Amenities Audit
Site Name:
*
Name of Auditor:
*
First Name
Last Name
Is the floor clean and dry?
*
Yes
No
Comment/Action Required:
Take Photo
Are the toilet bowls, seats and cisterns clean and undamaged? Check toilet bowl, under seat, and general area
*
Yes
No
Comment/Action Required:
Take Photo
Is the hand basin clean and undamaged?
*
Yes
No
Comment/Action Required:
Take Photo
Is there an adequate supply of toilet paper, soap, hand towels?
*
Yes
No
Comment/Action Required:
Take Photo
Are the electrical appliances clean and functioning correctly eg electric hand dryer? Check and operate appliance
*
Yes
No
Comment/Action Required:
Take Photo
Are the electrical power points/switches/cables undamaged?
*
Yes
No
Comment/Action Required:
Take Photo
Are all other fittings undamaged and functioning correctly? Check other fittings, e.g. soap holders, shower rails, seats, grab bars, etc.
*
Yes
No
Comment/Action Required:
Take Photo
Is the syringe disposal unit clean, secure on wall and regularly emptied? Check that unit is clean, undamaged and is not overflowing
*
Yes
No
Comment/Action Required:
Take Photo
Is female hygiene unit clean, secure and regularly emptied? Check that unit is clean, undamaged and is not overflowing
*
Yes
No
Comment/Action Required:
Take Photo
Are all lights operating correctly?
*
Yes
No
Comment/Action Required:
Take Photo
Are all door locks operating correctly?
*
Yes
No
Comment/Action Required:
Take photo of Male toilets:
Take photo of Female toilets:
Auditor Signature:
*
Submit
Should be Empty: