Information

  • Client

  • Assessment Location

  • Building:

  • Inspection conducted by:

  • Inspector Signature

  • Document No.

Cleanness

Elevator Bank 1

  • Ready to Inspect?

  • Floors clean?

  • Walls clean?

  • Ceilings are clean?

  • Area free of dust?

  • Air vents clean?

  • Elevator tracks clean?

Elevator Bank 2

  • Ready to Inspect?

  • Floors clean?

  • Walls clean?

  • Ceilings are clean?

  • Area free of dust?

  • Air vents clean?

  • Elevator tracks clean?

Stairs A

  • Ready to Inspect?

  • Steps clean?

  • Landing clean?

  • Railings clean?

  • Walls clean?

  • Stairwell doors clean?

Stairs B

  • Ready to Inspect?

  • Steps clean?

  • Landing clean?

  • Railings clean?

  • Walls clean?

  • Stairwell doors clean?

Main Entrance

  • Ready to Inspect?

  • Outside walks free of litter?

  • Entrance glass clean?

  • Entrance floor mats clean?

  • Inside floors clean?

  • Inside Walls clean?

  • Waste baskets and liners clean?

  • Picture frames on walls clean?

Lounge 2nd FL

  • Ready to Inspect?

  • Floors clean?

  • Walls clean?

  • Area free of dust?

  • Waste baskets and liners clean?

  • Furniture clean?

  • White boards clean?

  • Air vents clean?

  • Windows and sills clean?

  • Blinds clean?

Lounge 3rd FL

  • Ready to Inspect?

  • Floors clean?

  • Walls clean?

  • Area free of dust?

  • Waste baskets and liners clean?

  • Furniture clean?

  • White boards clean?

  • Air vents clean?

  • Windows and sills clean?

  • Blinds clean?

Lounge 4th FL

  • Ready to Inspect?

  • Floors clean?

  • Walls clean?

  • Area free of dust?

  • Waste baskets and liners clean?

  • Furniture clean?

  • White boards clean?

  • Air vents clean?

  • Windows and sills clean?

  • Blinds clean?

Lounge 5th FL

  • Ready to Inspect?

  • Floors clean?

  • Walls clean?

  • Area free of dust?

  • Waste baskets and liners clean?

  • Furniture clean?

  • White boards clean?

  • Air vents clean?

  • Windows and sills clean?

  • Blinds clean?

Lounge 6th FL

  • Ready to Inspect?

  • Floors clean?

  • Walls clean?

  • Area free of dust?

  • Waste baskets and liners clean?

  • Furniture clean?

  • White boards clean?

  • Air vents clean?

  • Windows and sills clean?

  • Blinds clean?

Hallway 2nd FL

  • Ready to Inspect?

  • Floors clean?

  • Walls clean?

  • Area free of dust?

  • Waste baskets and liners clean?

  • Air vents clean?

  • Windows and sills clean?

  • Blinds clean?

  • Water fountain clean?

Hallway 3rd FL

  • Ready to Inspect?

  • Floors clean?

  • Walls clean?

  • Area free of dust?

  • Waste baskets and liners clean?

  • Air vents clean?

  • Windows and sills clean?

  • Blinds clean?

  • Water fountain clean?

Hallway 4th FL

  • Ready to Inspect?

  • Floors clean?

  • Walls clean?

  • Area free of dust?

  • Waste baskets and liners clean?

  • Air vents clean?

  • Windows and sills clean?

  • Blinds clean?

  • Water fountain clean?

Hallway 5th FL

  • Ready to Inspect?

  • Floors clean?

  • Walls clean?

  • Area free of dust?

  • Waste baskets and liners clean?

  • Air vents clean?

  • Windows and sills clean?

  • Blinds clean?

  • Water fountain clean?

Hallway 6th FL

  • Ready to Inspect?

  • Floors clean?

  • Walls clean?

  • Area free of dust?

  • Waste baskets and liners clean?

  • Air vents clean?

  • Windows and sills clean?

  • Blinds clean?

  • Water fountain clean?

Equipment?

  • Ready to Inspect?

  • Brute and caddy clean and organized?

  • Vacuum clean?

  • Buffer clean?

  • Mop bucket and wringer clean?

  • Dust mop clean?

  • Safety goggles ready and accessible?

  • Safety gloves readily accessible?

Custodial Closet - 3rd FL

  • Ready to Inspect?

  • Floors clean?

  • Deep sink and drain clean?

  • Equipment stored properly?

  • Shelves organized adequately stocked?

  • Walls clean?

  • All chemicals stored below eye level?

  • All chemicals are properly label?

  • Area free of dust?

Custodial Closet - 5th FL

  • Ready to Inspect?

  • Floors clean?

  • Deep sink and drain clean?

  • Equipment stored properly?

  • Shelves organized adequately stocked?

  • Walls clean?

  • All chemicals stored below eye level?

  • All chemicals are properly label?

  • Area free of dust?

Laundry area

  • Ready to Inspect?

  • Floors clean?

  • Walls clean?

  • Doors clean?

  • Equipment clean?

  • Waste baskets and liners clean?

  • Air vents clean?

  • Windows clean?

Safety Elements and compliance?

  • Ready to Inspect?

  • Floor care: wet floor signs in use (when needed)

  • Proper foot wear for the task?

  • Slips, trips and fall hazards?

  • Eye / face protection: safety glasses, goggles?

  • Hand protection: Disposable gloves chemical resistant gloves?

  • Proper labeling of containers?

  • Uniform: Appearance & in compliance?

Notes: Please indicate anything else not covered through the inspection.

  • Your notes

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