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QF Bathrooms
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Instructions/qualifications
Received special training and was certified within 12 months or less.
Information Page
Survey/Inspection details and requirements
Maintenance and testing is critical to the health requirements
Report Type
*
Scheduled inspection
Ad hoc inspection - per request
Repeat inspection (prior failure)
Date/Time of inspection
*
Inspection Report Prepared by
*
Employee/Badge #
*
Other personnel participating
Remarks/Notes (i.e reason for Ad-Hoc or Re-Inspection)
Equipment location*
Women's Office Bathroom
Men's Office Bathroom
Women's Warehouse Bathroom
Men's Warehouse Bathroom
Customer Service Bathroom
Inspection and repair
Are all toilet bowls, sinks, and urinals damage free and working properly?
*
Yes
No, list repair needed and any parts
Are all taps, flushers, and any other associated fittings, including tap washers adjusted and operating properly?
*
Yes
No, list repair needed and any parts
Are all toilet seats adjusted properly and in good condition?
*
Yes
No, list repair needed and any parts
Are all strainers in sinks and urinals in good condition?
*
Yes
No, list repair needed and any parts
Do all floor drains work properly and contain water?
*
Yes
No, list repair needed and any parts
Is all associated trash removed on completion of work?
Yes
No
Is there any other minor damage?
*
None
List any minor repair work that needs to be done
Are there any other property related matters?
*
None
Description