Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by Trista Winnett

  • Location
  • Personnel

Manager

  • Can Manager describe the system used to determine food needs when ordering?

  • Can Manager provide procedures for receipt of shipments, etc.?

  • Is the most recent FNS-152 report for this location available?

  • Can manager readily explain how complaints are handled, including verbal complaints, alleging discrimination?

  • Is an updated equipment listing for this location available?

  • Is rodent control being monitored?

  • Are no show clients being contacted, via mail, phone call, home visit, etc.?

  • Is a current OEH Report on hand?

  • Are periodic staff meetings held at this location and documented?

  • Are temperature readings up to date for both cold and dry storage areas?

  • Are mileage logs being monitored?

Certification Procedures/Management

  • Application includes a description of the violations and consequences in understandable terms and in prominent lettering.

  • All forms are up to date to include current information as well as current approval by USDA and the Civil Rights Non-Discrimination Statement.

  • Dual participation controls are in force?

  • Certification procedures are followed as stated in the FNS-501.

  • Documentation of Quality Control of case file review is readily available.

  • Case files are kept in secure storage.

  • Are applications available to all clients and potential clients either in person, by mail, phone, authorized representative, or website?

Record Retention/Management

  • Are records, including training, certification files, issuance logs, commodity receipts, fair hearing records, claims records, management reviews, audit reports, investigations, civil rights complaints, FNS reports, etc. are kept for 3 years?

Customer Service/Satisfaction

  • Are boxes or bags provided to clients for transporting USDA Foods?

  • Is adequate access to the office provided for disabled participants?

  • Is an employee with the ability to speak the Tribes indigenous language available at all times?

  • Can staff readily explain how complaints are handled, including verbal complaints, alleging discrimination?

  • Is assistance provided by staff to participants who are unable to carry their USDA Foods to their car?

  • Is home delivery of USDA Foods provided for those senior citizens and disabled persons who are unable to pick up their USDA Foods at the distribution site?

  • Are special needs of others, such as blind, hearing-impaired, or handicapped participants considered?

  • Is seating adequate to accommodate all participants waiting for service?

  • Are current and upcoming events and activities communicated effectively to FDPIR participants?

  • Is a suggestion box set up for participant input?

Warehouse Procedures/Compliance

  • Are inventory levels below a three month supply?

  • Are claim loss register logs established?

  • Are pallets at least 18" from the wall, 2' from the ceiling and 6" a part?

  • Are all loses reported correctly?

Staff Interactions/Involvement

  • Is a suggestion box set up for employee input?

  • Are employees encouraged to make suggestions for improvements in the program?

Nutrition Education

  • Are on going Nutrition Education incentives being conducted?

Training

  • Is customer service conducted periodically at the distribution site, and are corrective actions undertaken to ensure adequate service is provided to participants?

  • Do employees receive adequate training on customer service, including answering questions in a professional manner, handling complaints, dealing with people in a professional manner, and program facilitation in general, etc.?

General Compliance

  • Are over issuance claims handled by the guidelines set within the FNS-501?

  • Is signage displayed with current guide rates in view for FDPIR participants?

  • Is signage displayed advising FDPIR participants to accept only quantities of USDA Foods that they can consume?

  • Is Civil Rights compliance being met including training staff, outreach materials provided, posters posted, and program materials printed with current statement?

  • Latest version of AIS installed on computers.

  • Is a place available to post public notices of an informational, educational and/or promotional nature?

Telephone

  • Extension/phone answered within three rings.

  • Staff spoke clearly and audibly.

  • Staff used caller's name once known.

  • If person caller requested was not available, did staff offer assistance.

  • Extension/phone answered with department/program name, staff name and offer of assistance.

  • Voice mail recording was answered in three rings, and include a greeting, department/program name, staff's name and message explaining when call would be returned.

  • Staff was informative, courteous, and patient.

  • Was there minimal background noise or interruptions.

  • Staff offered further assistance at end of call never disconnected before caller.

  • Staff made proper referrals for services not provided by said program.

  • Staff was knowledgable, professional, and able to answer questions in a way that was easily understood.

Staff Interactions with Participants

  • Staff acknowledged the guest with eye contact and smile.

  • Staff introduced themselves to guest.

  • Staff speaks first with friendly, polite greeting and offer of assistance.

  • Staff addressed guest by name once known.

  • Staff offered the correct service or referral.

  • Staff was knowledgeable, professional, and able to answer questions in a way that was easily understood.

  • Staff handled request to guest's satisfaction.

  • Staff thanked guest at close of process, offered a referral, and/or extended a parting pleasantry.

  • Staff was well groomed, neatly attired in clean garments.

  • Staff name tag was visible and in good condition.

  • Staff did not slouch, keep hands in pockets or arms folded.

  • Staff made eye contact during interaction.

Safety

  • First aid kits present and easily accessible.

  • Fire extinguishers checked on a monthly basis and documented.

  • Is the physical environment at the office and warehouse neat, orderly, attractive, safe and free of hazards for children?

  • Wet floor signs present if needed.

  • Are evacuation routes clearly posted in case of emergency?

  • Blood born pathogen kit present and easily accessible.<br>

  • Is adequate safety lighting present and working properly?

Kitchen

  • Stove clean?

  • Cabinet tops clean?

  • Trash receptacles well maintained?

  • Floors clean?

Office Area

  • Desk/work areas neat and orderly?

  • Trash receptacle well maintained.<br>

Store Area/Warehouse

  • Checkout stands clean?

  • Is office, store and warehouse maintained at a comfortable temperature?

  • Shelves clean?

  • Shelves adequately stocked?

  • Is lighting adequate in all areas of building?

  • Is a clear path, free of obstacles, maintained for the use of wheeled carts or other devices used to transport food from the warehouse or store to the parking lot?

General Interior

  • Appropriate notices/ materials posted set in a protective sleeve or enclosed in a display case/frame, in good conditions free of stains and damage.

  • Windows and doors were free of prints and smudges.

  • Walls, ceilings, and floors free of spots, dust, and in good condition.<br>

  • Building interior had consistently comfortable air temperature, no odors.

  • Lighting at appropriate level with no burned out light bulbs.

  • Plants/floral fresh, dust free and in good condition.

  • Television turned on, in working condition and at an appropriate sound level.

  • Brochures/reading material in good condition and we'll organized.

  • Restroom walls and floors free of dirt and debris.

  • Restroom toilet, sink, faucet, fixtures, and mirror in good working condition; free of spots and rust.

  • Restrooms stocked with sufficient supplies and waste receptacles well maintained.

  • Garbage receptacles easily located and well maintained.

  • Ample and accurate directional/signs free of markings and in good condition.

  • Furniture free of spots, dust, debris, in good condition, maintained and organized.

  • Area is welcoming and inviting to guest.

  • Interior we'll organized, free of debris, and hazards.

General Exterior

  • Driveway area and curb in good condition, free of stains and damage.

  • Planters, lawn and walkways were well kept, mowed and trimmed.

  • Entrance area in good condition, free of stains and damage.

  • Exterior walls free of markings, free of stains and damage.

  • Ample and accurate directional/informational signs on grounds, free of markings and in good condition.

  • Premises free of debris.

  • Adequate parking space available.

  • Sufficient illumination in all outside areas.

  • Free of hazards.

Case File Reviews

  • Proof of Tribal descent

  • SS cards in file

  • Address verification

  • Income verification

  • Complete application

  • Complete notice of action

  • Complete worksheet

  • Other verification as needed

  • Well explained narrative

  • SNAP question answered

  • File complete and passes audit

  • Proof of Tribal descent

  • SS cards in file

  • Address verification

  • Income verification

  • Complete application

  • Complete notice of action

  • Complete worksheet

  • Other verification as needed

  • Well explained narrative

  • SNAP question checked

  • File complete and passes audit

  • Proof of Tribal descent

  • SS cards in file

  • Address verification

  • Income verification

  • Complete application

  • Complete notice of Action

  • Complete worksheet

  • Other verification as needed

  • Well explained narrative

  • SNAP question answered

  • File complete and passes audit

  • Proof of Tribal descent

  • SS cards in file

  • Address verification

  • Income verification

  • Complete application

  • Complete notice of action

  • Complete income worksheet

  • Other verification as needed

  • Well explained narrative

  • SNAP question answered

  • File complete and passes audit

  • Proof of Tribal descent

  • SS cards in file

  • Address verification

  • Income verification

  • Complete application

  • Complete notice of action

  • Complete income worksheet

  • Other verification as needed

  • Well explained narrative

  • SNAP question answered

  • File complete and passes audit

  • Proof of Tribal descent

  • SS cards in file

  • Address verification

  • Income verification

  • Complete application

  • Complete notice of action

  • Complete income worksheet

  • Other verification as needed

  • Well explained narrative

  • SNAP question answered

  • File complete and passes audit

  • Proof of Tribal descent

  • SS cards in file

  • Address verification

  • Income verification

  • Complete application

  • Complete notice of action

  • Complete income worksheet

  • Other verification as needed

  • Well explained narrative

  • SNAP question answered

  • File complete and passes audit

  • Proof of Tribal conscientious

  • SS cards in file

  • Address verification

  • Income verification

  • Complete application

  • Complete notice of action

  • Complete income worksheet

  • Other verification as needed

  • Well explained narrative

  • SNAP question answered

  • File complete and passes audit

  • Proof of Tribal descent

  • SS cards in file

  • Address verification

  • Income verification

  • Complete application

  • Complete notice of action

  • Complete income worksheet

  • Other verification as needed

  • Well explained narrative

  • SNAP question answered

  • File complete and passes audit

  • Proof of Tribal descent

  • SS cards in file

  • Address verification

  • Income verification

  • Complete application

  • Complete notice of action

  • Complete income worksheet

  • Other verification as needed

  • Well explained narrative

  • SNAP question answered

  • File complete and passes audit

  • Proof of Tribal descent

  • SS cards in file

  • Address verification

  • Income verification

  • Complete application

  • Complete notice of action

  • Complete income worksheet

  • Other verification as needed

  • Well explained narrative

  • SNAP question asked

  • File complete and passes audit

  • Proof of Tribal descent

  • SS cards in file

  • Address verification

  • Income verification

  • Complete application

  • Complete notice of action

  • Complete income worksheet

  • Other verification as needed

  • Well explained narrative

  • SNAP question answered

  • File complete and passes audit

  • Proof of Tribal descent

  • SS cards in file

  • Address verification

  • Income verification

  • Complete application

  • Complete notice of action

  • Complete income worksheet

  • Other verification as needed

  • Well explained narrative

  • SNAP question answered

  • File complete and passes audit

  • Proof of Tribal descent

  • SS cards in file

  • Address verification

  • Income verification

  • Complete application

  • Complete notice of action

  • Complete income worksheet

  • Other verification as needed

  • Well explained narrative

  • SNAP question qnswered

  • File complete and passes audit

  • Proof of Tribal descent

  • SS cards in file

  • Address verification

  • Income verification

  • Complete application

  • Complete notice of action

  • Complete income worksheet

  • Other verification as needed

  • Well explained narrative

  • SNAP question answered

  • File complete and passes audit

  • Proof of Tribal descent

  • SS cards in file

  • Address verification

  • Income verification

  • Complete application

  • Complete notice of action

  • Complete income worksheet

  • Other verification as needed

  • Well explained narrative

  • SNAP question answered

  • File complete and passes audit

  • Proof of Tribal descent

  • SS cards

  • Address verification

  • Income verification

  • Complete application

  • Complete notice of action

  • Complete income worksheet

  • Other verification as needed

  • Well explained narrative

  • SNAP question answered

  • File complete and passes audit

  • Proof of Tribal descent

  • SS cards in file

  • Address verification

  • Income verification

  • Complete application

  • Complete notice of action

  • Complete income worksheet

  • Other verification as needed

  • Well explained narrative

  • SNAP question answered

  • File complete and passes audit

  • Proof of Tribal descent

  • SS cards in file

  • Address verification

  • Income verification

  • Complete application

  • Complete notice of action

  • Complete income worksheet

  • Other verification as needed

  • Well explained narrative

  • SNAP question answered

  • File complete and passes audit

  • Proof of Tribal descent

  • SS card

  • Address verification

  • Income verification

  • Complete application

  • Complete notice of action

  • Complete income worksheet

  • Other verification as needed

  • Well explained narrative

  • SNAP question answered

  • File complete and passes audit

Audit Summary

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.