Title Page

  • Document No.

  • Jack in the box

  • Conducted on

  • Prepared by

  • Location
  • 1. Safety poster posted, Safety training guide used? Employees have knowledge of current safety topic?

  • 2. Triage poster Posted?

  • 3. Federal and State poster posted and is current?

  • 4. ROL employee/guest Incident Forms available?

  • 5. MSDS book is available, and PIC is is aware of location?

  • 6. First aid kit is stocked, and PIC is aware of location?

  • 7. Proper safety equipment is available, fryer apron, gloves and face shield or goggles?

  • 8. Bodily Fluid clean up kit is available?

  • 9. Chemicals are not stored above or with equipment, packaging or food?

  • 10. All chemicals are stored with common name on bottle?

  • 11. PIC is aware of the main water and gas shut off in case of an emergency?

  • 12. All fire extinguishers are currently tagged and the PFS number is available?

  • 13. All emplyees are wearing non slip resistant shoes?

  • 14. Employees are using assigned register? No more than 5 $20's in a drawer and no $50's or $100's?

  • 15. Cashiers are assigned an employee ID number to drop funds into the smart safe?

  • 16. Only authorized personnel allowed in the kitchen, employees are checking ID?

  • 17. Back door is secured, keys are with PIC, door is locked?

  • 18. Exit emergency signs are readable and are locted at the exits of restaurant?

  • 19. No ice build up on freezer floor?

  • 20. No trip hazards, missing tiles, drain covers, pallets or boxes stored on floor, and floors are swept?

  • 21. Separate mops and mop buckets are used for kitchen and lobby? Blue/lobby, yellow/kitchen.

  • 22. Wet floor signs are in good repair, clean and available?

  • 23. Wet floor signs are used properly and wet floor signs are not out when floor is dry causing trip hazzards?

  • 24.. Step stool and ladders are available, and used properly to reach high items?

  • 25. Safety Box cutters are being used and employees can demostrate how to cut a box? Knifes are not being used for box cutting.

  • 26. Employees can demonstrate how to properly lift a box, bending at the knees to lift?

  • 27. No heavy equipment or product stored above head level?

  • 28. Exterior/Interior lighting working properly?

  • 29. Food safety training compliance: all TM have food handler card, RM and AM Servsafe Certificates are available and current.

  • 30. Employee files are in a secured location?

  • NOTES:

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.