Washroom Cleaning Inspection form
Name
*
Project
*
Please Select
Yard Facilities
Date
*
-
Month
-
Day
Year
Date
Location
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Checklist
Toilets and seats cleaned, disinfected, wiped dry
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Yes
No
Urinal flush handles cleaned, disinfected, wiped dry
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Yes
No
Sinks and fixtures cleaned, disinfected, wiped dry
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Yes
No
Faucet, valves and hoses condition
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Yes
No
Door handles, wall switches and other 'high contact" area cleaned, disinfected, wiped dry
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Yes
No
Soap and paper dispenser disinfected and restocked
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Yes
No
Trash cans emptied, new liners put in place
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Yes
No
Floors free of paper and trash
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Yes
No
Air/odor control system(exhaust) operating correctly
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Yes
No
Floor drains and drain covers are open and free of debris
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Yes
No
Light bulbs are functioning
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Yes
No
Ceiling wall vents cleaned
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Yes
No
Floor has been mopped clean with a proper cleaning or disinfecting solution
*
Yes
No
I acknowledge I have read and completed the questions above
*
I acknowledge
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