Title Page

  • Document No.

  • PUBLIC / STAFF TOILET CLEANING AUDIT

  • WARD / AREA / DEPARTMENT

  • Conducted on

  • Prepared by

  • Location
  • Personnel

  • TOILET AUDITED

  • TOILET CLEANED AM?

  • TIME CLEANED AM.

  • TOILET CLEANED PM?

  • TIME CLEANED PM.

  • TOILET CLEANED EVE?

  • TIME CLEANED EVE.

  • TOILET CLEANED OTHER.

  • TIME CLEANED OTHER.

  • IS THE ENVIRONMENT CLEANED SATISFACTORILY

  • HAVE ANY DAYS BEEN MISSED IN THE LAST WEEK

COMMENTS AND SIGN-OFF

  • PHOTOGRAPHIC EVIDENCE

  • COMMENTS

  • SIGN-OFF

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