COVER
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
REST ROOM
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Building
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Room number or designation
REST ROOM USE
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Rest room size is SUITABLE FOR THE NUMBER of USERS
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Rest room ARRANGEMENT is suitable FOR THE NUMBER OF USERS
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Comments on use of rest room facilities
ROOM FEATURES
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Rest room can be SECURED
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Rest room has suitable VENTILATION
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Rest room has suitable MAINS HEATING
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Rest room has suitable SUPPLEMENTARY HEATING
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Rest room users have suitable access to a TELEPHONE
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Rest room has suitable NATURAL LIGHTING
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Rest room has suitable ARTIFICIAL LIGHTING
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Rest room has a suitable FLOOR COVERING
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Report any negative features of the FLOOR COVERING
- NOT SUITABLE
- NOT CLEANABLE
- NOT CLEAN
- NOT GOOD REPAIR
- NOT ACCESSIBLE
- POOR ACCESS
ROOM HOUSEKEEPING
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Standard of HOUSEKEEPING suitable
ROOM FURNISHINGS
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Rest room equipped with suitable CHAIRS
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Report any negative features of the CHAIRS
- NOT SUITABLE
- NOT CLEANABLE
- NOT CLEAN
- NOT GOOD REPAIR
- NOT ACCESSIBLE
- POOR ACCESS
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Rest room equipped with suitable TABLES
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Report any negative features of the TABLES
- NOT SUITABLE
- NOT CLEANABLE
- NOT CLEAN
- NOT GOOD REPAIR
- NOT ACCESSIBLE
- POOR ACCESS
FOOD PREPERATION
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Rest room has reasonable access to potable WATER
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Rest room equipped with a suitable FRIDGE
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Report any negative features of the FRIDGE
- NOT SUITABLE
- NOT CLEANABLE
- NOT CLEAN
- NOT GOOD REPAIR
- NOT ACCESSIBLE
- POOR ACCESS
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Rest room equipped with a suitable KETTLE or alternative
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Report any negative features of the KETTLE or alternative
- NOT SUITABLE
- NOT CLEANABLE
- NOT CLEAN
- NOT GOOD REPAIR
- NOT ACCESSIBLE
- POOR ACCESS
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Rest room equipped with a suitable means to HEAT FOOD
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Report any negative features of the means to HEAT FOOD
- NOT SUITABLE
- NOT CLEANABLE
- NOT CLEAN
- NOT GOOD REPAIR
- NOT ACCESSIBLE
- POOR ACCESS
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Rest room equipped with a suitable WASTE BIN for FOOD WASTE
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Report any negative features of the WASTE BIN for FOOD
- NOT SUITABLE
- NOT CLEANABLE
- NOT CLEAN
- NOT GOOD REPAIR
- NOT ACCESSIBLE
- POOR ACCESS
HAND HYGIENE
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Rest room users have reasonable access to a SINK for HAND-WASHING
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Rest room equipped with a suitable SINK for HAND-WASHING
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Report any negative features of the SINK for HAND-WASHING
- NOT SUITABLE
- NOT CLEANABLE
- NOT CLEAN
- NOT GOOD REPAIR
- NOT ACCESSIBLE
- POOR ACCESS
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Rest room users hand-washing facilities include suitable SOAP
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Rest room users hand-washing facilities include suitable HAND DRYING facilities
PERSONAL LOCKERS
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Rest room users have access to secure means to STORE PERSONAL EFFECTS
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Rest room user have access to secure personal LOCKERS to STORE PERSONAL EFFECTS
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Report any negative features of personal LOCKERS
- NOT SUITABLE
- NOT CLEANABLE
- NOT CLEAN
- NOT GOOD REPAIR
- NOT ACCESSIBLE
- POOR ACCESS
CLEANING MATERIAL STORAGE
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Rest room is not used as a STORAGE FACILITY
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Any materials stored in the rest room are SUITABLE STORED or secured
ACCESS TO TOILETS
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Rest room users have reasonable access to TOILET FACILITIES
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Report any negative features of the TOILET FACILITIES
- NOT SUITABLE
- NOT CLEANABLE
- NOT CLEAN
- NOT GOOD REPAIR
- NOT ACCESSIBLE
- POOR ACCESS
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Rest room users have access to male and female toilets or unisex toilets
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The "same building" means can be accessed from the rest room without exiting a building.
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Rest room users have access to TOILETS IN THE SAME BUILDING as the rest room is situated