Title Page
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Date of Inspection
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Name of Inspector
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Office Level / Floor Inspected
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Department/s
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Total Number of Employees
1. General Workplace Cleanliness
Floors and Walkways
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Floors are free from dust, dirt, and spills.
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Walkways are clear of obstructions.
Waste Management
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Trash bins are available and properly labeled.
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Trash is regularly emptied and disposed of.
Surfaces (Desks, Counters, Equipment)
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All surfaces are clean and disinfected.
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No accumulation of unnecessary items or clutter.
2. Personal Hygiene Facilities
Restrooms
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Restrooms are clean and well-maintained.
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Soap, hand dryers, and paper towels are stocked and functional.
3. Ventilation and Air Quality
Air Circulation
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Ventilation systems are functional and properly maintained.
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No odors or stale air detected.
Filters and Air Ducts
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Air ducts are free from dust and debris.
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Air filters are clean and replaced regularly.
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Date of last air filter cleaning or replacement
4. Shared Equipment and Tools
Shared Equipment and Tools
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Shared tools and equipment are regularly cleaned and disinfected.
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Proper protocols are in place for cleaning after each use.
5. Employee Hygiene
Personal Protective Equipment (PPE)
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PPE is stored properly when not in use.
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Employees have access to and are using PPE as required.
Hand Sanitizing
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Sanitizing stations are placed in key areas.
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Employees are following hand sanitizing protocols.
6. Kitchen/Break Areas
Cleanliness of Kitchen Area
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Surfaces are clean, and food waste is properly disposed of.
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Appliances are clean and functional.
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Dishwasher and hand soap are regularly replenished.
Food Storage
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Refrigerators and storage areas are organized and cleaned regularly.
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No expired or improperly stored food is in the refrigerators and cupboards.
7. Pest Control
Presence of Pests
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Pest control measures are in place and effective.
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No pests (insects, rodents, etc.) have been reported.
Sign-off
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Comments and Feedback
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Report Reviewed By
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Designation
