Janitorial inspection report sample.pdf

PDF 342 KB Posted

Attached to
Student Support/Facilities Operation Maintenance Services Federal contract opportunity
Solicitation number
70LCHS25RPFB00001
Issued by
Department of Homeland Security Federal Law Enforcement Training Center

About this file

Written by GovTribe AI ·

This is GSA Form 1181A, a Contract Cleaning Inspection Report form used to document inspection results of contract cleaning services. The form is prescribed by the GSA Custodial Management Desk Guide and allows inspectors to rate cleaning services as either "Satisfactory" or "Unsatisfactory" for specific locations within a building.

The form contains fields for recording essential inspection details including building information, inspector name, inspection date/time, contractor receipt acknowledgment, and a detailed table to document specific work locations (room numbers, corridors, lobbies). For each location inspected, the form provides columns to record quantities (by measure or count), a rating checkbox (SAT/UNSAT), and remarks - particularly for explaining any unsatisfactory ratings. This is a blank template form that would be used during actual cleaning service inspections to document contractor performance.

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CONTRACT CLEANING INSPECTION REPORT

INSTRUCTIONS: Form is used for inspection of contract cleaning by inspectors to record results. The condition of area(s) inspected will be rated SATISFACTORY or UNSATISFACTORY. Explain unsatisfactory rating in remarks column and complete quantity column.

BUILDING

INSPECTOR (Print name)

TIME STARTED

INTERVIEWED BY

WORK DESCRIPTION - LOCATION

(Room No., Corridor, Lobby or either)

QUANTITY

(By measure or count)

CHECK ONE

REMARKS

SAT. UNSAT.

TIME COMPLETED

DATE

REPORT NO. CONTRACT NO.

INSPECTOR'S SIGNATURE

DATE OF INSPECTION

CONTRACTOR'S RECEIPT TIME DATE

GSA FORM 1181A (REV. 12-97)

Prescribed by Custodial Management Desk Guide

GENERAL SERVICES ADMINISTRATION

GSA FORM 1181A (REV. 12-97)

Prescribed by Custodial Management Desk Guide

GENERAL SERVICES ADMINISTRATION

REMARKS

UNSAT.SAT.

CHECK ONEQUANTITY

(By measure or count)

WORK DESCRIPTION - LOCATION

(Room No., Corridor, Lobby or either)

CONTRACT CLEANING INSPECTION REPORT

INSTRUCTIONS: Form is used for inspection of contract cleaning by inspectors to record results. The condition of area(s) inspected will be rated SATISFACTORY or UNSATISFACTORY. Explain unsatisfactory rating in remarks column and complete quantity column.

BUILDING

INSPECTOR (Print name)

TIME STARTED

INTERVIEWED BY

WORK DESCRIPTION - LOCATION

(Room No., Corridor, Lobby or either)

QUANTITY

(By measure or count)

CHECK ONE

REMARKS

SAT.

UNSAT.

TIME COMPLETED

DATE

REPORT NO.

CONTRACT NO.

INSPECTOR'S SIGNATURE

DATE OF INSPECTION

CONTRACTOR'S RECEIPT

TIME

DATE

GSA FORM 1181A (REV. 12-97)

Prescribed by Custodial Management Desk Guide

GENERAL SERVICES ADMINISTRATION

GSA FORM 1181A (REV. 12-97)

Prescribed by Custodial Management Desk Guide

GENERAL SERVICES ADMINISTRATION

REMARKS

UNSAT.

SAT.

CHECK ONE

QUANTITY

(By measure or count)

WORK DESCRIPTION - LOCATION

(Room No., Corridor, Lobby or either)

BUILDING:
REPORT NUMBER:
CONTRACT NUMBER:
CONTRACTOR'S RECEIPT:
INSPECTOR (Print name):
TIME STARTED:
INTERVIEWED BY:
WORK DESCRIPTION - LOCATION (Room Number, Corridor, Lobby or either). Line 28 of 28:
QUANTITY (By measure or count):
REMARKS:
TIME COMPLETED:
TIME :
Date. Enter 2 digit month, 2 digit day and 4 digit year.:
Date. Enter 2 digit month, 2 digit day and 4 digit year.:
Date of Inspection. Enter 2 digit month, 2 digit day and 4 digit year.:
INSPECTOR'S SIGNATURE. This is a protected field.:
INSPECTOR'S SIGNATURE. DIGITAL SIGNATURE.:
CHECK ONE. SATISFACTORY: 0
CHECK ONE. SATISFACTORY: 0
CHECK ONE. UNSATISFACTORY: 0
CHECK ONE. UNSATISFACTORY: 0
CHECK ONE. SATISFACTORY: 0
CHECK ONE. SATISFACTORY: 0
CHECK ONE. UNSATISFACTORY: 0
CHECK ONE. UNSATISFACTORY: 0
CHECK ONE. SATISFACTORY: 0
CHECK ONE. SATISFACTORY: 0
CHECK ONE. UNSATISFACTORY: 0
CHECK ONE. UNSATISFACTORY: 0
CHECK ONE. SATISFACTORY: 0
CHECK ONE. SATISFACTORY: 0
CHECK ONE. UNSATISFACTORY: 0
CHECK ONE. UNSATISFACTORY: 0
CHECK ONE. SATISFACTORY: 0
CHECK ONE. SATISFACTORY: 0
CHECK ONE. UNSATISFACTORY: 0
CHECK ONE. UNSATISFACTORY: 0
CHECK ONE. SATISFACTORY: 0
CHECK ONE. SATISFACTORY: 0
CHECK ONE. UNSATISFACTORY: 0
CHECK ONE. UNSATISFACTORY: 0
CHECK ONE. SATISFACTORY: 0
CHECK ONE. SATISFACTORY: 0
CHECK ONE. UNSATISFACTORY: 0
CHECK ONE. UNSATISFACTORY: 0
CHECK ONE. SATISFACTORY: 0
CHECK ONE. SATISFACTORY: 0
CHECK ONE. UNSATISFACTORY: 0
CHECK ONE. UNSATISFACTORY: 0
CHECK ONE. SATISFACTORY: 0
CHECK ONE. SATISFACTORY: 0
CHECK ONE. UNSATISFACTORY: 0
CHECK ONE. UNSATISFACTORY: 0
CHECK ONE. SATISFACTORY: 0
CHECK ONE. SATISFACTORY: 0
CHECK ONE. UNSATISFACTORY: 0
CHECK ONE. UNSATISFACTORY: 0
CHECK ONE. SATISFACTORY: 0
CHECK ONE. SATISFACTORY: 0
CHECK ONE. UNSATISFACTORY: 0
CHECK ONE. UNSATISFACTORY: 0
CHECK ONE. SATISFACTORY: 0
CHECK ONE. SATISFACTORY: 0
CHECK ONE. UNSATISFACTORY: 0
CHECK ONE. UNSATISFACTORY: 0
CHECK ONE. SATISFACTORY: 0
CHECK ONE. SATISFACTORY: 0
CHECK ONE. UNSATISFACTORY: 0
CHECK ONE. UNSATISFACTORY: 0
CHECK ONE. SATISFACTORY: 0
CHECK ONE. SATISFACTORY: 0
CHECK ONE. UNSATISFACTORY: 0
CHECK ONE. UNSATISFACTORY: 0
CHECK ONE. SATISFACTORY: 0
CHECK ONE. SATISFACTORY: 0
CHECK ONE. UNSATISFACTORY: 0
CHECK ONE. UNSATISFACTORY: 0
CHECK ONE. SATISFACTORY: 0
CHECK ONE. SATISFACTORY: 0
CHECK ONE. UNSATISFACTORY: 0
CHECK ONE. UNSATISFACTORY: 0
CHECK ONE. SATISFACTORY: 0
CHECK ONE. SATISFACTORY: 0
CHECK ONE. UNSATISFACTORY: 0
CHECK ONE. UNSATISFACTORY: 0
CHECK ONE. SATISFACTORY: 0
CHECK ONE. SATISFACTORY: 0
CHECK ONE. UNSATISFACTORY: 0
CHECK ONE. UNSATISFACTORY: 0
CHECK ONE. SATISFACTORY: 0
CHECK ONE. SATISFACTORY: 0
CHECK ONE. UNSATISFACTORY: 0
CHECK ONE. UNSATISFACTORY: 0
CHECK ONE. SATISFACTORY: 0
CHECK ONE. SATISFACTORY: 0
CHECK ONE. UNSATISFACTORY: 0
CHECK ONE. UNSATISFACTORY: 0
CHECK ONE. SATISFACTORY: 0
CHECK ONE. SATISFACTORY: 0
CHECK ONE. UNSATISFACTORY: 0
CHECK ONE. UNSATISFACTORY: 0
CHECK ONE. SATISFACTORY: 0
CHECK ONE. SATISFACTORY: 0
CHECK ONE. UNSATISFACTORY: 0
CHECK ONE. UNSATISFACTORY: 0
CHECK ONE. SATISFACTORY: 0
CHECK ONE. UNSATISFACTORY: 0
CHECK ONE. SATISFACTORY: 0
CHECK ONE. UNSATISFACTORY: 0
CHECK ONE. SATISFACTORY: 0
CHECK ONE. UNSATISFACTORY: 0
CHECK ONE. SATISFACTORY: 0
CHECK ONE. UNSATISFACTORY: 0
CHECK ONE. SATISFACTORY: 0
CHECK ONE. UNSATISFACTORY: 0
CHECK ONE. SATISFACTORY: 0
CHECK ONE. UNSATISFACTORY: 0

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