'Data Capture IL-WI'

Client Rep:

STORE

Description	Response		Details	Notes
Flooring			Are the floors free from gum, debris, or spills?
Glass			Is the glass free from smudges, dust, or other debris?
Tables & Desks			Is the store free from dust or debris under racks or tables, or behind mirrors leaning against the walls?
Tables & Desks 2			Are the shelves and tables free from dust?
Carpet Mattings			Are the rugs free from debris?
Fitting Rooms			Do the fitting rooms look clean?
Restroom Cleaning			Do the restrooms look and smell clean?
Breakroom/Offstage			Does the breakroom look and smell clean?
Office			Is the weekly office cleaning being done - empty trash/recycling. Sweeping the floor?
Hallways			Does the hallway along restrooms, break room and offices look clean?
Elevators			Where present - are elevators clean; including walls, edges and corners?
Escalators			Where present - are escalators clean; including handrails, edges and corners?
Stairs			Where present - are stairs clean; inclduing handrails, edges and corners?

EMPLOYEES

Description	Response		Details	Notes
Vacuum			Are backpack vacuums being used for cleaning under tables/tracks, and for spot-cleaning?
Dusters			Are extension dusters being used for shelves and high glass?
Mops			Are glass mops and squeeges being used for cleaning mirrors?
C0062 - Citrus Express Gel Solvent spotter and Gum			Is the citrus express chemical being used for gum that cannot be removed with a scraper?

MECHANICAL ROOM

Description	Response		Details	Notes
Equipment			Is the equipment in good working condition? If not, please report to Steve.
Scrubber			Please verify the scrubber tab number or serial number by adding to Notes.
Backpack Vacuum			Please verify the backpack vacuum tag number or serial number by adding to notes.

SUPPLY CLOSET

Description	Response		Details	Notes
Supply Closet			Are any supplies running low or in bad condition? If so please report to Steve for more supplies.
Supply Closet 2			Have paper towels/toilet paper/disinfectant/trash bags, etc. been ordered from the store manager? If no, please advise why and when the order will be placed.

WORKPLACE SAFETY INSPECTION - STORE

Description	Response		Details	Notes
Equipment			Is all equipment stored in its proper place - not blocking walkways, doors, or fire lanes?
Safety Box			Is the Safety Box in the store?
Safety Box 2			Are the SDS Sheets inside the Safety Box?
Safety Box 3			Is the Site Log inside the Safety Box?
Safety Box 4			Are there dust masks available for the employees to use?
Safety Box 5			Are there ear plugs avialable for the employees to use?
Safety Box 6			Is there a first aid kit in the Safety Box?
Safety Box7			Are there gloves available for the employees to use?
Eye Wash Station			Is there an eye wash station for the employees to use?
Safety Cones			Are there wet floor signs/cones available for use?
Danger Tape			Is Danger Tape available for projects?
Chemicals			Are all chemicals on the shelves in their proper locations?
Chemicals 2			Are all chemicals stored in their proper containers?
Chemicals 3			Are all chemicals preperly marked?
Scrape Sticks			Are the scrape sticks stored in a safe manner, and are the blades secured properly?
Power Cords			Are the power cords on all vacuums, extractors, air movers, and extension cords in good condition (ground terminal in place, no frays or broken casing)?
Propane			If used at this location, is propane being removed from the store each day after use?
Propane Cage			If used at this location, is the propane cage locked when left unattended?
Propane Cage 2			If used at this location, is access to the propane cage clear and free of danger, such as ice and snow?

WORKPLACE SAFETY INSPECTION - EMPLOYEES

Description	Response		Details	Notes
Footwear			Are the employees using approved shoes and attire?
SDS Sheets			Do all of the employees know where the SDS Sheets are and how to use them?
PPE			Are the employees using the PPE?
Proper Lifting			Are the employees implementing proper lifting procudures?
Operation			Are the employees operating the equipment in a proper and safe manner?
Food Cleaning			Are the employees trained on the proper cleaning procedures for food preparation areas, including the danger of cross contamination (if applicable)?
Safety Cones			Are the employees using safety cones to indicate trip hazards, such as electrical cords, rolled up carpet runners, and rolle up mats?
Aisles			Are the employees properly blocking aisles when doing wet work?
Mopping Excess			Are the employees mopping excess water left by the scrubber?
Air Movers			Are the employees using Air Movers to dry wet carpet?
Supply closet			Are the employees leaving the supply closet neat and orderly?

****************************Nordstrom ONLY*************************************************

Vendor Log

Description	Response		Details	Notes
Log Entries			Entries legible and complete including employee first and last name.
Urgent Issues			Are there any urgent issues/major service/projects. If so indicated in comments.

Review Equipment Operation/Needs

Job Board

Description	Response		Details	Notes
Schedule			Schedule works for next week/month
Routines			Routines posted in Contractor Letterhead
Employee Picture			Employees picture posted and current
Employee Badge			Employees wearing badges/shirt
Employee Checking Out			Employees Checking out with MIC prior to leave (Review with SM or Admin)

Overall Satisfaction: Daily and Weekly Service Level Expectations Met:

Additional Comments