots with a toothbrush or angled grout brush
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Check for leaks (water supply hoses, shut off valves, and exposed plumbing pipes)
Shower
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Clean the soap dish
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Check drains and remove any hair that would otherwise cause clogs in the future
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Clean and dry the shower/tub stall
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Wash shower doors/curtain
Toilet
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Wipe toilet handle and seat
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Disinfect toilet sides and base for urine drips
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Check flush if in good working condition
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Check bidet if in good working condition
Accessories
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Replace used towels
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Refill toilet paper and tissue boxes
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Replace bathmats
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Replace used bathroom toiletries
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Replace or refill any scent dispensers you may use
Completion
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Recommendation
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Employee's Full Name and Signature
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Inspector's Full Name and Signature