Assessment Questionnaire
Assessment Questionnaire
01 Swachha Municipalities
4-5
03 Swachha SLF
9
05 Swachha Schools
11-12
06 Swachha Anganwadis
13-14
07 Swachha Hospitals
15-18
11 Swachha Hostels
25-26
13 Swachha NGOs
31-32
14 Swachhta Warriors
33-34
Total - 100%
30
1 What percentage of waste is segregated at household level?
Marks
76% - 100% → 30 Marks
50% - 75% – 15 Marks
Less than 75% – 0 Marks
Has the ULB formally notified and enforced a ban on single-use plastics
4 15
across
Marks
all wards?
5
CATEGORY 2:
SWACHHA GRAM PANCHAYAT
Total - 100%
To what extent are NADEP/Earthen pits in Gram Panchayat filled and used
4 20
for
Marks
wet waste processing?
≥
High ( 500 kg) – 10 Marks
Medium (100kg–499 kg) – 5 Marks
Low (<100 kg) – 0 Marks
≥
High ( ₹5,000) – 10 Marks
Medium (₹2,000–4,999) – 5 Marks
Low (<₹2,000) – 0 Marks
What is the average monthly income generated from the sale of dry waste 10
7
after segregation? Marks
≥
High ( ₹10,000) – 10 Marks
Medium (₹3,000–9,999) – 5 Marks
Low (<₹3,000) – 0 Marks
7
Is the processing facilities free from foul smell and flies in and around 5
8
premises? Marks
Yes – 5 Marks
No – 0 Marks
How many garbage heaps have been identified within Panchayat jurisdiction? 5
9
Marks
None – 5 Marks
Few (1-3) – 2 Marks
Many (4+) – 0 Marks
How many cattle dung heaps are present along the roadsides within 5
10 Panchayat jurisdiction? Marks
None – 5 Marks
Few (1-3) – 2 Marks
Many (4+) – 0 Marks
8
CATEGORY 3:
SWACHHA SLF
(SWACHHATA SLUM LEVEL FEDERATION)
SLF
Total - 100%
Are Self Help Groups trained in rooftop gardening techniques, including soil 20
1
preparation and irrigation? Marks
Yes – 20 Marks
No – 0 Marks
9
CATEGORY 4:
SWACHHA VILLAGE ORGANISATION
Village Organisation
Total - 100%
Are Self Help Groups trained in Home composting and Kitchen Gardens? 20
1
Marks
Yes – 20 Marks
No – 0 Marks
10
CATEGORY 5:
SWACHHA SCHOOLS
Schools
FUNCTIONAL, GENDER-SEPARATED
1 30%
TOILETS
Total - 100%
11
C5. SWACHHA SCHOOLS (100 Marks)
30
1 Does the school have separate toilets for boys and girls?
Marks
Yes, all toilets are Gender Separated – 30 Marks
Few toilets are gender separated – 15 Marks
No, not available – 0 Marks
Are handwashing stations with soap dispensers available and functional near 20
3
toilets? Marks
Has the school formed a student-led Swachhata club and are students 15
4
actively participating in cleanliness campaigns/awareness activities? Marks
Yes, active club formed, and students are actively involved – 15 Marks
Club formed but inactive / limited student involvement – 8 Marks
No club formed and no student involvement – 0 Marks
12
CATEGORY 6:
SWACHHA ANGANWADIS
Anganwadis
Total - 100%
Are the toilets in AWCs cleaned and maintained daily to ensure hygiene and 10
1
child safety? Marks
Yes – 10 Marks
No – 0 Marks
Mandatory Evidence: Picture of kitchen/Feeding area.
2 Are kitchen and feeding areas cleaned before and after food preparation and 10
distribution? Marks
Yes – 10 Marks
No – 0 Marks
10
3 Is Hand Wash Practice being observed in AWC?
Marks
Yes – 10 Marks
No – 0 Marks
13
4 Is AWC having proper ventilation and adequate lighting arrangements? 10
Marks
Yes – 10 Marks
No – 0 Marks
Yes – 10 Marks
No – 0 Marks
Yes – 10 Marks
No – 0 Marks
Are the Anganwadi Workers giving awareness to the community i.e. mothers 10
7
and parents on nutrition, sanitation and hygiene? Marks
Yes – 10 Marks
No – 0 Marks
8 Is waste generated at the AWC segregated into wet and dry categories using 10
labelled bins? Marks
Yes – 10 Marks
No – 0 Marks
10
9 Are segregated waste bins placed in accessible areas and emptied regularly?
Marks
Yes – 10 Marks
No – 0 Marks
Hospitals
CLEAR INSTRUCTIONS/MESSAGES
5 10%
DISPLAYED ON CLEANLINESS
Total - 100%
15
C7. SWACHHA HOSPITALS (100 Marks)
5
1 Are color-coded bins available in all patient care areas?
Marks
Yes – 5 Marks
No – 0 Marks
Mandatory Evidence: Picture of colour-coded bins.
Yes – 5 Marks
No – 0 Marks
5
3 Are bins covered and not overflowing?
Marks
Yes – 5 Marks
No – 0 Marks
Yes – 5 Marks
No – 0 Marks
Yes – 5 Marks
No – 0 Marks
Yes – 5 Marks
No – 0 Marks
16
5
7 Are floors, walls, and surfaces visibly clean and dust-free?
Marks
Yes – 5 Marks
No – 0 Marks
Yes – 5 Marks
No – 0 Marks
5
9 Is disinfectant used properly as per guidelines?
Marks
Yes – 5 Marks
No – 0 Marks
10 Are waiting areas and corridors free from litter and spills? 5
Marks
Yes – 5 Marks
No – 0 Marks
Yes – 5 Marks
No – 0 Marks
Yes – 5 Marks
No – 0 Marks
Yes – 5 Marks
No – 0 Marks
17
5
14 Is soap/hand sanitizer available near washbasins?
Marks
Yes – 5 Marks
No – 0 Marks
Mandatory Evidence: Picture of Soap dispenser/sanitizer near washbasins.
Yes – 5 Marks
No – 0 Marks
5
16 Are infection control committees/teams functional?
Marks
Yes – 5 Marks
No – 0 Marks
Yes – 5 Marks
No – 0 Marks
Yes – 5 Marks
No – 0 Marks
Are IEC materials (posters, boards, stickers) displayed on hand hygiene, waste 5
19
segregation, and cleanliness? Marks
Yes – 5 Marks
No – 0 Marks
Mandatory Evidence: Picture of IEC materials displayed in campus.
Yes – 5 Marks
No – 0 Marks
18
CATEGORY 8:
SWACHHA GOVT. OFFICES
Govt. Offices
CITIZEN/EMPLOYEE FEEDBACK
4 10%
MECHANISM
Total - 100%
19
C8. SWACHHA GOVT. SCHOOLS (100 Marks)
Whether toilets are clean and usable with handwashing facilities within the 30
1 Marks
premises?
20
3 Whether signages promoting cleanliness displayed on the walls appropriately?
Marks
Yes – 20 Marks
No – 0 Marks
Yes – 10 Marks
No – 0 Marks
20
CATEGORY 9:
SWACHHA BUS STATION
Bus Station
Total - 100%
21
C9. SWACHHA BUS STATION (100 Marks)
30
1 Are platforms and waiting area cleaned regularly?
Marks
Yes – 30 Marks
No – 0 Marks
Yes – 20 Marks
Available but spillage found – 10 Marks
No Twin Bin installed – 0 Marks
Yes – 10 Marks
No – 0 Marks
22
CATEGORY 10:
SWACHHA RYTHU BAZAARS
Rythu Bazaars
FEEDBACK MECHANISM ON
5 10%
CLEANLINESS
Total - 100%
23
C10. SWACHHA RYTHU BAZAARS (100 Marks)
Are vendors practicing waste segregation at source using bins for dry 30
1
and wet waste? Marks
More than 80% Segregation – 30 Marks
40% - 80% – 15 Marks
Less than 40% – 0 Marks
2 Are drains and stall area found clean in and around Bazaar? 25
Marks
20
3 What percentage of organic waste is being composted on-site?
Marks
Available – 15 Marks
Not available – 0 Marks
Yes – 10 Marks
No – 0 Marks
24
CATEGORY 11:
SWACHHA HOSTELS
Hostels
Total - 100%
25
C11. SWACHHA HOSTELS (100 Marks)
Yes - 15 Marks
No - 0 Marks
20
3 Are dining and kitchen area cleaned before and after meals?
Marks
Yes – 20 Marks
No – 0 Marks
Mandatory Evidence: Picture of Dining area.
15
5 Is there availability of Twin Bins/Segregated bins in corridors?
Marks
Yes – 15 Marks
No – 0 Marks
Yes – 10 Marks
No – 0 Marks
Mandatory Evidence: Picture of on-site composting. 26
CATEGORY 12A:
SWACHHA INDUSTRIES (LARGE/
MEGA)
Total - 100%
27
C12A. SWACHHA INDUSTRIES (LARGE/ MEGA) (100 Marks)
No – 0 Marks
Mandatory Evidence: Picture of Segregated waste storage area.
2 Are workspaces and restrooms well-maintained, clean, and hygienic all time? 25
Marks
Always Clean & hygienic –25 Marks
Partially clean / not regularly maintained – 12 Marks
Unclean / poor hygiene – 0 Marks
Yes – 15 Marks
No – 0 Marks
5 Is there compliance with pollution control and sanitation norms for all forms
10
of waste viz. Solid, Liquid and Gas?
Marks
28
CATEGORY 12B:
SWACHHA INDUSTRIES (MSMES)
MSMEs
Total - 100%
29
C12B. SWACHHA INDUSTRIES (MSME’S) (100 Marks)
Are work areas kept clean with proper waste bins provided at certain 30
1
interval and used? Marks
Clean areas & proper bins in place – 30 Marks
Bins/cleanliness partial or irregular – 15 Marks
Unclean areas / no bins – 0 Marks
Mandatory Evidence: Picture of Work area.
Yes – 25 Marks
No – 0 Marks
Mandatory Evidence: Picture of toilet block.
Are toilets and handwashing facilities for workers available and well 20
3
maintained? Marks
30
CATEGORY 13:
SWACHHA NGOS
NGOs
SBM COLLABORATION
3 20%
DOCUMENTATION
INNOVATION IN COMMUNITY
4 15%
MOBILIZATION
Total - 100%
31
C13. SWACHHA NGO’s (100 Marks)
2 Has the NGO conducted effective IEC campaigns with wide community 25
reach maintaining decent quality of work? Marks
Yes – 25 Marks
No – 0 Marks
Are toilets and handwashing facilities for workers available and well 20
3
maintained? Marks
32
CATEGORY 14:
SWACHHATA WARRIORS
(SANITATION WORKERS)
Sanitation Workers
Total - 100%
33
C14. SWACHHA WARRIORS (Sanitation Workers) (100 Marks)
What percentage of worker’s assigned area are found clean and well- 20
3
maintained during Spot Audits? Marks
4 Does the worker actively take part in awareness activities (rallies, meetings, 15
IEC drives)? Marks
Yes – 15 Marks
No – 0 Marks
34
CATEGORY 15:
SWACHHA GREEN AMBASSADORS
Green Ambassodors
FEEDBACK OF CITIZENS/GP
5 10%
FUNCTIONARIES
Total - 100%
35
C15. SWACHHA GREEN AMBASSADORS (100 Marks)
Yes – 10 Marks
No – 0 Marks
Yes – 10 Marks
No – 0 Marks
Yes – 10 Marks
No – 0 Marks
Yes – 10 Marks
No – 0 Marks
Yes – 10 Marks
No – 0 Marks
36
Does the Green Ambassador promptly address missed households or 10
7
complaints? Marks
Yes – 10 Marks
No – 0 Marks
Yes – 10 Marks
No – 0 Marks
Yes – 10 Marks
No – 0 Marks
Has the Green Ambassador received positive feedback from citizens and 10
10
Gram Panchayat officials? Marks
Yes – 10 Marks
No – 0 Marks
37
CATEGORY 16:
SWACHHA RESIDENTIAL SCHOOLS
Total - 100%
38
C16. SWACHHA RESEDENTIAL SCHOOL (100 Marks)
Are residential school dormitory rooms found clean with daily cleaning 15
1
schedule? Marks
Yes– 15 Marks
No – 0 Marks
Mandatory Evidence: Picture of Dormitory.
2 Are dormitory toilets & bathrooms found clean with daily cleaning schedule? 15
Marks
Yes– 15 Marks
No – 0 Marks
Mandatory Evidence: Picture of Dormitory toilet blocks.
3 Are handwashing stations with soap functional and adequate for peak use? 15
Marks
Are dining & kitchen areas cleaned before/after meals with protocols? 20
5
Marks
Yes – 20 Marks
No – 0 Marks
Mandatory Evidence: Picture of Dining/Kitchen Area
Are segregated waste bins placed in corridors and correctly labeled? 15
6
Marks
Yes – 15 Marks
No – 0 Marks
Mandatory Evidence: Picture of Waste-Bin.
Yes, active club formed, and students are actively involved – 10 Marks
Club formed but inactive / limited student involvement – 5 Marks
No club formed and no student involvement – 0 Marks
39
40