Weekly Facility Cleaning Checklist Form
Record completed cleaning tasks, inspection results, issues found, and follow-up actions for weekly facility maintenance.
Date of Cleaning
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Staff Name
*
First Name
Last Name
Area or Zone Cleaned
*
Completed Cleaning Tasks
*
Floors swept and mopped
Trash bins emptied and replaced
Restrooms cleaned and sanitized
Surfaces wiped and disinfected
Mirrors and glass cleaned
Supplies restocked
Equipment checked and cleaned
Other
Inspection Result
*
Pass
Fail
Issues Found (if any)
Follow-up Actions Required
Supervisor Comments
Supervisor Name
Staff Signature
*
Submit Checklist
Submit Checklist
Should be Empty: