Information

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • P = Priority (-15%); PF = Priority Foundation (-5%); C - Core (-1.5%)

  • Squeegees hanging near/at all pumps<br>

  • Windshield washer fluid at least 1/2 full and clean<br>

  • Entrance clean of cigarette butts and ashtray maintained<br>

  • Outside of store appearance<br>

  • Garbages maintained<br>

  • Sidewalk area clean<br>

  • Ceiling tiles and vents clean

  • All lighting in working order

  • Clean bathrooms

  • No odor in bathrooms

  • Bathroom supplies properly stocked

  • Drinking fountain clean

  • Signs on display items

  • Open product labeled and dated/Out-dated product found on display (Non-Vendor items)

  • Vendor Out-dates

  • Sell-by-dates (Burritos, Hot pockets, sandwiches, Nemo cakes)

  • Cross-contamination concern

  • Condition of bakery case

  • Bakery Case Food Allergen Sign

  • All beverage dispensers have ingredient statements

  • Flavored syrups (cleanliness of bottles)

  • All beverage dispensers are clean

  • Beverage area properly stocked

  • Coffee filters

  • Temperature Log

  • Cooler temps (cheese, sandwich, etc)

  • Milk temperature

  • Chemical programs are followed/ MSDS sheets available

  • Product 6" off the floor

  • Sanitizer concentration

  • Clutter by electrical boxes (not covering boxes)

  • Backroom OR Equipment room (clutter?)

  • Storage of personal belongings

  • Name tags

  • Dress code followed

  • Sanitizer log

  • Handsink properly stocked and clean

  • Sanitizer log

  • Calibration log

  • Employee Illness Log

  • Food equipment and utensils maintained clean and stored in a manner to prevent contamination

  • Coolers maintained clean

  • Customers receive a greeting

  • Customers receive greeting at pump

  • Did you have gas today?

  • Would you like a car wash?

  • Car Wash Instruction Sheet given with code

  • Customers receive a thank-you and are offered a receipt

  • Employees using 1-2 call for help

  • Signature of Auditor

  • Signature of PIC

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.