Housekeeping Service Report
1300 JAYCHEM (1300 529 243)
Site details
Site name
Address
Contact name
Position
Email
Additional Email
Additional Email
Phone
Jaychem representative
Name
Phone
Date
Service Type
Please select
Preventative Maintenance
Emergency Callout
Project Work
Audit Process
Program validation audit
Other
Facility Inspection
Staff member's name
Room inspected
Product Use
Used for correct purpose
Impact
Corrections / Recommendations
Bathroom Cleaner
Please select
Good
Poor
Correct
N/A
Please select
Poor results
Increased water/energy cost
Increased labour cost
Brand image impact
Safety issue
Guest satisfaction
Other
Please select
Adjusted product concentration to improve outcome
Provided staff training to improve outcome
Adjusted product concentration and provided staff training to improve outcome
Recommended change in product to improve outcome
Recommended supplementary product to improve outcome
Provided staff training to improve safety
Recommended change in product to improve staff safety
Repaired broken/damaged equipment to improve outcome
Repaired broken/damaged equipment to improve safety
Referred issue to JayChem technical centre for review/recommendation
Unable to correct issue, please see comments below
Spare part required, ordered, will fit as a priority
Glass Cleaner
Please select
Good
Poor
Correct
N/A
Please select
Poor results
Increased water/energy cost
Increased labour cost
Brand image impact
Safety issue
Guest satisfaction
Other
Please select
Adjusted product concentration to improve outcome
Provided staff training to improve outcome
Adjusted product concentration and provided staff training to improve outcome
Recommended change in product to improve outcome
Recommended supplementary product to improve outcome
Provided staff training to improve safety
Recommended change in product to improve staff safety
Repaired broken/damaged equipment to improve outcome
Repaired broken/damaged equipment to improve safety
Referred issue to JayChem technical centre for review/recommendation
Unable to correct issue, please see comments below
Spare part required, ordered, will fit as a priority
Odour Counteractant
Please select
Good
Poor
Correct
N/A
Please select
Poor results
Increased water/energy cost
Increased labour cost
Brand image impact
Safety issue
Guest satisfaction
Other
Please select
Adjusted product concentration to improve outcome
Provided staff training to improve outcome
Adjusted product concentration and provided staff training to improve outcome
Recommended change in product to improve outcome
Recommended supplementary product to improve outcome
Provided staff training to improve safety
Recommended change in product to improve staff safety
Repaired broken/damaged equipment to improve outcome
Repaired broken/damaged equipment to improve safety
Referred issue to JayChem technical centre for review/recommendation
Unable to correct issue, please see comments below
Spare part required, ordered, will fit as a priority
Neutral Cleaner
Please select
Good
Poor
Correct
N/A
Please select
Poor results
Increased water/energy cost
Increased labour cost
Brand image impact
Safety issue
Guest satisfaction
Other
Please select
Adjusted product concentration to improve outcome
Provided staff training to improve outcome
Adjusted product concentration and provided staff training to improve outcome
Recommended change in product to improve outcome
Recommended supplementary product to improve outcome
Provided staff training to improve safety
Recommended change in product to improve staff safety
Repaired broken/damaged equipment to improve outcome
Repaired broken/damaged equipment to improve safety
Referred issue to JayChem technical centre for review/recommendation
Unable to correct issue, please see comments below
Spare part required, ordered, will fit as a priority
Hand Hygiene
Please select
Good
Poor
Correct
N/A
Please select
Poor results
Increased water/energy cost
Increased labour cost
Brand image impact
Safety issue
Guest satisfaction
Other
Please select
Adjusted product concentration to improve outcome
Provided staff training to improve outcome
Adjusted product concentration and provided staff training to improve outcome
Recommended change in product to improve outcome
Recommended supplementary product to improve outcome
Provided staff training to improve safety
Recommended change in product to improve staff safety
Repaired broken/damaged equipment to improve outcome
Repaired broken/damaged equipment to improve safety
Referred issue to JayChem technical centre for review/recommendation
Unable to correct issue, please see comments below
Spare part required, ordered, will fit as a priority
Add field
Procedures
Actual cleaning process
Impact
Corrections / Recommendations
Toilet
Please select
Good
Poor
Correct
N/A
Please select
Poor results
Increased water/energy cost
Increased labour cost
Brand image impact
Safety issue
Guest satisfaction
Other
Please select
Provided staff training to improve outcome/safety
Group training required to improve outcome/safety
Group training delivered to improve outcome/safety
Trained Supervisor who will on-train staff
Referred issue to JayChem technical centre for review/recommendation
Shower/bath
Please select
Good
Poor
Correct
N/A
Please select
Poor results
Increased water/energy cost
Increased labour cost
Brand image impact
Safety issue
Guest satisfaction
Other
Please select
Provided staff training to improve outcome/safety
Group training required to improve outcome/safety
Group training delivered to improve outcome/safety
Trained Supervisor who will on-train staff
Referred issue to JayChem technical centre for review/recommendation
Mirrors/glass
Please select
Good
Poor
Correct
N/A
Please select
Poor results
Increased water/energy cost
Increased labour cost
Brand image impact
Safety issue
Guest satisfaction
Other
Please select
Provided staff training to improve outcome/safety
Group training required to improve outcome/safety
Group training delivered to improve outcome/safety
Trained Supervisor who will on-train staff
Referred issue to JayChem technical centre for review/recommendation
Vanity/basin
Please select
Good
Poor
Correct
N/A
Please select
Poor results
Increased water/energy cost
Increased labour cost
Brand image impact
Safety issue
Guest satisfaction
Other
Please select
Provided staff training to improve outcome/safety
Group training required to improve outcome/safety
Group training delivered to improve outcome/safety
Trained Supervisor who will on-train staff
Referred issue to JayChem technical centre for review/recommendation
Damp dusting
Please select
Good
Poor
Correct
N/A
Please select
Poor results
Increased water/energy cost
Increased labour cost
Brand image impact
Safety issue
Guest satisfaction
Other
Please select
Provided staff training to improve outcome/safety
Group training required to improve outcome/safety
Group training delivered to improve outcome/safety
Trained Supervisor who will on-train staff
Referred issue to JayChem technical centre for review/recommendation
Floors
Please select
Good
Poor
Correct
N/A
Please select
Poor results
Increased water/energy cost
Increased labour cost
Brand image impact
Safety issue
Guest satisfaction
Other
Please select
Provided staff training to improve outcome/safety
Group training required to improve outcome/safety
Group training delivered to improve outcome/safety
Trained Supervisor who will on-train staff
Referred issue to JayChem technical centre for review/recommendation
Odour control
Please select
Good
Poor
Correct
N/A
Please select
Poor results
Increased water/energy cost
Increased labour cost
Brand image impact
Safety issue
Guest satisfaction
Other
Please select
Provided staff training to improve outcome/safety
Group training required to improve outcome/safety
Group training delivered to improve outcome/safety
Trained Supervisor who will on-train staff
Referred issue to JayChem technical centre for review/recommendation
Add field
Facility Condition Report
Impact
Corrections / Recommendations
Walls
Please select
Good
Poor
Clean
Worn
Faded
Peeling
Damaged
Mould
N/A
Please select
Poor results
Increased water/energy cost
Increased labour cost
Brand image impact
Safety issue
Guest satisfaction
Other
Please select
Provided staff training to improve outcome/safety
Group training required to improve outcome/safety
Group training delivered to improve outcome/safety
Advised Supervisor of issue, awaiting feedback on assistance required
Non JayChem product is use, recommended JayChem alternative
Recommended supplementary product to improve outcome
Referred issue to JayChem technical centre for review/recommendation
Unable to correct issue, please see comments below
Floors
Please select
Good
Poor
Clean
Worn
Faded
Peeling
Damaged
Mould
N/A
Please select
Poor results
Increased water/energy cost
Increased labour cost
Brand image impact
Safety issue
Guest satisfaction
Other
Please select
Provided staff training to improve outcome/safety
Group training required to improve outcome/safety
Group training delivered to improve outcome/safety
Advised Supervisor of issue, awaiting feedback on assistance required
Non JayChem product is use, recommended JayChem alternative
Recommended supplementary product to improve outcome
Referred issue to JayChem technical centre for review/recommendation
Unable to correct issue, please see comments below
Bathrooms
Please select
Good
Poor
Clean
Worn
Faded
Peeling
Damaged
Mould
N/A
Please select
Poor results
Increased water/energy cost
Increased labour cost
Brand image impact
Safety issue
Guest satisfaction
Other
Please select
Provided staff training to improve outcome/safety
Group training required to improve outcome/safety
Group training delivered to improve outcome/safety
Advised Supervisor of issue, awaiting feedback on assistance required
Non JayChem product is use, recommended JayChem alternative
Recommended supplementary product to improve outcome
Referred issue to JayChem technical centre for review/recommendation
Unable to correct issue, please see comments below
Doors
Please select
Good
Poor
Clean
Worn
Faded
Peeling
Damaged
Mould
N/A
Please select
Poor results
Increased water/energy cost
Increased labour cost
Brand image impact
Safety issue
Guest satisfaction
Other
Please select
Provided staff training to improve outcome/safety
Group training required to improve outcome/safety
Group training delivered to improve outcome/safety
Advised Supervisor of issue, awaiting feedback on assistance required
Non JayChem product is use, recommended JayChem alternative
Recommended supplementary product to improve outcome
Referred issue to JayChem technical centre for review/recommendation
Unable to correct issue, please see comments below
Paint
Please select
Good
Poor
Clean
Worn
Faded
Peeling
Damaged
Mould
N/A
Please select
Poor results
Increased water/energy cost
Increased labour cost
Brand image impact
Safety issue
Guest satisfaction
Other
Please select
Provided staff training to improve outcome/safety
Group training required to improve outcome/safety
Group training delivered to improve outcome/safety
Advised Supervisor of issue, awaiting feedback on assistance required
Non JayChem product is use, recommended JayChem alternative
Recommended supplementary product to improve outcome
Referred issue to JayChem technical centre for review/recommendation
Unable to correct issue, please see comments below
Furnishings
Please select
Good
Poor
Clean
Worn
Faded
Peeling
Damaged
Mould
N/A
Please select
Poor results
Increased water/energy cost
Increased labour cost
Brand image impact
Safety issue
Guest satisfaction
Other
Please select
Provided staff training to improve outcome/safety
Group training required to improve outcome/safety
Group training delivered to improve outcome/safety
Advised Supervisor of issue, awaiting feedback on assistance required
Non JayChem product is use, recommended JayChem alternative
Recommended supplementary product to improve outcome
Referred issue to JayChem technical centre for review/recommendation
Unable to correct issue, please see comments below
Add field
Dispenser Inspection
Functional test
Please select
Complete - system fully operational
Complete - system faulty, repaired, tested, ok
Complete - system faulty, unable to repair, parts ordered
Complete - system operational, parts proactively ordered for next visit
Complete - system operational, parts proactively replaced
Complete - additional equipment required
Incomplete - unable to access one or more dispensers (ref General Comments)
Correct labelling
Please select
Labelling correct and in place
Mislabelled items found, removed from circulation
Mislabelled items found, relabelled
No labels found
Bottle labels
Please select
Screen printed labels correct and in place
Mislabelled bottles found, removed from circulation
Mislabelled bottles found, relabelled
Wall charts
Please select
Wallcharts inspected, correct and in good condition
Wallcharts inspected, correct but in poor condition, replaced
Wallcharts inspected, incorrect or in poor condition, replaced
No charts found
SDS
Please select
SDS inspected, correct, within date and accessible
SDS inspected, incorrect, replacement required
SDS wall charts in place and in good condition
Add field
Product requirements
Order code
Pack size
PAR level
Stock take
Suggested order
Product
Product name
Bleach Plus
Builder HP
Builder LA
Builder Plus
Clinical Wash Plus
Detergent Emulsifier
Detergent GP
Emulsifier HP
Jay Spot
Laundry Powder Plus
Laundry Spotter
Oxy Bleach
Oxy Bleach LT
Sour Conditioner
Sour Softener
Bathroom Cleaner
Carpet Extractor
Carpet Spotter
Chlorgel
Creme Cleanser
Glass & Chrome Cleaner
Neutral Cleaner
Odour Counteractant
Dishmachine Detergent
Glass Wash
Pot & Pan Plus
Rinse Additive
Cleaner Degreaser
Foam Chlor
Fast Oven & Grill
Fruit & Veg Sanitiser
Hard Surface Sanitiser
Oven & Grill HD
Antibac Foam
Antibac Sani
Hand & Body Wash
Hand Sanitiser
Chlorsoak
Oxy Soak
Rust Remover
Scale Remover
Surface Spray Disinfectant
Dishmachine Detergent NC
Order code
Pack size
PAR level
Stock take
Suggested order
Product
Product name
Bleach Plus
Builder HP
Builder LA
Builder Plus
Clinical Wash Plus
Detergent Emulsifier
Detergent GP
Emulsifier HP
Jay Spot
Laundry Powder Plus
Laundry Spotter
Oxy Bleach
Oxy Bleach LT
Sour Conditioner
Sour Softener
Bathroom Cleaner
Carpet Extractor
Carpet Spotter
Chlorgel
Creme Cleanser
Glass & Chrome Cleaner
Neutral Cleaner
Odour Counteractant
Dishmachine Detergent
Glass Wash
Pot & Pan Plus
Rinse Additive
Cleaner Degreaser
Foam Chlor
Fast Oven & Grill
Fruit & Veg Sanitiser
Hard Surface Sanitiser
Oven & Grill HD
Antibac Foam
Antibac Sani
Hand & Body Wash
Hand Sanitiser
Chlorsoak
Oxy Soak
Rust Remover
Scale Remover
Surface Spray Disinfectant
Dishmachine Detergent NC
Order code
Pack size
PAR level
Stock take
Suggested order
Product
Product name
Bleach Plus
Builder HP
Builder LA
Builder Plus
Clinical Wash Plus
Detergent Emulsifier
Detergent GP
Emulsifier HP
Jay Spot
Laundry Powder Plus
Laundry Spotter
Oxy Bleach
Oxy Bleach LT
Sour Conditioner
Sour Softener
Bathroom Cleaner
Carpet Extractor
Carpet Spotter
Chlorgel
Creme Cleanser
Glass & Chrome Cleaner
Neutral Cleaner
Odour Counteractant
Dishmachine Detergent
Glass Wash
Pot & Pan Plus
Rinse Additive
Cleaner Degreaser
Foam Chlor
Fast Oven & Grill
Fruit & Veg Sanitiser
Hard Surface Sanitiser
Oven & Grill HD
Antibac Foam
Antibac Sani
Hand & Body Wash
Hand Sanitiser
Chlorsoak
Oxy Soak
Rust Remover
Scale Remover
Surface Spray Disinfectant
Dishmachine Detergent NC
Order code
Pack size
PAR level
Stock take
Suggested order
Add Product
General Comments / Follow Up
Project work
Yes
No
Project type
Asset audit
Staff procedural audit
Equipment audit
Water and energy audit
Chemical safety audit
Cleaning and sanitation audit
Non JayChem product audit
Hand hygiene audit
PPE audit
Cross infection audit
Chemical store audit
Process Validation
Rating
To be completed by the customer
Based on our service today, would you recommend JayChem to a friend or colleague?
Please select
1 - Strongly recommend JayChem
2 - Would recommend
3 - Neutral
4 - Would not recommend
5 - Strongly recommend against JayChem
Reviewed by
Signature
+
Full name
Contact number