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Premises and facilities checks · PF-01

Washroom Cleaning Sign-Off Sheet

A free printable washroom cleaning sign-off sheet — date and time slot, cubicles, basins, floor, consumables, bins, faults and two sets of initials.

First page of the Washroom Cleaning Sign-Off Sheet — Show that a round actually happened, at what time and by whom, and get a reported fault in front of somebody who can fix it.
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One page. Choose your paper size — both versions are laid out identically, so neither one gets shrunk to fit.

Print it and write on it

Fill it in type and save

The fillable versions have real form fields — open them in any PDF reader, type into them and save. Printing help.

What this sheet is for

Show that a round actually happened, at what time and by whom, and get a reported fault in front of somebody who can fix it.

Who it is for

Pubs, cafés, village halls, gyms, offices, schools, sports clubs and cleaning contractors — anywhere a washroom is checked more than once a day.

How to use it

  1. Write the frequency agreed for this washroom in the header, so the sheet says what it is measured against.
  2. Pin it inside the door at eye height and leave a pen on the string.
  3. Initial each slot as the round is completed, not at the end of the shift.
  4. Use the faults column for anything that needs somebody else, and have a supervisor countersign the day.

What is on the sheet

One page, top to bottom:

Printed under the title: The round, signed for: cubicles, basins, floor, soap, paper and towels restocked and bins emptied — with room to note a fault and space for a supervisor to countersign. Printed to be read pinned to a door.

The frequency is yours to set — check what applies. How often a washroom is attended to, what a round has to cover and what has to be recorded are set locally — they differ by country, by the kind of premises and by the operator, and they change. Check what applies to yours and write the frequency in below. This is a record of rounds carried out; it is not a standard and it sets no requirement.

Write-on lines: Premises and washroom · Week commencing · Frequency agreed for this washroom

Table, 11 rows: Date · Time · Cubicles · Basins and mirrors · Floor · Soap · Paper · Towels · Bins · Faults or damage noted · Cleaner · Supervisor

Questions

How often should a washroom be cleaned?

That is set locally and differs by country, by the kind of premises and by the operator, so no frequency is printed on the sheet. There is a header box for the frequency you have agreed or been given, which is the figure the completed sheet should be read against.

Is a completed sheet proof of anything?

It is a contemporaneous record of what was done and by whom, which is far better than a recollection. It is not a certificate and it does not by itself demonstrate that any requirement has been met — keep it as part of your own records and check what your premises is expected to hold.

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Also in the resources library

The same subject, with a version you can fill in on screen.

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