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I’d usually start with my suite of cleanup tools, do some manual cleanup if needed, apply all the software and security updates, and then give it a day with some light test usage. Then I’d re-run the tools to see if they picked anything back up. If not, I released it back to the customer. If anything at all came back, I’d backup their data, pull all the product keys I could (Office, Photoshop, etc), nuke the OS, and reinstall what I could as close to the original as possible.
I’d usually start with my suite of cleanup tools, do some manual cleanup if needed, apply all the software and security updates, and then give it a day with some light test usage. Then I’d re-run the tools to see if they picked anything back up. If not, I released it back to the customer. If anything at all came back, I’d backup their data, pull all the product keys I could (Office, Photoshop, etc), nuke the OS, and reinstall what I could as close to the original as possible.