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GLOS Housekeeping Inspection Report

Please make sure to complete all sections of the form.  Enter N/A in any blank comments section.

Inspection Type:
Initial Inspection
Re-Inspection

Organization:

Location:

Priority Items

1. Grounds are free of litter by 8:00 a.m. Lawn is mowed and walks are shoveled and free of ice.
Pass
Fail

Comments:

2. Hallways and stairs are clean and free of obstructions. (Trash and recycling containers empty.)
Pass
Fail

Comments:

3. Common area furniture and tables clean; floors vacuumed and mopped.
Pass
Fail

Comments:

4. Bathrooms are clean.
Pass
Fail

Comments:

5. Basement is clean and floors are mopped.
Pass
Fail

Comments:

Failure of any 1 of the 5 priority areas will result in a Housekeeping Inspection Failure and a Warning for the organization. Each subsequent Failure will result in a more severe sanction. A re-inspection will be scheduled within a 72 hour period.

Areas not covered under the Priority Sections will be judged as a whole with comments below. This section includes kitchens, fireplaces, boiler room, windows and any areas not covered under the priority sections. Failure of this section will count the same as a single priority failure.
Pass
Fail

Comments:

Overall Score:
Pass
Fail

Date (MM/DD/YYYY):

Inspection completed by:

Report Submission

Please click on the "Submit Report" button to send the report to ORL and the specific Organization. You will be redirected to a webpage confirming you have successfully submitted the GLOS Housekeeping Inspection Report. If you are not redirected, the form was not successfully submitted.

Last Updated: 3/27/09