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comm-clean-standard-with-appendices.pdf

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ISSA CLEAN STANDARD: MEASURING THE EFFECTIVENESS OF CLEANING Adapted from: Housekeeping Survey Form – The Ashkin Group School General Checklist – Shaughnessy, et.al., University of Tulsa Indoor Air Quality Program ISSA® — The Worldwide Cleaning Industry Association • 3300 Dundee Road, Northbrook, IL 60062 USA 800-225-4772 (North America) or 847-982-0800 • issa.com A: Entrances/Lobbies/Halls #: __________ Follow-up dates/initials: __________ /__________ B: Stairwells #: __________ Follow-up dates/initials: __________ /__________ C: Offices #: __________ Follow-up dates/initials: __________ /__________ D: Meeting Rooms #: __________ Follow-up dates/initials: __________ /__________ E: Restrooms #: __________ Follow-up dates/initials: __________ /__________ F: Food Prep/Dining #: __________ Follow-up dates/initials: __________ /__________ G1: Other 1 #: __________ Follow-up dates/initials: __________ /__________ G2: Other 2 #: __________ Follow-up dates/initials: __________ /__________ G3: Other 3 #: __________ Follow-up dates/initials: __________ /__________ G4: Other 4 #: __________ Follow-up dates/initials: __________ /__________ G5: Other 5 #: __________ Follow-up dates/initials: __________ /__________ G6: Other 6 #: __________ Follow-up dates/initials: __________ /__________ G7: Other 7 #: __________ Follow-up dates/initials: __________ /__________ TOTAL NUMBER OF AREAS NEEDING IMMEDIATE ATTENTION: Appendix B: Building Audit - Short Form Building Name & Location: ___________________________________________________________________ Investigators: Primary: _______________________________________________________________________ Others Involved: _________________________________________________________________ Date: _______________________ Size of Building: ___________________ sq. ft. Number of Floors: ___________ Number of Occupants: ______________ Visitors: ____________________________ Number of Areas Needing Immediate Attention Other Notes: _______________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________

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