Information

  • Client

  • Assessment Location

  • Building:

  • Inspection conducted by:

  • Inspector Signature

  • Document No.

Cleanness

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?

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?

Restroom - 1st Floor - Women

  • Ready to Inspect?

  • Toilets clean?

  • Partitions Clean?

  • Sinks clean and free of soap buildup?

  • Fixtures and drain pipes clean?

  • Mirrors clean?

  • Stainless steel polished?

  • Wastebaskets and liners clean?

  • Floor clean?

  • Air vents clean?

  • Walls clean?

  • Supply adequately stocked?

Restroom - 1st Floor - Men

  • Ready to Inspect?

  • Toilets clean?

  • Urinal clean?

  • Partitions Clean?

  • Sinks clean and free of soap buildup?

  • Fixtures and drain pipes clean?

  • Mirrors clean?

  • Stainless steel polished?

  • Wastebaskets and liners clean?

  • Floor clean?

  • Air vents clean?

  • Walls clean?

  • Supply adequately stocked?

Restroom - 1st Floor - Multi-Gender

  • Ready to Inspect?

  • Toilets clean?

  • Urinal clean?

  • Partitions Clean?

  • Sinks clean and free of soap buildup?

  • Fixtures and drain pipes clean?

  • Mirrors clean?

  • Stainless steel polished?

  • Wastebaskets and liners clean?

  • Floor clean?

  • Air vents clean?

  • Walls clean?

  • Supply adequately stocked?

Restroom - 2nd Floor - Women

  • Ready to Inspect?

  • Toilets clean?

  • Partitions Clean?

  • Sinks clean and free of soap buildup?

  • Fixtures and drain pipes clean?

  • Mirrors clean?

  • Stainless steel polished?

  • Wastebaskets and liners clean?

  • Floor clean?

  • Air vents clean?

  • Walls clean?

  • Supply adequately stocked?

Restroom - 2nd Floor - Men

  • Ready to Inspect?

  • Toilets clean?

  • Urinal clean?

  • Partitions Clean?

  • Sinks clean and free of soap buildup?

  • Fixtures and drain pipes clean?

  • Mirrors clean?

  • Stainless steel polished?

  • Wastebaskets and liners clean?

  • Floor clean?

  • Air vents clean?

  • Walls clean?

  • Supply adequately stocked?

Conference Rooms - Palm Room

  • 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?

Conference Rooms - Ocean Room

  • 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?

Conference Rooms - Coral Room

  • 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?

Conference Rooms - Regatta Room

  • 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?

Office 1

  • Ready to Inspect?

  • Enter the Office Number

  • Floors clean?

  • Walls clean?

  • Area free of dust?

  • Waste baskets and liners clean?

  • Furniture clean?

  • Air vents clean?

  • Windows and sills clean?

  • Blinds clean?

  • Telephone clean?

Office 2

  • Ready to Inspect?

  • Enter the Office Number

  • Floors clean?

  • Walls clean?

  • Area free of dust?

  • Waste baskets and liners clean?

  • Furniture clean?

  • Air vents clean?

  • Windows and sills clean?

  • Blinds clean?

  • Telephone clean?

Office 3

  • Ready to Inspect?

  • Enter the Office Number

  • Floors clean?

  • Walls clean?

  • Area free of dust?

  • Waste baskets and liners clean?

  • Furniture clean?

  • Air vents clean?

  • Windows and sills clean?

  • Blinds clean?

  • Telephone clean?

Office 4

  • Ready to Inspect?

  • Enter the Office Number

  • Floors clean?

  • Walls clean?

  • Area free of dust?

  • Waste baskets and liners clean?

  • Furniture clean?

  • Air vents clean?

  • Windows and sills clean?

  • Blinds clean?

  • Telephone clean?

Office 5

  • Ready to Inspect?

  • Enter the Office Number

  • Floors clean?

  • Walls clean?

  • Area free of dust?

  • Waste baskets and liners clean?

  • Furniture clean?

  • Air vents clean?

  • Windows and sills clean?

  • Blinds clean?

  • Telephone clean?

Office 6

  • Ready to Inspect?

  • Enter the Office Number

  • Floors clean?

  • Walls clean?

  • Area free of dust?

  • Waste baskets and liners clean?

  • Furniture clean?

  • Air vents clean?

  • Windows and sills clean?

  • Blinds clean?

  • Telephone clean?

Office 7

  • Ready to Inspect?

  • Enter the Office Number

  • Floors clean?

  • Walls clean?

  • Area free of dust?

  • Waste baskets and liners clean?

  • Furniture clean?

  • Air vents clean?

  • Windows and sills clean?

  • Blinds clean?

  • Telephone clean?

Office 8

  • Ready to Inspect?

  • Enter the Office Number

  • Floors clean?

  • Walls clean?

  • Area free of dust?

  • Waste baskets and liners clean?

  • Furniture clean?

  • Air vents clean?

  • Windows and sills clean?

  • Blinds clean?

  • Telephone clean?

Office 9

  • Ready to Inspect?

  • Enter the Office Number

  • Floors clean?

  • Walls clean?

  • Area free of dust?

  • Waste baskets and liners clean?

  • Furniture clean?

  • Air vents clean?

  • Windows and sills clean?

  • Blinds clean?

  • Telephone clean?

Office 10

  • Ready to Inspect?

  • Enter the Office Number

  • Floors clean?

  • Walls clean?

  • Area free of dust?

  • Waste baskets and liners clean?

  • Furniture clean?

  • Air vents clean?

  • Windows and sills clean?

  • Blinds clean?

  • Telephone 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 - 1st 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 - 2nd 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?

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

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.