I feel your pain, I hope to try and get 5 stars too, I am also currently on 4 stars. I have unlocked the best equipment, have the patience perk and still it says my equipment needs to be better, I have 3 staff that only clean and 4 super upgraded vacuums that constantly clean but I still get the our place needs to be clean thing as well, its quite frustrating, there is not one vomit, pee or poo dropping anywhere, the only ones are the ones acuring during the exam and then a vet or robot cleans it up asap while the exam is happening so no reason why I should get that. I have learned to not check mouth that seems to lessen vomiting. My sim is maxed in vet and charisma and logic so yeah its frustrating.
