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New Branch Evaluation


Staff Present (with shift)
A. Reception / Waiting Area Section Avg: 0
Cleanliness & order (Floors, seats, tables, glass)

Waste management (bins emptied, liners; no odor)

Aroma/Ambience (scent diffuser working)

Lighting & sound (all lights operational & sound level appropriate)

Signages & Service Menu operational (Acrylic/TV/Sintra Board)

B. Treatment Rooms Section Avg: 0
Treatment bed & linens clean; changed per patient

Surfaces disinfected between clients

Tools/consumables organized

Machines present, clean & functional

Room condition (floors, comfort, privacy)

C. Procedure / Prep Section Avg: 0
Hand hygiene before & during procedure

New & used items separated on tray

Tools & sharps positioned safely in tray

Consumables properly scaled

D. Restroom & Utility Section Avg: 0
Toilets/sinks/floors cleaned & disinfected

Soap/tissue/towels replenished

Odor/ventilation acceptable; fixtures working

Mirrors & surfaces spotless; no water spots

Trash bins closed; no foul odor

E. Hallway Section Avg: 0
Surfaces (panels/fixtures/mirrors) clean; no dust buildup

Lighting operational

Storage organized & labeled

Floors clutter-free; no slip/trip hazard

F. Utility / Pantry / Machine / Inventory Room Section Avg: 0
FIFO observed for products & clinic use

Proper segregation (products/clinic use/tools)

Shelving neat, labeled, and off-floor

G. Equipment Care Section Avg: 0
Machines wiped after use; no exposed wires

Cords/cables stored safely

PM logs up to date; inventory tags present & updated

Incident/accident reports submitted when applicable

Overall Average: 0.00
Rate each item 1–5 (1=Poor, 5=Excellent).
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