Washroom Cleaning Record Log Form
Use this form to record and inspect washroom cleaning tasks. Maintain clear, accurate cleaning records for each washroom.
Date of Cleaning
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Washroom Location or ID
*
Cleaner Name
*
First Name
Last Name
Cleaning Tasks Completed
*
Floors mopped
Toilets cleaned
Sinks cleaned
Mirrors cleaned
Trash emptied
Supplies restocked
Other
Inspection Status
*
Passed
Needs attention
Inspector Name (if applicable)
First Name
Last Name
Additional Comments or Issues
Photo of Completed Cleaning (optional)
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Signature of Cleaner
Submit Record
Submit Record
Should be Empty: