Pay Test 1

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Time and date of visit:

  Date

Exterior Cleanliness

• Does appear to be clean and in good repair?

  Yes

  No

  N/A

• Signage on and working?

  Yes

  No

  N/A

• Is the outside clean and free of litter? No gum, cigarette butts or build up along the curbs or under windows.

  Yes

  No

  N/A

• Windows clean and free of stickers? No fingerprints.

  Yes

  No

  N/A

• Does the landscaping appear to be clean and well maintained?

  Yes

  No

  N/A

• Do the sidewalks appear to be clean and in good condition?

  Yes

  No

  N/A

• Does the building appear to be clean and in good condition?

  Yes

  No

  N/A

• Comments:

Interior Cleanliness

• Are the toilets clean and stocked? Free of odor? Seats Secure?

  Yes

  No

  N/A

• Are the floors, tables and seating clean and in good condition?

  Yes

  No

  N/A

• Is the bar area clean, stocked and clutter free?

  Yes

  No

  N/A

• Is the front counter clean and clutter free?

  Yes

  No

  N/A

• Is all lighting working and in good condition?

  Yes

  No

  N/A

• Are the highchairs clean ready to use with crowns and bibs in place?

  Yes

  No

  N/A

• Are the highchairs in good condition with functioning safety belts?

  Safe

  At Risk

  N/A

• Comments:

Team Image

• Are all employees wearing a complete uniform. Hat, shirt, shoes. No excessive jewelry. Hair. Good hygiene and grooming standards are practiced.

  Yes

  No

  N/A

• Are all managers wearing a complete uniform?

  Yes

  No

  N/A

• Comments:

Kitchen Cleanliness

• Are the floors, walls and baseboards clean and in good condition?

  Yes

  No

  N/A

• Is all lighting working and in good repair? No bugs, dust or cracked lenses.

  Yes

  No

  N/A

• Is the microwave clean, labeled correctly and tested weekly?

  Yes

  No

  N/A

• Are the fryers clean and free of grease build up?

  Yes

  No

  N/A

• Is the ice machine clean and functioning properly?

  Yes

  No

  N/A

• Are the boards clean and well maintained? Stainless, wrap holders, condiment holders, shelves.

  Yes

  No

  N/A

• Is the prep area and equipment clean and well maintained?

  Yes

  No

  N/A

• Is the break/training area clean and organized?

  Yes

  No

  N/A

• Are all storage areas clean and organized? Box flaps, shelving labeled.

  Yes

  No

  N/A

Restaurant Systems

• Are leaders paths being completed as required?

  Yes

  No

  N/A

• Is waste being tracked in the QSC book and entered by day part?

  Yes

  No

  N/A

• Are temperature checks being completed as required?

  Yes

  No

  N/A

• Is the 12 critical checklist being completed as required?

  Yes

  No

  N/A

• Is the cleaning calendar being utilized as intended on a daily basis?

  Yes

  No

  N/A

• Are beef cookouts being completed as required?

  Yes

  No

  N/A

• Is the communication board set up and used correctly? Is all information up to date?

  Yes

  No

  N/A

• Is the restaurant following a build to when completing orders? Have the build to's been recently updated?

  Yes

  No

  N/A

• Are crew schedules completed and posted at least 1 week in advance?

  Yes

  No

  N/A

• Are both main boards open during peak periods?

  Yes

  No

  N/A

• Does the crew know what today's Guest Trac goal is? Do they know what the score is MTD?

  Yes

  No

  N/A

• Does the crew know what today's SOS goal is? Do they know what the average is for the month?

  Yes

  No

  N/A

• Are table touch's being completed frequently?

  Yes

  No

  N/A

• Is the team doing "window wow's" consistently?

  Yes

  No

  N/A

• Comments:

Top 12 Critical Safety Factors

• Are hand washing procedures being properly executed correctly and consistently at a properly stocked hand washing sink?

  Yes

  No

  N/A

• Are all health inspection violations corrected within 10 days of the citation?

  Yes

  No

  N/A

• Do all sinks meet the minimum hot water requirement and are they in good repair?

  Yes

  No

  N/A

• Is food product temperature not in the danger zone? (41-139 degrees)

  Yes

  No

  N/A

• Does sanitizer meet the correct PPM at all sinks and open stations with properly labeled spray bottles and buckets?

  Yes

  No

  N/A

• Are approved, clean shake brushes available and stored properly? Are they in good condition and free of rust? Is the restaurant using the green pack sanitizer? Are carburetor tubes free from build-up?

  Yes

  No

  N/A

• Is the restaurant only using approved products?

  Yes

  No

  N/A

• Are items held at room temperature marked with proper holding times and discarded when expired?

  Yes

  No

  N/A

• Is cross-contamination not apparent In any stations or storage areas?

  Yes

  No

  N/A

• Is the restaurant free of any rodent, insect and pest activity?

  Yes

  No

  N/A

• Are cookouts and temperature checks Recorded consistently and correctly?

  Yes

  No

  N/A

• Is the restaurant free of other critical food safety violations? (drains backed up, reverberator screens, all chemicals labeled)

  Yes

  No

  N/A

• Comments:

Goal Achievement

• Is the restaurant meeting or exceeding their sales plan?

  Yes

  No

  N/A

• Is the restaurant within 1% variance to theoretical FGP?

  Yes

  No

  N/A

• Is food waste at or below 0.4% of sales?

  Yes

  No

  N/A

• Is the restaurant at or under their labor plan?

  Yes

  No

  N/A

• Is the restaurant meeting or exceeding their ROPO plan?

  Yes

  No

  N/A

• Is the restaurant SOS average at or below 150 seconds for the current month?

  Yes

  No

  N/A

• Is the restaurants Guest Trac score equal to or greater than 70% for the current month?

  Yes

  No

  N/A

• Comments:

Overall Visit Comments

• Auditor Comments:

• Auditor Signature

  Sign

MOD Comments and Acknowledgement

• MOD Comments:

• By signing this form you acknowledge the following; that you have reviewed this report with the auditor, that you have 10 days to correct any of the negative findings in this report. Failure to correct negative findings within the specified time will result in disciplinary action up to and including termination of employment.

  Sign