Title Page

  • Site conducted

  • Conducted on

  • Prepared by

  • Location
  • Manager on Duty

  • Previous Visit Date & Score

Exterior

Landscaping

  • Is the landscaping free of litter?

  • Are all landscaping plants alive?

  • Are all landscaping plants trimmed neatly, and not blocking windows?

Parking Lot and Sidewalks

  • Are sidewalks and parking lots free of litter?

Dumpster Area

  • Is dumpster area clear of debris? If this is not from our location, please contact the landlord.

  • Are boxes broken down in the dumpster?

Outer Building & Windows

  • Are all awnings clean and in good repair?

  • Are store front windows and doors clean?

Marketing

  • Are window clings in place, in good condition and up to date?

  • Is A-Frame in place and in good condition?

Outdoor Seating Area

  • Is outside seating area clean and clear of debris?

  • Are outside tables clean and in good condition?

  • Are outside chairs clean and in good condition?

  • Are outdoor umbrellas in place and in good condition?

Signs and Lighting

  • Are all exterior lights in working condition?

  • Is the Open sign in place and in working condition?

  • Is building Green District sign in place and in working condition?

Dining Room

Walls, Ledges, Floors & Baseboards

  • Are dining room walls clean and smudge-free?

  • Are dining room baseboards clean and smudge-free?

  • Are dining room ledges dust-free and clean?

  • Are dining room floors clean?

  • Are rugs in place and clear of debris?

Plants, Art and Decor

  • Are live plants healthy and well-attended to?

  • Are fake plants dust-free?

  • Is art and decor in place and dusted if necessary?

Outer Build Line & Register Area

  • Is glass sneeze guard clean and streak-free?

  • If in place, is sanction or half-wall clean and free of scuff-marks?

  • Is register area clean, organized and clutter-free?

Seating

  • Are tables tops clean and in good condition?

  • Are table bases clean and dust free?

  • Are tables balanced with use of wobble wedges where needed?

  • Are chairs and chair legs clean and in good condition?

  • Are highchairs clean and in good condition?

Dining Room Garbage

  • Are outer garbage cabinets clean and in good condition?

  • Is the inner garbage can clean and clear of food debris?

Lighting

  • Are all lights in working condition?

  • Are lights and light covers free of dust?

Restrooms

Restroom #1

  • Is the toilet/urinal, (bowl, base and fixture handle) clean in bathroom 1?

  • Are all the fixtures in good repair in bathroom 1? (sink, toilet/urinal)

  • Is the mirror clean and streak-free in bathroom 1?

  • Are the counter top and sink fixtures clean and stain-free in bathroom 1?

  • Is the baby changing table clean and in working condition in bathroom 1?

  • Is the hand towel dispenser stocked, clean and in working condition in bathroom 1?

  • Is the hand soap dispenser stocked, clean and in working condition in bathroom 1?

  • Is the toilet paper dispenser stocked, clean and in working condition in bathroom 1?

  • Are the walls clean and smudge-free in bathroom 1?

  • Are the floors clean and clear of debris in bathroom 1?

  • Is the inner trash can in bathroom 1 clean and clear of debris?

  • Is the ceiling clean, and vents dust-free in bathroom 1?

  • Is the employee handwashing sign present?

  • Is bathroom 1 free of bag aromas?

Restroom #2

  • Is the toilet/urinal, (bowl, base and fixture handle) clean in bathroom 2?

  • Are all the fixtures in good repair in bathroom 2? (sink, toilet/urinal)

  • Is the mirror clean and streak-free in bathroom 2?

  • Are the counter top and sink fixtures clean and stain-free in bathroom 2?

  • Is the baby changing table clean and in working condition in bathroom 2?

  • Is the hand towel dispenser stocked, clean and in working condition in bathroom 2?

  • Is the hand soap dispenser stocked, clean and in working condition in bathroom 2?

  • Is the toilet paper dispenser stocked, clean and in working condition in bathroom 2?

  • Are the walls clean and smudge-free in bathroom 2?

  • Are the floors clean and clear of debris in bathroom 2?

  • Is the inner trash can in bathroom 2 clean and clear of debris?

  • Is the ceiling clean, and vents dust-free in bathroom 2?

  • Is the employee handwashing sign present?

  • Is bathroom 2 free of bad aromas?

Beverage Station, Reach-in & Air Coolers

Beverage Station

  • Are the outer surfaces and tray of the ice machine (if not connected to the coke machine) clean and in good working condition?

  • Are the outer surfaces, trays and dispenser tanks for the tractor, lemonade or tea dispensers clean and in good working condition?

  • When was is the date of the last time the tractor, lemonade or tea dispenser was completely broken down and cleaned?

  • If present, Is the outer surface of the soda fountain clean?

  • If present, are the soda fountain tray and dispensing nozzles clean?

  • If present, when was the date of the last service call for calibration on the soda fountain?

  • Is all beverage station equipment in proper working condition?

  • Are the cabinet facings on the beverage station clean and smudge-free?

  • Are the inner cabinets organized and free of clutter?

  • Are the paper goods stocked?

  • Is the paper good caddy clean and clear of debris?

Reach-In Coke Coolers

  • Are the beverage coolers stocked and front facing?

  • Is there a stationary thermometer mounted in the beverage cooler?

  • Are the outer doors and glass clean and streak-free?

Air Coolers

  • Is the air cooler stocked with sides or beverages?

  • Are all sides properly labeled with branded sticker on top and prep and print date sticker on the bottom?

  • Is there a stationary thermometer mounted in the air cooler?

  • Is the air cooler clean and in good working condition?

Service

Through-put Audit

  • Guest #1: What time was the guest order taken and what time was the order completed?

  • Guest #2: What time was the guest order taken and what time was the order completed?

  • Guest #3: What time was the guest order taken and what time was the order completed?

Steps of Service at the Register

  • Are customers being greeted upon arrival?

  • Did the person working register have a good understanding of the menu and were able to answer the guests questions correctly?

  • Did the person working the register repeat the order back to the customer?

  • Did the person working the register try to upsell to the customer?

  • Did the person working the register ask the customer about the rewards app?

  • Did the person working the register direct the customer to watch their salad being built?

  • Did the person working the register thank the customer?

  • Did the person working the register seem to have an overall upbeat and positive attitude?

Steps of Service at the Expo Station

  • Did the expediter greet customers looking for their to-go order?

  • Did the expediter help place the order with the correct customer in a timely manner?

  • Did the expediter ask the customer if they would like their order bagged if not already bagged?

  • Did the expediter thank the customer?

  • Did the expediter seem to have an overall upbeat and positive attitude?

Management

  • Did the manager preform table touches if they were not working a station?

Food Quality

  • Where all food items delivered fresh (hot if hot item, cold if cold)?

  • Was the order correct?

  • Did the order come with the proper amount of utensils and napkins?

  • Rate the presentation of the order. Please attach a photo of the order.

Expo Station

  • Is the expo station stocked and organized?

  • Is the expo pick-up window shelving clean and in good working condition and labeled?

  • Are the shelves under the expo station clean and organized?

  • Is the dressing back-up cooler stocked, organized and clean?

  • Are any dressings in the dressing back-up cooler out of date?

  • Is there a stationary thermometer mounted in the dressing back-up cooler?

  • If sides cooler is present, is it stocked, organized and clean?

  • If sides cooler is present are all sides labeled correctly with branded labeled on top and prep and print label on bottom?

  • If sides cooler is present, is there a stationary thermometer mounted inside?

Hot Station

Food Safety

  • What is the internal temp of the Soup?

  • What is the internal temp of the Wild Rice Blend?

  • What is the internal temp of the Pulled Chicken?

MerryChef Oven

  • Is the MerryChef oven clean and in good working condition?

  • Are the trays for the MerryChef oven in good condition?

Hot Well

  • What is the number setting adjusted to on the hot well?

  • Are the lids for each hot well item wrapped in plastic wrap to hold in moisture?

  • Do the lids fit each pan properly on the hot well station?

  • Are the utensils for each item properly stored on the hot well and are they the correct portioning tools for each item?

  • Is the hot well station clean and well-organized?

  • Are job aids present and up to date?

  • Is a labeled non-expired sanitizer bucket present with one towel submerged?

Tortilla Steamer & Tortilla Storage

  • Is the tortilla steamer clean and in good working condition?

  • Is the tortilla steamer filled appropriately with water?

  • Are the drawers or area where the tortillas are stored clean and organized?

  • Are the tortillas stocked and properly stored and rotated?

Chop Pits

Crunchies

  • Are the crunchies properly labeled on each chop pit?

  • Are the proper portioning tools present for each crunch item?

  • Are job aids present and up to date?

Chop

  • Is the chop station clean and well-stocked?

  • Is the shelving under the chop station clean and organized?

  • Are the bench scraper, mezzaluna and cutting board (with non-slip board if plastic) present on each chop station in use?

  • Is a labeled non-expired sanitizer bucket present with one towel submerged?

In-Counter Dressing Cooler Wells

  • Is there a stationary thermometer present in each dressing well?

  • Are each dressing wells clean and in good working conditon?

  • Are any dressings in the dressing well expired?

  • Are the job aids posted, up to date and in good condition?

Build Station

Food Safety

  • What is the internal temperature of one dairy item?

  • What is the internal temperature of one protein item?

  • What is the internal temperature of one vegetable item?

  • Is a labeled non-expired sanitizer bucket present with one towel submerged?

  • Is all product filled to the appropriate fill line and not above?

Product Quality

  • Is all product in the top and bottom of the cooler properly labeled?

  • Rate the quality of the prepped product from 1-10. Please take a photo of the build line top of cooler.

Build Cooler

  • Are job aids present, up to date and in good condition?

  • Is a stationary thermometer mounted in each build cooler?

  • Are the outer doors to the cooler clean and streak-free?

  • Are in the inner shelves in the cooler clean and free of debris?

  • Are the cooler gaskets clean and in good condition?

  • Are the dividing bars clean?

  • Does each item have the correct portioning tool?

  • Is the lettuce portioning cup present?

  • Pull out the cooler, are under and behind in good clean condition?

Prep Area

Prep Table

  • Are the prep table and shelving clean and organized?

  • Is the recipe booklet organized, clean, easily accessible and up to date?

  • Are the FRP wall in the prep area clean and clear of debris?

  • If there a glass sneeze guard or wall near the prep area is it clean and streak-free?

  • Is a labeled non-expired sanitizer bucket present with one towel submerged?

  • Were correct food thawing processes being used?

  • Did you see any signs of cross contamination?

  • Did you witness correct prep procedures being used by the prep cook?

  • Take the weight of 2 different sides, are they the correct weights?

  • Are scales stored properly and not stacked on top of each other?

Prep Sink

  • Is the prep sink clean and in good working condition?

  • Is the drain under the prep sink clean and in good working condition?

  • Are the FRP walls in the prep sink area clean and clear of debris?

Equipment

Rational Oven

  • Is the Rational oven clean and in good working condition?

  • Is the Rational oven programming up to date?

  • Is the Rational oven stand clean and clear of debris?

  • Are the oven mitts clean, easily accessible and in good condition?

Smallware Equipment

  • Is the Robot Coupe clean and in good working condition?

  • Is the Stick Emersion Blender clean and in good working condition?

  • Is the Stick Emersion Blender mounted properly on the wall?

  • Is the Vitamix Blender clean and in good working condition?

  • Are all of the cords to smallware equipment clean and stored properly?

  • Is the lettuce chopper clean and in good working condtion?

  • Is the vegetable chopper clean and in good working condition?

  • Are cutting gloves clean, in good condition and easily accessible?

  • How many cutting gloves are present?

  • Is the stationary can opener clean and in good working condition?

Lettuce Spinner

  • Is the lettuce spinner clean and in good condition?

Speed Racks & Utility Carts

  • Are the speed racks clean and in good conditon?

  • Is the utility cart clean and in good condition?

Walk-In Cooler& Reach-in Freezer

Walk-in Cooler

  • Is the walk-in organized with all labels facing out?

  • Are all items in the walk-in properly labeled?

  • Is there a stationary thermometer mounted located in the walk-in cooler?

  • Are all items in the walk-in within proper use by date?

  • Are all the products in the walk-in stored in the proper sequence for food safety?

  • Are all products properly rotated, first in first out?

  • Are the floors of the walk-in clean and clear of debris?

  • Is the walk-in shelving clean and labeled?

  • Is the fan and ceiling of the walk-in clean and clear of dust?

  • Are the walk-in walls clean and clear of debris?

  • Are broken bags of product properly transferred into labeled storage containers?

  • Are there minimal boxes?

  • Are all food items stored at least 6 inches off of floor?

  • Are the walk-in lights working and covers clean, in good condition?

Reach-in Freezer

  • Is the freezer clean and well organized?

  • Are all of the items in the freezer properly labeled and within proper date?

  • Are all of the products in the freezer stored in the proper sequence for food safety?

  • Is there a stationary thermometer mounted located in the freezer?

  • Are all products properly rotated, first in first out?

  • Is the freezer shelving clean and labeled?

  • Is the outer freezer clean, and streak-free?

  • Is the freezer gaskets clean and in good condition?

  • Are broken bags of product properly transferred into labeled storage containers?

Dry Storage

Dry Food Storage

  • Are all food and paper goods stored up off of the floor 6 inches?

  • Is storage area well organized with labeled shelving?

  • Are there minimal boxes or are box tops removed in the storage area?

  • Are broken bags of product properly transferred into labeled storage containers?

  • Is all food properly rotated? First in, first out.

  • If ingredient bins are present, are they clean, labeled and in good condition?

  • If ingredient bins are present, are portioning scoops properly stored outside of the product?

Chemical Storage

  • Are all chemicals stored away from food and food contact products?

  • Are there any unapproved chemicals present in the restaurant?

  • Is chemical storage organized and labeled?

Dish Area

  • Is the FRP wall behind the 3 compartment sink clean and clear of debris?

  • Are all faucets putting out cold and hot water?

  • Is the 3 compartment sink clean?

  • Is the 3 compartment sink set up correctly if in use?

  • Test the sanitizer. Is it at the proper concentration level?

  • Are all chemicals, for the dish machine and 3 compartment sink available and hooked up correctly?

  • Are the outer surfaces of the dish machine clean and streak-free?

  • Is the dish machine in good working condition?

  • Is the dolly for the dish racks clean and clear of debris?

  • Are the drains under the dish area clean and clear of debris?

  • Are all clean dishes stored properly and organized?

  • Are smallwares organized and clean?

Back of House

  • Are the floors in the BOH clean and in good condition?

  • Are the baseboards in the BOH clean and in good condition?

  • Are the walls in the BOH clean and in good condition?

  • Are clean linens kept organized in a dry storage space?

  • Is there a storage area away from food prep and storage areas for dirty linens?

  • Are all handwashing sinks clean and clear of debris?

  • Are all soap dispensers for handwashing sinks stocked?

  • Are all paper towel dispensers for handwashing sinks stocked?

  • Is the mop sink clean and clear of debris?

  • Is the mop bucket clean and in good working condition?

  • Are mops, brooms, squeeges, deck scrubbers and dust pans hung and organized when not in use?

  • Are mops, brooms, squeeges, deck scrubbers and dust pans in good working condition?

  • Are dust pans clear of build-up and debris?

  • Are mops heads stored properly and switched out frequently?

  • If present, is the bag in a box soda rack organized and rotated properly?

  • Is there a designated area for personal drinks?

  • Do all personal drinks have a lid?

Office Area

  • Is the office area organized with minimal clutter?

  • Is there a cash safe present and in working condition?

  • Are the MSDS sheets present and easily accessible?

  • Is prep and print label printer in working condition?

  • Is the first aid kit mounted and stocked with all necessary items?

  • Is the filing system organized?

  • Is the printer in working condition?

  • Are all certifications, premits and official documents framed and hung in an easily accessible area?

Team Members

Hygiene & Grooming

  • Are all employees practicing good hygiene and grooming standards?

  • Do employees uniforms appear clean and in good condition?

Uniform Policy

  • Are all employees wearing GD branded shirts?

  • Are all employees wearing non-slip shoes?

  • Are all employees wearing head coverings or hats?

Personal Items

  • Are all personal items stored in designated areas?

  • Is personal item area organized and clean?

Operational Tools

  • Is the Manager Opening Checklist utilized and up to date?

  • Is the Manager Mid-Shift Checklist utilized and up to date?

  • Is the Manager Closing Checklist utilized and up to date?

  • Is the Weekly Deep Cleaning List utilized and up to date?

  • Is the Cooler Temperature Log up to date and filled out 2 times daily?

  • Is the Master Prep and Product Quality Checklist utilized and up to date?

  • Is the Food Internal Temperature Log Utilized and up to date?

  • Is the Waste Log utilized and up to date?

  • Is there presence of 30 days on-hand record of all operational tools and forms?

Safety, Sanitation and Training Requirements

Training Requirements

  • Have all employees have completed a station certification?

  • Have all employees completed onboarding lessons in edapp?

Safety and Sanitation Requirements

  • Are all managers and key hourlies certified in Safety & Sanitation?

  • Are all certifications framed and posted in an easily accessible area?

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.