Spreadsheet: 145301d1331510295-circular-reference-proposal-sheet
Sheet: Site Evaluation Form 

Site Evaluation Form |  |  |  |  |  |  |  |  |  |  |  |  |  | Type | Type | Type
 |  |  |  |  |  |  |  |  |  |  |  |  |  | [NAME] | 3x5 | 2x3
 |  |  |  |  |  |  |  |  |  |  |  |  |  | 3x5 Safety | 4x6 | 3x5
 |  |  |  |  |  |  |  |  |  | Areas to Tour |  |  |  | 4x6 Safety
Date: |  |  |  |  |  |  |  |  |  |  | Entrances |  |  | 3x10 Pizza
Company Name: |  |  |  |  |  |  |  |  |  |  | Transition Areas |  |  | Black
Contact: |  |  |  |  |  |  |  |  |  |  | Cafeteria/Break Room |  |  | Blue
 |  |  |  |  |  |  |  |  |  |  | Supply Closet |  |  | [NAME]
 |  |  |  |  |  |  |  |  |  |  | Restrooms |  |  | Grey
 |  |  |  |  |  |  |  |  |  |  |  |  |  | Red
Clean Restrooms |  |  |  |  |  |  | Safe Floors |  |  |  |  |  |  | Muti
What Percentage of your business is repeat ? |  |  |  |  |  |  | Are you concerned about slips, trips and falls?
Do you receive complants about your restroom ? |  |  |  |  |  |  | How important is the image of your facility?
Who is currently responsible for cleaning your restroom? |  |  |  |  |  |  | What are you doing today to maintain your floors? |  |  |  |  |  |  | Weekly
 |  |  |  |  |  |  |  |  |  |  |  |  |  | EOW
 |  |  |  |  |  |  |  |  |  |  |  |  |  | Monthly
Restroom |  |  |  |  |  |  |  | Notes
Essentials: | Are all the dispensers full and functioning? |  |  |  |  | Yes | No
Protect: | Does the restoom have a clean fragrance? |  |  |  |  | Yes | No
Maintain: | Are surfaces and fixtures dry and free of debris? |  |  |  |  | Yes | No |  |  |  |  |  |  | Which Package
 | Are mirrors clean and spot-free? |  |  |  |  | Yes | No |  |  |  |  |  |  | None
 | Are surfaces, vents and door james free of dust? |  |  |  |  | Yes | No |  |  |  |  |  |  | [NAME]
Deep Clean: | Are grout lines free of soil build-up? |  |  |  |  | Yes | No |  |  |  |  |  |  | Silver
 | Are partitoons free of graffiti and soil? |  |  |  |  | Yes | No |  |  |  |  |  |  | Gold
Items | Type | Quantity | [NAME] | Refill | Program | Notes/Specs
Dispensers |  |  |  |  | None
Soap |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Type
Sanitizer | Foam | 1 | Weekly | EOW |  |  |  |  |  |  |  |  |  |  |  | Foam
Heavy Duty |  | 2 | Weekly | EOW |  |  |  |  |  |  |  |  |  |  |  | Alcohol Foam
Antibacterial Spray | Large | 1 | Weekly | EOW |  |  |  |  |  |  |  |  |  |  |  | Instant
Antibacterial Foam | Small | 2 | Weekly | EOW |  |  |  |  |  |  |  |  |  |  |  | Size
Moisturizing | Small | 3 | Weekly | EOW |  |  |  |  |  |  |  |  |  |  |  | Small
Paint Remover |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Large
Food Grade |  | 1 | Weekly | EOW |  |  |  |  |  |  |  |  |  |  |  | Type
Hair & Body |  | 1 | Weekly | EOW |  |  |  |  |  |  |  |  |  |  |  | Mist
Hand Towels |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Fan
Toilet Paper |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Size
Air Fresheners | Type |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Short
Auto Flushing |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Tall
Sanibin | Short | 2 | Weekly
Auto Drip
Inline
Urinal Screen
[NAME]
SANIS Cleaning
Bathroom/Café Size      (SQ Foot) |  |  |  |  |  | Type in total sq footage of all rooms in C48
Sinks
Toliets
Urinals
Notes :
Site Evaluation Form
[NAME]
 |  |  |  |  |  |  |  | Notes
Entrance Zones: | Are the areas employees and customer enter properly protected |  |  |  |  | Yes | No
High Risk Zones: | Is there a likelihood of contaminants on the floor? ([NAME], oil) |  |  |  |  | Yes | No
High Traffic Zones: | Are there wear patterns or worn areas on the floor? |  |  |  |  | Yes | No
Productivity Zones: | Are there areas where employees stand for long periods? |  |  |  |  | Yes | No
Items | Color | Quantity | [NAME] | Program | Notes/Specs
Carpet Mat |  |  |  | None
3x5 Mat | Black | 1 | Weekly
4x6 Mat | Blue | 2 | Weekly
3x10 Mat | [NAME] | 3 | EOW
4x8 Mat | Grey | 4 | EOW
Other [NAME] (type in) | Blue | 1 | Weekly
60 |  |  |  |  | type in the total sq feet of the special rug in A65. (example custom 6x10= 60) just type in 60
[NAME]
3x5 Logo Mat |  | 2 | Weekly
[NAME]
3x10 Logo Mat
4x8 Logo Mat
Other [NAME] (type in)
0 |  |  |  |  | type in the total sq feet of the special rug in A65. (example custom 6x10= 60) just type in 60
[NAME] | Type
Spring Step Mat | Type
Safety Mat/Message | Type
Dura-Lite Mat
Maintain |  |  |  |  |  |  |  | Notes
Are you starting with cleaning tools? |  |  |  |  |  | Yes | No
Are the cleaning tools designated for specific areas? |  |  |  |  |  | Yes | No
Are the chemicals safely stored? |  |  |  |  |  | Yes | No
Are the chemicals properly diluted? |  |  |  |  |  | Yes | No
Are the chemicals being used for the right application |  |  |  |  |  | Yes | No
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  | color
Items | Color | Quantity | [NAME] | Program | Notes/Specs |  |  |  |  |  |  |  |  |  | white
Linen |  |  |  | None |  |  |  |  |  |  |  |  |  |  | black
[NAME] |  | 200 | Weekly |  |  |  |  |  |  |  |  |  |  |  | red
Kitchen Towels |  | 122 | Monthly |  |  |  |  |  |  |  |  |  |  |  | blue
Aprons | white | 100 | Weekly |  |  |  |  |  |  |  |  |  |  |  | green
Wet Mop |  | 2 | Monthly
Dust Mop |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Size
Dust Mop 24" |  | 2 | Weekly |  |  |  |  |  |  |  |  |  |  |  | 12
Dust Mop 36" |  | 1 | Weekly |  |  |  |  |  |  |  |  |  |  |  | 20
Dust Mop 48" |  | 2 | EOW |  |  |  |  |  |  |  |  |  |  |  | 36
Dust Mop 60" |  | 3 | Monthly |  |  |  |  |  |  |  |  |  |  |  | Type
Micro Fiber Mops | 36 | 10 | Weekly |  |  |  |  |  |  |  |  |  |  |  | 12x12 Blue
Micro Fiber Wipes | 12x12 Blue | 10 | Weekly |  |  |  |  |  |  |  |  |  |  |  | 12x12 Orange
Shop Towels | Red | 100 | EOW |  |  |  |  |  |  |  |  |  |  |  | 16x16 White
Parts Washer |  | 1 | Monthly |  |  |  |  |  |  |  |  |  |  |  | Color
Chemicals |  |  |  | None |  |  |  |  |  |  |  |  |  |  | White
Chemical Dispenser |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Red
Neutral Floor |  | 3 | Weekly |  |  |  |  |  |  |  |  |  |  |  | Blue
HD Floor/Dgrsr
Bio Based Floor
Industrial Floor |  | 3 | Monthly
Sanitizer
Glass/Multi |  | 4 | Monthly
Disinfectant
Odor Counteract
Foaming Dgrsr
Pot & Pan
Sink Sanitizer
Drain Line Mntnr
Notes :