Locker Room Shower Checklist Form
Complete this form to document the inspection of locker room shower facilities. Ensure all checklist items are reviewed for cleanliness, safety, and functionality.
Date of Inspection
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Inspector Name
*
Overall cleanliness of shower area
*
Excellent
Good
Fair
Poor
Are all shower heads functioning properly?
*
All working
Some not working
None working
Condition of shower floors (clean, free of debris, not slippery)
*
Clean and safe
Minor issues
Needs immediate attention
Are soap dispensers stocked and operational?
*
All stocked and working
Some empty or broken
None available
Are towels or drying facilities available?
*
All available
Some missing
None available
Are drains clear and functioning?
*
All clear and draining
Some blocked
All blocked
Condition of lighting in shower area
*
Well-lit
Dim or flickering
No lighting
Any hazards present (e.g., broken tiles, mold, exposed wiring)?
*
No hazards
Minor hazards
Serious hazards
Additional comments or issues observed
Submit Inspection
Should be Empty: