Building Name

Email inspection to

Notes: Glass; High / Low Dusting; Horizontal Surfaces;; Phone(s); Water Fountains; Furnishings;Light switches and door handles; Flooring Bathroom(s) Breakroom(s) + Sinks; Microwaves; Refrigerator; Urinal; Toilet; Dispensers; Hand Rails, Consumables

Lobby -2 -4 -6 -8 -10 -12 -14 -16 Lobby

Exam Rooms -2 -4 -6 -8 -10 -12 -14 -16 Exam Rooms

Conference Rooms -2 -4 -6 -8 -10 -12 -14 -16 Conference Rooms

Bathroom & Breakroom -2 -4 -6 -8 -10 -12 -14 -16 Bathroom & Breakroom

Office(s); Common Area(s) -2 -4 -6 -8 -10 -12 -14 -16 Office(s); Common Area(s)

Inspection Results Pass Remedy Required Failed: Immediate Remedy Required Inspection Results

Inspection Score ⭐️ (100% - points missed) /20)