Store Information
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Store Number
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Date and Time
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Evaluator Name
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Manager In Charge
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Location
PRODUCT
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Dough properly managed and properly proofed
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Approved pizza procedures in use
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Approved side item procedures in use
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Product prepped for expected sales volume (1)
Pizza Great/Remake Calculation (4 per pizza)
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Pizza#1
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Pizza#2
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Pizza#3
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Pizza#4
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Pizza#5
Sides: Great/Remake Calculation (3 per side)
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Side #1
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Side #2
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Side #3
FOOD SAFETY
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All products dated properly and not expired
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All refrigerated products held within specified temperature ranges
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Pest control standards are maintained
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All cooked product temperatures at least 165°F / 74°C
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Store personnel maintain proper appearance and hygiene standards
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Hand washing, hand sanitizing, and dishwashing procedures done<br>properly and supplies accessible and properly stocked
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All food contact surfaces, small-wares, and utensils clean and sanitized
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Proper food and beverage handling procedures in use
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Food packaging, food contact surfaces, equipment, and chemicals<br>protected from cross-contamination and stored off of floor
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Sanitizer concentration within specified range and temperature
IMAGE AND CLEANLINESS
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Domino's logo apparel (hats, shirts, shorts/pants/skirts, and outerwear) worn properly and represents a positive brand image
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Aprons must be clean and worn at full-length, tied, during food preparation and not outside the store
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Hot bags clean and free of debris and mold
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Production area walls, floors, and baseboards are clean and free of dirt and debris
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Customer area walls, floors, baseboards, windows, and windowsills are clean and free of dirt and debris
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Customer area seating, counter, and surfaces are clean, sanitized, and free of dirt and debris
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Restrooms are clean, sanitary, and fully stocked
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Walk-in clean, free of debris, mold, and mildew
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Makeline and additional refrigeration units are clean, free of debris, mold and mildew
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Store set up properly during operational hours
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Parking lot and entryway sidewalk are free of debris and windows and windowsills are clean
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Bake-wares clean and free of excessive carbon build-up
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Oven catch trays, oven exterior, and heat rack are free of built-up debris
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Delivery vehicles represent a positive brand image
EQUIPMENT AND STORE CONDITION
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Store ceiling, T-bars, and vents are clean and not broken, chipped, or cracked
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Store walls, floors, and baseboards are not broken, chipped, or cracked
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Hand sinks operational and handwashing reminder signage is present
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Customer area seating, counter, and tables are not faded, broken, chipped, or cracked
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Restrooms and fixtures are not broken, chipped, or cracked
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Parking lot, entryway sidewalk, and customer-facing building exterior are clean and not damaged
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Signage is clean, properly illuminated, and not damaged
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Refrigeration units operational, not broken, chipped, or cracked, and free of rust
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Calibrated thermometer(s) available
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Small-wares and utensils are not broken, chipped, or cracked
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Bake-wares are not damaged
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Oven fingers and hood are clean and free from excessive grease buildup and yellowing. Oven, hood, and heat rack are operational and undamaged
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Sufficient number of hot bags available and are not torn, faded, or melted
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Calibrated, working scale(s) and product build job aids available
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Caller ID is installed and working
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Safe and drop boxes are present, operational, and secured
BRAND SAFETY
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Delivery experts making drops, carrying less than $20 (or international equivalent)
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Security callbacks are completed for new and suspicious orders, for Pinpoint delivery, and for orders where Caller ID is unavailable
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Safe in use and deposit procedures followed
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No more than $150 USD in front till (or international equivalent) and till locked
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Safety equipment in use and store personnel delivering safely to customers
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No weapons, including pocket knives, mace, pepper spray, and similar items
CRITICAL OPERATIONS ELEMENTS
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Four (4) or more sizes/types of expired or eight (8) or more sizes/types of unlabeled products/ingredients (non-dough)
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Lack of available cleaning supplies, potable water, and/or no functioning hand sink in the production area
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Hazardous temperatures past critical thresholds
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Pest control standards past critical thresholds
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Mold found on food products and/or on food contact surfaces
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Dough management procedures neglected
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Five (5) or more core apparel, appearance, and/or hygiene violations
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Mature content, including profanity, found on store premises
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Firearms, knives, illegal drugs, marijuana (in any form), or alcohol found on store premises (to the extent permitted by applicable law) (-10)
SIGN OFF
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Manager Name and Signature
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Additional Observations