Bunbury & Districts Hockey Assoc. Cleaning Inspection
Complete this inspection form to assess cleaning standards for facility changerooms, toilets, and stadium areas. Score each item and provide notes where necessary.
Legend: Scoring Standards
5 points – Excellent:
No visible dust, dirt, marks or streaks. All surfaces appear freshly cleaned and well maintained.
4 points – Good:
Minor dust or marks visible on close inspection. Overall appearance is clean and well maintained.
3 points – Fair:
Noticeable dust, dirt or marks. Cleaning is adequate but not thorough; improvement required.
2 points – Poor:
Significant dust, dirt, stains or build-up. Cleaning standards not met; immediate improvement required.
1 point – Unacceptable:
Very dirty, unsanitary or neglected. Cleaning standards seriously breached; urgent corrective action required.
Women’s Changerooms
Floors, walls, partitions - Score
*
Floors, walls, partitions - Notes
Basins, benches, mirrors - Score
*
Basins, benches, mirrors - Notes
Toilet bowls, seats, lids - Score
*
Toilet bowls, seats, lids - Notes
Showers - Score
*
Showers - Notes
Rubbish removal, soap refills - Score
*
Rubbish removal, soap refills - Notes
Exhaust fans - Score
*
Exhaust fans - Notes
Windowsills - Score
*
Windowsills - Notes
Men’s Changerooms
Floors, walls, partitions - Score
*
Floors, walls, partitions - Notes
Basins, benches, mirrors - Score
*
Basins, benches, mirrors - Notes
Toilet bowls, seats, lids, urinals - Score
*
Toilet bowls, seats, lids, urinals - Notes
Showers - Score
*
Showers - Notes
Rubbish removal, soap refills - Score
*
Rubbish removal, soap refills - Notes
Exhaust fans - Score
*
Exhaust fans - Notes
Windowsills - Score
*
Windowsills - Notes
Changeroom Walkway
Litter, leaves, sand - Score
*
Litter, leaves, sand - Notes
Stadium Hall & Meeting Room
Carpets - Score
*
Carpets - Notes
Rubbish removal - Score
*
Rubbish removal - Notes
Tables - Score
*
Tables - Notes
Hard floors - Score
*
Hard floors - Notes
Stadium Entry
Hard floors - Score
*
Hard floors - Notes
Women’s Toilets
Floors, walls, partitions - Score
*
Floors, walls, partitions - Notes
Basins, benches, mirrors - Score
*
Basins, benches, mirrors - Notes
Toilet bowls, seats, lids - Score
*
Toilet bowls, seats, lids - Notes
Rubbish removal, soap refills - Score
*
Rubbish removal, soap refills - Notes
Exhaust fans - Score
*
Exhaust fans - Notes
Windowsills - Score
*
Windowsills - Notes
All-access toilet
Floors, walls - Score
*
Floors, walls - Notes
Basins, benches, mirrors - Score
*
Basins, benches, mirrors - Notes
Toilet bowls, seats, lids - Score
*
Toilet bowls, seats, lids - Notes
Rubbish removal, soap refills - Score
*
Rubbish removal, soap refills - Notes
Exhaust fans - Score
*
Exhaust fans - Notes
Windowsills - Score
*
Windowsills - Notes
Men’s Toilets
Floors, walls, partitions - Score
*
Floors, walls, partitions - Notes
Basins, benches, mirrors - Score
*
Basins, benches, mirrors - Notes
Toilet bowls, seats, lids, urinal - Score
*
Toilet bowls, seats, lids, urinal - Notes
Rubbish removal, soap refills - Score
Rubbish removal, soap refills - Notes
Exhaust fans - Score
*
Exhaust fans - Notes
Windowsills - Score
*
Windowsills - Notes
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Scoring Summary
Total possible score = 190
80% is considered satisfactory.
Total score
Assessment rating %
Sign-off
BDHA Representative
*
BDHA Signature
*
Inspected By:
Please Select
Please Select
Brodie Morris
Daniel Keegan
Bruce Curciarello
Danika Wylie
Cleanway Xtra Signature
*
Date
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Day
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Month
Year
Date
Submit
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