Title Page

  • Store #

  • Conducted on

  • Location
  • Manager

  • Personnel on duty

  • Prepared by

  • All promotional signage is up.

  • All shippers are more than half full.

  • All current shippers are in proper place.

  • All promotional signage from prior month is gone.

  • Cigarette fixture pricing matches price sheet.

  • Cigarette signs match price sheet.

  • Other tobacco fixture pricing matches price sheet.

  • All items in open faced coolers are priced.

  • All cooler items (non carbonated/soda) are priced.

  • All beer is priced.

  • All pricing decals/labels are in good shape (e.g. fountain).

  • New Core-Mark replacement price tags are up.

  • There are no "never out" items missing.

Restrooms - Mens

  • Walls/stall dividers - wiped down, clean, unsoiled?

  • Mirrors - wiped down, clean, unsoiled?

  • Sinks - wiped down, clean, unsoiled?

  • Toilet - clean tank, base, lid, bowl, behind, seat tight?

  • Urinal - flushes properly, floor clean?

  • Stocked - toilet paper, paper towels, soap, air freshener, diaper deck liners?

  • Operational - toilets flush, sink runs/no leaks, soap dispenses, and hand dryer in good repair?

  • Trash - emptied, clean?

  • Floor - clean, bug free, litter free?

  • Lighting - all bulbs burning, lenses clean, bug free?

  • Vents - clean, dust free?

Restrooms - Womens

  • Walls/stall dividers - wiped down, clean, unsoiled?

  • Mirrors - wiped down, clean, unsoiled?

  • Sinks - wiped down, clean, unsoiled?

  • Toilet - clean tank, base, lid, bowl, behind, seat tight?

  • Stocked - toilet paper, paper towels, soap, air freshener, diaper deck liners?

  • Operational - toilet flushes, sink runs/no leaks, soap dispenses, and hand dryer in good repair?

  • Trash - emptied, clean?

  • Floor - clean, bug free, litter free?

  • Lighting - all bulbs burning, lenses clean, bug free?

  • Vents - clean, dust free?

Checklist

  • Check soda/non-carbonated planogram compliance.

  • Check to see if store has proper stock on promotional items.

  • Check to see if store has proper stock on Star Saver items.

  • Check other tobacco planogram compliance.

  • Discuss out of stocks with manager.

  • Ask team member and manager about items not scanning and any customer requests for items not stocked.

  • Talk with manager about any vendor issues.

Signature

  • Attach prior month's promo sheet, current promo sheet, cigarette price sheet, OT price sheet, OT planogram, and soda/non-carb planogram.

  • I hereby certify that the above form is true and accurate to the best of my knowledge.

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.