1) Follow Work Safety

Yes

No
If no, Reason
Type here
2) Is there a Cob Web ?

Yes

No
If no, Reason
Type here
3) Exhaust Working

Yes

No
If no, Reason
Type here
4) AC Grill working

Yes

No
If no, Reason
Type here
5) Lights in proper condition

Yes

No
If no, Reason
Type here
6) Soap Dispenser working

Yes

No
If no, Reason
Type here
7) Mirror clean

Yes

No
If no, Reason
Type here
8) Taps & Fittings in proper condition

Yes

No
If no, Reason
Type here
9) Wash Basins in proper condition

Yes

No
If no, Reason
Type here
10) Hand Dryer in proper condition

Yes

No
If no, Reason
Type here
11) Water Closet in proper condition

Yes

No
If no, Reason
Type here
12) Water Closet Flush is working

Yes

No
If no, Reason
Type here
13) Health Faucet in proper condition

Yes

No
If no, Reason
Type here
14) Dust Bin is free form litter

Yes

No
If no, Reason
Type here
15) Water Closet Cubical and doors are clean

Yes

No
If no, Reason
Type here
16) Wall Tile is clean

Yes

No
If no, Reason
Type here
17) Floor is cleaned

Yes

No
If no, Reason
Type here
18) Floor Trap in proper condition

Yes

No
If no, Reason
Type here
19) Floor mats maintained properly

Yes

No
If no, Reason
Type here
CONSUMABLES AVAILABILITY
1) Toilet Roll

Yes

No
If no, Reason
Type here
2) Hand Wash

Yes

No
If no, Reason
Type here
3) Urinal Screener
Type here
4) Signature
Type here