39. Baldwin UFSD School Custodial Inspection Form School: Date: Inspected by: 1: unsatisfactory 2: needs improvement 3: satisfactory 4: excellent 1 2 3 4 N/A Remarks Lobby/entrance/halls Floors are clean and finished Corners are clean and free of dust, no build-up Baseboard clean, no build-up Entrance mats are clean and vacuumed Entrance doors are clean & in working order Showcase locked and dusted, glass clean Fire equipment clean and dusted, unobstructed, fire exting. sign displayed Hall/door glass is clean Lights are working and clean Trash receptacles are empty and clean, no odor Walls are clean and free of marks Ceiling tile in good condition, no roof leaks Lockers in good order, clean, Electrical panels clean and locked Water fountains clean and in working order Student displays w/i guidelines Stairs clean and swept AED charged and inspected, sign posted Hand sanitizers full and in place 1 2 3 4 N/A Restrooms There are no odors, appropriate ventilation Toilets are clean, working, no leaks Urinals are clean, working no leaks Partitions are clean and free of marks Sinks are clean, working, no leaks Dispensers are filled & working Floor is clean, free of stains Corners/ cove base is clean and free of marks Walls are clean and free of marks Mirrors clean and free of marks Trash receptacles are clean and empty Ceiling/wall registers are dust free and working Lights are clean & working Entrance door is clean and free from marks Door frame is clean free of marks Hand washing poster displayed
40. Hand washing poster displayed 1 2 3 4 N/A Classrooms Door clean and vision panel unobstructed Door frame clean and free of marks Light switch clean and working Emergency exit directions are posted at the door All lights clean and working Ceiling in good condition Windows clean and working, Blinds/shades clean and working adjusted evenly Window sill clean and dust free Univents clean & unobstructed Emg. Window free from obstructions No fire code violations found No extension cords in use Computers clean and dust free Computers, printers, monitors are turned off Floor is clean Corners/cove base clean and free of marks Furniture in good condition, clean Chalk bd/tray clean and washed American flag displayed and in good condition Area rugs vacuumed and clean, fire rated Pencil sharpener emptied and working Trash receptacles clean and empty No unusual odors Food is kept in sealed containers Bathrooms clean No refrigs, mico’s, coffee makers etc. No unlabeled containers/bottles Walls painted and free from marks 1 2 3 4 N/A Offices/lounges Door is clean and vision panel unobstructed Door frame is clean and free of marks Light switch clean and working All lights clean and working Ceiling in good condition Windows clean and working Blinds/shades, adjusted evenly Window sill clean and dust free Computers clean and dust free Floor/carpet clean and in good condition Corners clean and free of marks Desks clean and free from dust Trash receptacles clean and empty Computers, monitors turned off 1 2 3 4 N/A Gym
41. Report completed by: M. Sheehan General notes: Copies to: Assistant Superintendent for Business, Principal, Head Custodian, District file Floor is clean and free of marks, properly finished Corners are clean and free of marks Lights are clean and working Ceiling is in good repair, no roof leaks Stage clean and neat, drapery is in good repair Walls clean and free of marks Exit lights working Doors clean and free of marks Folding door in proper working order Locker rooms clean, no odor Lockers in good condition Water fnt clean and working 1 2 3 4 N/A Cafeteria/kitchen Floor is clean and free of marks Corners are clean and free of marks Lights are clean and working Ceiling in good repair, no roof leaks Walls clean and free of marks Exit lights working Doors clean and free of marks Kitchen equipment clean and free of marks Choking Poster displayed 1 2 3 4 N/A Custodial closet Floor clean No odors Equipment clean & in working order Slop sink clean and working Storage is neat and orderly Lights clean and working Door clean and locked 1 2 3 4 N/A Boiler room Floor clean and painted Boilers clean and maintained No oil leaks/free standing oil No improper storage All logs maintained Room is neat and orderly Lights clean and working Drains clear and working No plumbing leaks
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43. BALDWIN UFSD SPECIAL ENVIRONMENTAL SURVEY CHECKLIST Mid-Year (Inspection #2 only) School:_______________________________________DATE:____________________ Present:________________________________________________________________ *HIGH SCHOOL AND MIDDLE SCHOOL ONLY Submitted by:_____________________________________________________________ ITEM STATUS RECOMMENDATIONS MSDS BINDER KEPT CURRENT EMG. MAN. PLAN UPDATED BOMB CARD PLACED UNDER PHONE EMG. PHONE # ON PHONE ASBESTOS MAN. PLAN KEPT CURRENT LOCK OUT/TAG OUT BEING USED ALL DEPT. SUPPLIES PROPERLY STORED IPM PROCEDURES BEING FOLLOWED FIRE DRILLS CURRENT EMG. WINDOWS KEPT CLEAR EXTENSION CORDS NOT BEING USED RIGHT TO KNOW POSTER DISPLAYED OIL TANK ALARM WORKING MEDICAL WASTE PROCEDURES IN USE HANTA VIRUS PROCEDURESFOLLOWED PPE CURRENT CHEMICAL HYGEINE PROGRAM FOLLOWED* PLAYGROUND INSPECTIONS CURRENT GYM FOLDING DOOR NOTICE POSTED DO NOT ENTER POSTED ON ALL EXTERIOR DOORS EMERGENCY LIGHT LOG CURRENT CHOKING POSTER DISPLAYED IN CAF. and Folding Table Warning posted A.E.D. VISUAL INSPECTION IPM Practices being followed IAQ Practices being followed Fire extinguishers are tagged & pressurized
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