DM Quick Visit Quarter 2

• Conducted on

  Date

• Prepared by

• Location
  Address

• Unemployement Insurance Benefits Poster Eng and Span

  Yes

  No

  N/A

• Workplace Discrimination Poster Eng and Span

  Yes

  No

  N/A

• Your Rights and Obligation s Pregnant Employee Poster Eng and Span

  Yes

  No

  N/A

• EDD CA Eng and Span

  Yes

  No

  N/A

• Outside POP current and correct

  Yes

  No

  N/A

• Outside POP clean and in good condition

  Yes

  No

  N/A

• Menu Board POP current and correct, in good condition

  Yes

  No

  N/A

• Menu Board POP clean and in good condition

  Yes

  No

  N/A

• DT window POP current and correct, in good condition

  Yes

  No

  N/A

• DT window POP clean and in good condition

  Yes

  No

  N/A

Team Member PPE

• All Team Members wearing Facemasks

  Yes

  No

  N/A

• All Team Members wearing facesheilds/goggles

  Yes

  No

  N/A

• All Team Members wearing gloves

  Yes

  No

  N/A

Covid-19 Items at the Manager Station

• IIPP Book with new Covid pages

  Yes

  No

  N/A

• COVID 19 Flow Chart

  Yes

  No

  N/A

• Jack in the box COVID 19 guide book

  Yes

  No

  N/A

• Zones Job Aid posted

  Yes

  No

  N/A

• Hourly Disinfection Process

  Yes

  No

  N/A

• Using current health screening questionaire

  Yes

  No

  N/A

Restrooms

• Toilets have lids installed

  Yes

  No

  N/A

• Toilets have toilet seat lid job aids

  Yes

  No

  N/A

• Is toilet paper inside the toilet paper dispenser

  Yes

  No

  N/A

Covid 19 Questions

• Ask two employees how would they know if someone test COVID 19 positive at the store? Through text message

  Yes

  No

  N/A

• Ask an employee where they would find what items need to be disinfected when taking over a station.

  Yes

  No

  N/A

• What is your disinfecting procedure? Hourly Peroxide Cleaning

  Yes

  No

  N/A

• How do you know if you have UV lights in the restaurant? There is a sticker on the door stating we have UVGI

  Yes

  No

  N/A

• What do the UV lights do? Kill harmful viruses and bacteria through the ventilation system

  Yes

  No

  N/A

• What is your Covid-19 protocols? The Covid-19 Restaurant and Field Guide at the manager station. (45 pages)

  Yes

  No

  N/A

• What is considered a Covid-19 outbreak? When 3 or more people have tested positive in a 14 day period

  Yes

  No

  N/A

• How do you report a Covid-19 outbreak? DM Reports to Main Office and Main Office reports to appropriate parties

  Yes

  No

  N/A

• What are the break room policies during covid-19?<br>• Only one Team Member can be in the break room at a time<br>• When TM is done using the break room they must disinfect the area they utilized<br>• There must be sanitizer available in the break room at all times.<br>

  Yes

  No

  N/A

• What social distancing measures do you have in place? We have red, yellow and green zones. (show the job aid)

  Yes

  No

  N/A

• What is the health screening process? When Team Members arrive at work their temperature checked and they are asked health screening questions

  Yes

  No

  N/A

• What PPE are you required to use at the store? Masks, gloves, and facesheilds/goggles

  Yes

  No

  N/A

• What do employees have to do when sharing the same equipment? Before handing off equipment such as a headset the employee disinfects it before giving it to the next employee.

  Yes

  No

  N/A

Food Safety Questions for PIC

• What were the last Health Inspection Items that were missed and were they fixed?

  Yes

  No

  N/A

• What do you do if there is a water outage?

  Yes

  No

  N/A

• Imminent Health Hazards

  Yes

  No

  N/A

• Crossing the blue door

  Yes

  No

  N/A

• Serve Safe / Manager Timer

  Yes

  No

  N/A

• Sanitizer Buckets

  Yes

  No

  N/A

• Handwash Sinks

  Yes

  No

  N/A

• A) Hot Holding Unit Timers on<br>B) TPH timers on

  Yes

  No

  N/A

• A) Clean - Dishes, Equipment, Food contact surfaces, and 4 hour tool rotation<br>B) Condition - Dishes, Equipment, Food contact surfaces, and 4 hour tool rotation

  Yes

  No

  N/A

• FSC complete and correct

  Yes

  No

  N/A

• 3 compartment sink and Dishwasher set up correctly and working<br>1 inch air gap<br>Drain - no slow drain

  Yes

  No

  N/A

• Nothing exposed<br>Nothing expired<br>Nothing Contaminated

  Yes

  No

  N/A

• Food Thermometers <br>Working and In the warmest part of the unit<br>Unit is at the correct temperature<br>Food in unit meets temp

  Yes

  No

  N/A

• What does the C stand for in CLAP 4 PIGGY?

  yes

  no

• What does the L stand for in CLAP 4 PIGGY?

  yes

  no

• What does the A stand for in CLAP 4 PIGGY?

  yes

  no

• What does the P stand for in CLAP 4 PIGGY?

  yes

  no

• What does the 4 stand for in CLAP 4 PIGGY?

  yes

  no

• How many cents is in your PIGGY?

  yes

  no

• What is the 5 cents of your PIGGY?

  yes

  no

• What are the 3 Parts of your Hands PIGGY?

  yes

  no

• What are the 2 parts of your SICK PIGGY?

  yes

  no

• What are the 2 parts of your FOOD PIGGY?

  yes

  no

Food Safety Questions for Team Member Ask 2 Team Members

• Ask one EE what are the 75 cents of your piggy bank?

  Yes

  No

  N/A

• Ask one EE what are the 75 cents of your piggy bank?

  Yes

  No

  N/A