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I learned it only AFTER completing a total master planned starter hospital, with all the proper wall colors and all.
One thing to be mindful of with janitors is that once they start cleaning a room they completely finish the job before moving on, at least when I last checked. If you have very busy and/or large rooms, especially corridors near entrances and elevators, this can result in them getting stuck for ages in that room as the foot traffic contributes more dirt.
This is worth checking for if they don't seem to be cleaning some areas. The solution can be to split a long corridor up into several shorter corridors, or hire more janitors of course.