Toilet Checklist Sample

Toilet Check List Premises Name………………………………..
Date………………
Time Supplies checked (C)/
refilled (R)
Cubicles
Checked
Details of any action Taken/
Comments
Name and
signature of staff
10:00am
11:00am
12:00am
1:00pm
2:00pm
3:00pm
4:00pm
5:00pm
6:00pm
7:00pm
8:00pm
9:00pm
10:00pm
11:00pm
12:00pm
1:00am
2:00am
If these toilets are not up to an acceptable standard please speak to a member of staff and we shall do our
best to sort any problems out.
Please contact a member of staff if any suspicious substances are seen or found in these toilets.
MANY THANKS
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