The short answer
The form is the Board’s own template for the record 21 NCAC 14H .0403(r) requires. One row is one cleaning, and every row has the same five columns: Date, Time, After Client, Daily, Employee Signature. The rule says what the record holds, not what it looks like: “A record shall be made of the date and time of each cleaning and disinfecting as required by this Rule including the date, time, reason, and name of the staff member who performed the cleaning. This record shall be made for each whirlpool or footspa and shall be kept and made available for at least 90 days upon request by either a patron or inspector.” The rule names no form. The Board’s form carries the first four things the rule asks for (date, time, reason, name) and leaves the last two (one per unit, ninety days) to you.
| The rule says (.0403(r)) | On the Whirlpool/Foot Spa Sanitation Form |
|---|---|
| “the date and time of each cleaning and disinfecting” | The Date and Time columns |
| “reason” | The After Client and Daily columns: the rule’s two cleanings, .0403(p) and (q) |
| “name of the staff member who performed the cleaning” | The Employee Signature column |
| “This record shall be made for each whirlpool or footspa” | Nothing on the form: it has no unit number field. One sheet per unit, numbered by hand at the top |
| “kept and made available for at least 90 days upon request by either a patron or inspector” | Nothing on the form. Your filing |
Download the form
One PDF, in English only, on the Board’s site; the same blank is served here, byte for byte. The Board links it as “Footspa Sanitation Form” on its Salon Licensure page, so a new owner usually meets it while licensing the shop. It is two letter pages: the first carries the Board’s header, the title band and thirty-five rows, the second a continuation of twenty-one rows with no header. It carries no form number and no revision date; the header is the Board’s address in Cary, and one line of instruction: “Whirlpool or footspa means any basin using circulating water.” The Board publishes no Spanish or Vietnamese version.
The top of the sheet
The header is the Board’s: its name, address, phone and website, its logo, the title and the one-line definition. What it does not have is a line for which foot spa the sheet belongs to, though the rule says the record is made “for each whirlpool or footspa”; nor is there a line for the shop’s name or license number. So the first thing to write on a fresh sheet, before any row, is the unit’s number at the top (the section on one sheet per foot spa has the method), and beside it the shop’s name and license number, in the blank space between the Board’s address and its logo. ReadyPedi prints the three there.
The five columns
Date. The date of the cleaning. The form has no month field at the top and its Date column carries no format hint, so write the full date on each row, not just the day. Time. When the cleaning was finished, written at the time. The rule asks for “the date and time of each cleaning and disinfecting”, and a column filled in at closing from memory is what an inspector is trained to notice: six rows in one hand with times five minutes apart. After Client and Daily. The rule’s “reason”: which of the two cleanings this row is, a check in one of the two cells, never both. Employee Signature. The name of the staff member who did the cleaning. Nothing on the form asks which disinfectant was used, and nothing in the rule does either.
After Client or Daily: the rule’s two reasons
The rule has two cleanings, and the form has one column for each. After Client is the cleaning .0403(p) asks for after each patron: the water drained, the debris out, a soap and a disinfectant circulated through the unit for ten minutes, the basin drained, rinsed and wiped dry. Daily is the form’s word for the end-of-day breakdown .0403(q) asks for, “At the end of the day”: the screen out and immersed in disinfectant, the inlet brushed, the system flushed. Different procedures, different rows. A chair that saw six patrons and was closed down that night has seven rows: six After Client and one Daily, because the rule asks for two cleanings and the last patron’s cleaning does not become the night’s. There is no Weekly column, because North Carolina’s rule has no weekly cleaning; the two schedules, and why there is no third, are in our guide to how often to clean a pedicure foot spa in North Carolina. The steps of each are in our guide to how to clean a pedicure foot spa in North Carolina.
The Employee Signature column and the rule’s “name of the staff member”
The rule’s word is name: “name of the staff member who performed the cleaning”. The form’s column is a signature line, on a template the rule does not name. What the column has to deliver, then, is a name an inspector can read and match to a person who was working that day. A signature that could be anyone’s satisfies the column heading and not the rule. On paper, print the name, or sign and print beside it. It is the name of the person who did the cleaning, usually the tech who did the pedicure, not the owner who checks the sheet at closing. ReadyPedi prints the staff member’s name in the column, from the roster, with nothing beside it.
One sheet per foot spa, on a form with no unit number
The rule is plain: “This record shall be made for each whirlpool or footspa.” The form gives you no place to say which one, so you make one. Number the chairs once, label each chair to match, and write that number at the top of every sheet the chair uses. One sheet per unit, never a shared one: a shared sheet cannot show which unit was cleaned after which patron, which is the whole point of the record. Adding a unit line to the form is safe because the form is a template, not a mandate; the rule says what the record holds and that it exists per unit, not what it looks like. A six-chair shop runs six sheets at a time. ReadyPedi prints one sheet per unit with the unit number at the top beside the Board’s address.
Keeping it and showing it
The rule sets a floor and an audience: the record “shall be kept and made available for at least 90 days upon request by either a patron or inspector.” It does not say where, and it does not say paper or electronic. Ninety days runs from each cleaning, so a sheet can leave the binder only when its newest row is more than ninety days old; the simple rule is the current sheet at the chair or the desk and the last four months in a binder at the shop. Inspections are annual and may come without notice (21 NCAC 14H .0501), and a patron may ask too, so “at the shop” means at the shop, not at home. An electronic record that can be shown on a screen and printed as the Board’s form meets “made available” as well as a binder does; what matters is that it exists for every unit and every cleaning and can be produced when asked. ReadyPedi keeps two years and opens the last ninety days in Inspection mode. Every state’s period, beside North Carolina’s ninety days, is in our guide on how long to keep foot spa cleaning records, by state.
What a missing record costs
The Board’s civil penalty schedule, 21 NCAC 14P .0117, sets a penalty per footspa, not per shop. Paragraph (d): a record not made, or not kept and made available for ninety days, is $25 per foot spa. Paragraph (e): a footspa not cleaned and disinfected as the rules require is $100 per foot spa. Paragraph (k): more than three written notifications of any one rule to one shop brings a mandatory disciplinary hearing. The schedule was read on the state’s administrative code host on October 23, 2026, in the text readopted April 1, 2026.
Filling the Board’s form from a record kept at the chair
In ReadyPedi, each chair is set up once as Whirlpool or Pipe-less. The tech taps the cleaning at the chair, which is the reason; the date, time and name are stamped. The app refuses both columns on one row and refuses a weekly row the rule does not have. Any unit and any date range prints as the Board’s own form, one sheet per unit with the unit number at the top. The rule next to the app is on the North Carolina page, and a shop can start a free trial today.
Frequently asked questions
Is the Whirlpool/Foot Spa Sanitation Form mandatory in North Carolina?
No. 21 NCAC 14H .0403(r) says what the record holds (date, time, reason, the staff member’s name), that it is made for each whirlpool or footspa, and that it is kept ninety days; it names no form. The Board’s form is its own template with exactly those columns, so it is the record inspectors recognize.
Do I need a separate sheet for every foot spa?
Yes. The rule says the record “shall be made for each whirlpool or footspa”. The form has no unit field, so write the unit’s number at the top of each sheet and never share a sheet between chairs.
Does a signature count as the staff member’s name?
The rule asks for the name. Sign the column if you like, but make sure the name can be read; a signature nobody can read back to a person is not what the rule asks for.
Can I keep the record on a tablet or phone instead of paper?
The rule does not say paper or electronic; it says the record is kept and made available on request to a patron or an inspector. An electronic record that can be shown and printed as the Board’s form meets that. Keep it at the shop.
How long do I keep old sheets?
At least ninety days from the cleanings they record. Keep them longer: an inspection is once a year, and a year of sheets shows a pattern where ninety days shows a quarter.
This guide explains North Carolina’s foot-spa cleaning record in plain language and is not legal advice. The North Carolina Board of Cosmetic Art Examiners’ rules are the authority on North Carolina foot-spa cleaning and recordkeeping requirements.