Communal areas (entrances, corridors and lifts, public toilets, bereavement rooms) COMMUNAL AREAS CLEANLINESS BLANK Pass = P Qualified Pass = Q Fail = F Not Applicable = X Please see page 8 of this assessment form for definitions of Clean, Pass, Qualified Pass and Fail LEAVE SHADED AREAS lifts, Notes optional (reasons for chapel failure must be recorded) e.g. toilets reception therapy Main Other Corridors, Public bereavement or stairwells rooms, Ceilings Curtains/blinds Dispensers soap/hand gel etc – Doors and frames Floor Glazing internal – Lighting Mirrors Pull cords/switches Radiators, heating panels and pipework Seating Sinks/basins Surfaces high – Surfaces low/visible (incl fire – extinguishers) Toilet TV/entertainment equipment Ventilation/air-conditioning grilles (visible) Waste bins Wheelchairs/walking aids
Communal areas (entrances, corridors and lifts, public toilets, bereavement rooms) COMMUNAL AREAS CLEANLINESS Pass = P Qualified Pass = Q Fail = F Not Applicable = X LEAVE SHADED AREAS BLANK Please see page 8 of this assessment form for definitions of Clean, Pass, Qualified Pass and Fail Main reception Corridors, lifts, stairwells Public toilets Other e.g. bereavement or therapy rooms, chapel Notes optional (reasons for failure must be recorded) Ceilings Curtains/blinds Dispensers – soap/hand gel etc Doors and frames Floor Glazing – internal Lighting Mirrors Pull cords/switches Radiators, heating panels and pipework Seating Sinks/basins Surfaces – high Surfaces – low/visible (incl fire extinguishers) Toilet TV/entertainment equipment Ventilation/air-conditioning grilles (visible) Waste bins Wheelchairs/walking aids
place-internal-communl-jan15.docx