Spa Health Code Compliance Inspection Form

Spa Health Code Compliance Inspection Form
Use this form to conduct and document a comprehensive health code compliance inspection of spa facilities.
Inspector Name
First NameLast Name
Inspection Date
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Hour MinutesAM/PM Option
Spa Facility Name
Facility Address
Street Address
Street Address Line 2
CityState / ProvincePostal / Zip Code
Contact Person at Facility
First NameLast Name
Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.

Cleanliness & Sanitation Assessment

Rows	Compliant	Non-Compliant	Not Applicable
Floors and surfaces are clean and disinfected
Towels and linens are properly laundered
Restrooms are adequately supplied and clean
Trash is disposed of regularly

Equipment Maintenance Assessment
Rows Compliant Non-Compliant Not Applicable
Equipment is cleaned and disinfected after each use
No broken or malfunctioning equipment
Proper storage of equipment and supplies
Staff Hygiene and Practices
Rows Compliant Non-Compliant Not Applicable
Staff wear clean uniforms or attire
Hand hygiene practices observed
Staff have valid health certificates
Record Keeping & Documentation
Rows Compliant Non-Compliant Not Applicable
Cleaning logs maintained and up to date
Incident/accident records available
Staff training records available
Overall Compliance Rating
Additional Comments or Observations
By signing below, I confirm that this inspection was conducted to the best of my ability and the information provided is accurate.
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Select theme:

Rows	Compliant	Non-Compliant	Not Applicable
Equipment is cleaned and disinfected after each use
No broken or malfunctioning equipment
Proper storage of equipment and supplies

Rows	Compliant	Non-Compliant	Not Applicable
Staff wear clean uniforms or attire
Hand hygiene practices observed
Staff have valid health certificates

Rows	Compliant	Non-Compliant	Not Applicable
Cleaning logs maintained and up to date
Incident/accident records available
Staff training records available