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Form Daily Inspection Report - Common Area

This document is a daily inspection report for common areas (lobby, corridor, and lifts) of a project. It lists 30 points of attention for cleanliness inspections and 7 items for personal protective equipment inspections. For each inspection, the number of satisfactory and total inspected items are recorded to calculate a satisfaction score percentage. The report also includes fields for remarks, inspection date and personnel. Inspections cover cleanliness, PPE usage, and aim to ensure hygiene quality and safety discipline are maintained.

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Wiid Si Petuallaang Aagresiff
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379 views1 page

Form Daily Inspection Report - Common Area

This document is a daily inspection report for common areas (lobby, corridor, and lifts) of a project. It lists 30 points of attention for cleanliness inspections and 7 items for personal protective equipment inspections. For each inspection, the number of satisfactory and total inspected items are recorded to calculate a satisfaction score percentage. The report also includes fields for remarks, inspection date and personnel. Inspections cover cleanliness, PPE usage, and aim to ensure hygiene quality and safety discipline are maintained.

Uploaded by

Wiid Si Petuallaang Aagresiff
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

DAILY INSPECTION REPORT/ LAPORAN PEMERIKSAAN HARIAN - COMMON/ PUBLIC AREA (LOBBY, CORRIDOR AND LIFT)

PROJECT : DAY / DATE :


HKA : NIK :
HKL/HKS/AM :

No Point of Attention Location Remarks

A CLEANLINESS Time
1 Ceiling / Langit-Langit

2 Lamp / Lampu

3 AC Diffuser / Penutup Saluran AC

4 Wall / Dinding / Pilar

5 Accessories/ Aksesoris

6 Electric Switch / Stop Kontak

7 Fire Extinguisher / Tabung Pemadam/ APAR

8 Standing Ashtray/ Asbak

9 Furniture / Furnitur

10 Reception Counter / Meja Resepsionis

11 Picture / Lukisan

12 Hydrant box / Kotak Selang Hidran

13 Planter pot / Pot Tanaman

14 Emergency Stair/ Tangga Darurat

15 Stair Cases/ Tangga

16 Railing Glass/ Kaca Pembatas

17 Escalator / Eskalator

18 Travelator

19 Janitor

20 Pantry/ Dapur

21 Floor / Lantai

22 Window / Jendela (kaca dan frame)

23 Light Difusers / Tutup Lampu

24 Door Tracks / Rel Pintu

25 Door Lift / Pintu Lift

26 Lift Floor/ Lantai Lift

27 Floor mat / Keset

28 Speaker / Pengeras Suara

29

30
Total Satisfaction (1)/ Total Jumlah (1) yang baik
Total Inspection Object/ Jumlah Obyek yang diperiksai
Score Satisfaction : (Jumlah Satisfaction / total item inspeksi) x 100%

B PERSONAL PROTECTIVE EQUIPMENT / APD


1 Safety Glass / Kaca Mata Pengaman
2 Masker / Pelindung Pernapasan
3 Safety Hand Gloves / Sarung Tangan Pengaman
4 Safety Shoes / Safety Boot / Canvas
5
6
7
Total Satisfaction (1)
Total Item Inspeksi
Score Satisfaction : (Jumlah Satisfaction / total item inspeksi) x 100%

Remarks : Jumlah
Total Penilaian Score (%)
0 = Unsatisfaction / PPE Not Used Item Inspeksi Satifaction
1 = Satisfaction / PPE Used A. Hygiene Quality
N/A = leave blank B. Kedisiplinan Pemakaian APD

Range : Diperiksa Oleh Diketahui Oleh


A > 91 % Sangat Baik/Execellent
B 81 % - 90 % Baik/Good
C 61 % - 80 % Cukup/fair
D < 60 % Kurang/Poor

HKL/ HKS/ AM Sr.Ops Mgr/GM


Nomor Form : QF 16-11-00

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