Facility Maintenance Evaluation Form

Facility Maintenance Evaluation Form
Please evaluate the maintenance status of the facility by answering the questions below.
Evaluator's Full Name
First NameLast Name
Date of Evaluation
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Facility Location
Street Address
Street Address Line 2
CityState / ProvincePostal / Zip Code
Cleanliness of Facility
Functionality of Equipment
Safety Compliance
Comments or Suggestions
Should be Empty: