Title Page

  • Conducted on

  • Prepared by

  • Store Location

  • GM

  • Manager On Duty

Extremes

  • Dough Management: No sheeted dough, no dough expired for 5 days, no green dough in use, not out of any size dough, not out of pan dough

  • No more than 4 non-dough expired products. 5 or more is -10

  • Any refrigeration unit over 50 degrees F / 10 degrees C that has food stored

  • Store Equipment excessively dirty / broken due to neglect - Includes walls, floors, ceilings, makelines, walk-ins, heat racks, ovens, screens, sandwich mats

  • Grooming / Uniform Issues: 3 or more employees is -10

  • Pest Control: Pest control not done on a 4-6 week basis, pest control documentation not posted, evidence of pests / rodents in store

Product (38 Points)

  • Pizza #1

  • Size, Crust, Toppings?

  • What was wrong?

  • Size, Crust, Toppings?

  • Pizza #2

  • Size, Crust, Toppings?

  • Size, Crust, Toppings?

  • What was wrong?

  • Pizza #3

  • Size, Crust, Toppings?

  • What was wrong?

  • Size, Crust, Toppings?

  • Pizza #4

  • Size, Crust, Toppings?

  • What was wrong?

  • Size, Crust, Toppings?

  • Pizza #5

  • Size, Crust, Toppings?

  • What was wrong?

  • Size, Crust, Toppings?

  • Side 1

  • Which Side?

  • Which Side?

  • What was wrong?

  • Side 2

  • Which Side?

  • Which Side?

  • What was wrong?

  • Side 3

  • Which Side?

  • Which Side?

  • What was wrong?

  • Dough Properly Managed

  • Proper Pizza Procedures in Use

  • Proper Side Item Procedures in Use

  • Adequate PRP

Food Safety (22 Points)

  • All products within shelf life and properly dated - Labels MUST be facing outward.

  • Refrigeration in spec - Walk-in (33-38), Makeline Cabinet / Rail (33-41), Soda Coolers (33-43) Any other coolers (33-41). All products above 42F for more than 2 hours DISCARDED.

  • Monthly Pest Control Service in Place

  • Proper End Bake Temps - All products MUST be at least 165F

  • Store Personel maintain proper appearance and hygiene standards

  • Proper Hand Washing, sanitizing, dishwashing procedures followed. Supplies adequately stocked and readily accessible.

  • All food contact surfaces, smallwares, and utensils clean and sanitized.

  • Proper food and beverage handling procedures in use - no bare handed contact with post-bake!

  • Food packaging products, food contact surfaces, equipment and chemicals protected from cross-contamination and stored off of floor

  • Sanitizer with-in proper range

Image and Cleanliness (18 Points)

  • Domino's logo apparel (hats, shirts, shorts/pants/skirts, and outerwear) worn properly and represents a positive brand image

  • Aprons must be clean and worn durin food preparation, and NOT outside the store

  • Hot bags are clean and free of debris

  • Store Wall, floors, baseboards, and equipment are clean and free of dirt and debris

  • Customer area walls, floors, and baseboards are clean and free if dirt and debris

  • Customer area seating, counter, and surfaces are clean, sanitized and free of dirt and debris

  • Restrooms are clean, sanitary, and fully stocked

  • Walk-in is clean, free of debris, mold and mildew

  • Makeline and additional refrigeration units are clean, free of debris, mold, mildew

  • Store setup properly during operational hours

  • Parkinglot and entryway sidewalk are free of debris and windows and windowsills are clean

  • Bake-wares clean and free of excessive carbon build-up

  • Oven catch trays, oven exterior, and heat rack are free of built-up debris

  • Delivery vehicles represent positive brand image

Equipment & Store Condition (16 Points)

  • Store Ceiling, T-Bars, ad vents are clean and not broken, chipped or cracked.

  • Store walls, floors, and baseboards are not broken, chipped or cracked

  • Hand sinks operational and handwashing reminder signage is present

  • Customer area seating, counter and tables are not faded, broken, chipped or cracked

  • Restrooms and fixtures are not broken, chipped or cracked

  • Parking lot, entryway sidewalk, and customer facing store exterior are clean and not damaged

  • Signage is clean, properly illuminated and not damaged

  • Refrigeration and/or HVAC units operational, not broken, chipped, or cracked and free of rust

  • Calibrated thermometers available

  • Small-wares and utensils are not broken, chipped or cracked

  • Bake-wares are not damaged

  • Oven fingers and hood clean and free from excessive grease buildup and yellowing. Oven, hood, and heat rack are operational

  • Sufficient number of hot bags available and are not torn, faded or melted

  • Calibrated, working scales and product job aids available

  • Caller ID is installed and working

  • Safe, Tills, and drop boxes are present, operational and secured

Brand Safety (6 Points)

  • Delivery experts making drops (cash drop OR lock box), carrying less than $20

  • Security Callbacks are completed for new and suspicious orders, and for orders where caller ID is unavailable

  • Safe in use and deposit procedures followed

  • No more than $150 in front till

  • Safety equipment in use and store personnel delivering safely to customers

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.