Facility Room Status Form
Please complete this Facility Room Status Form to record the current condition and details of the facility room.
Room Identifier
*
Room Location
*
Current Status
*
Available
Occupied
Out of Service
Reserved
Cleanliness Level
*
Clean
Needs Cleaning
Dirty
Occupancy
*
Vacant
Occupied
Issues Noted
None
Broken Equipment
Damage to Furniture
Plumbing Issue
Electrical Issue
Other
Supplies Availability
All Stocked
Low Supplies
Out of Supplies
Other
Maintenance Needed?
*
Yes
No
Last Inspected Date & Time
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Additional Notes
Submit
Should be Empty: