Shift Change Hygiene Checklist Form
Complete this checklist to verify hygiene and sanitation standards during shift handoff. Ensure all required areas and supplies are checked before completing the form.
Date and Time of Shift Handover
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Shift Type
*
Please Select
Morning
Afternoon
Evening
Night
Name of Person Completing Checklist
*
First Name
Last Name
Areas Checked
*
Workstations
Restrooms
Break Room
Storage Areas
Equipment
Other
Sanitation Status
*
All areas sanitized
Some areas sanitized
Sanitization pending
Supplies Status
*
Fully stocked
Low on supplies
Restock needed
Were any hygiene or safety issues found?
*
No issues found
Yes, issues found
If issues were found, describe them
Actions Taken to Address Issues
Signature of Person Completing Checklist
*
Submit Checklist
Submit Checklist
Should be Empty: