Restaurant Visitation Report

• Franchisee

• Store

• Location
  Address

• Document No.

• Conducted on

  Date

• Prepared by

Exterior Cleanliness

• Is the car park free from litter and weeds?

  Yes

  No

  N/A

• Is the drive thru menu board clean and in good repair?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Does the drive thru window area appear to be clean and free of clutter? 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:

Drive Thru Experience

• Did the order taker try to up sell?

  Yes

  No

  N/A

• Did your order appear on the DMB?

  Yes

  No

  N/A

• Did you see a smile at the window?

  Yes

  No

  N/A

• Did the employee say thank you?

  Yes

  No

  N/A

• Was a parting phrase used?

  Yes

  No

  N/A

• Was the drive thru time 2:30 or less? Record actual time?

  Yes

  No

  N/A

• Comments:

Product Observations

• What product(s) did you order?

• Was the build correct?

  Yes

  No

  N/A

• What your order hot and Fresh?

  Yes

  No

  N/A

• We're your chips properly salted?

  Yes

  No

  N/A

• Comments

Interior Cleanliness

• Are the restrooms clean and stocked? Free of odor? baby change table secure and stocked?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Are the bins clean and in good condition? Liners tucked? No odours?

  Yes

  No

  N/A

• Is the front counter clean and clutter free?

  Yes

  No

  N/A

• Is all lighting working and in good repair?

  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

• Is the playground area clean and well maintained?

  Yes

  No

  N/A

• Is the playground area in good condition and safe to use?

  Safe

  At Risk

  N/A

Team Image

• Are all employees wearing a complete uniform. Hat, shirt, name tag, belt, black pants, dark socks, slip-resistant shoes. No excessive jewelry. Hair restrained. Good hygiene and grooming standards are practiced?

  Yes

  No

  N/A

• Are all managers wearing a complete uniform?

  Yes

  No

  N/A

• Are all open sores and wounds properly covered with blue bandages?

  Yes

  No

  N/A

• Are all food handlers wearing gloves?

  Yes

  No

  N/A

• Comments:

Safety

• Are GPO's clean and free from damage?

  Safe

  At Risk

  N/A

• Are there any frayed or damaged cords visible?

  Safe

  At Risk

  N/A

• Is equipment in safe working order?

  Safe

  At Risk

  N/A

• Are WFS used when necessary?

  Safe

  At Risk

  N/A

• Are floors around fryers kept clean and oil free?

  Safe

  At Risk

  N/A

• Are there any cracked/broken tiles/flooring?

  Safe

  At Risk

  N/A

• Is the CCTV operational?

  Yes

  No

  N/A

• Is there a lockable door to prevent access to the burger room?

  Yes

  No

  N/A

• Are all managers fire and 1st aid trained? (with certificates in store)

  Yes

  No

  N/A

• Are all managers serve safe trained? (with certificates in store)

  Yes

  No

  N/A

Jack's Cafe

• Is the does set to 22g?

  Yes

  No

  N/A

• Is the grind set to achieve a 22-26sec small pour?

  Yes

  No

  N/A

• Barista towels available and clean?

  Yes

  No

  N/A

• Correct milk jug used?

  Yes

  No

  N/A

• Coffee is presented attractively without drips/spills?

  Yes

  No

  N/A

• Coffee is presented with correct topping? eg latte art, choc dusting?

  Yes

  No

  N/A

• Coffee station is kept clean and organised?

  Yes

  No

  N/A

Kitchen Cleanliness

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

  Yes

  No

  N/A

• Is the broiler & Hoods being properly cleaned and maintained?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Are PHU's clean and free of grease build up? And being used correctly?

  Yes

  No

  N/A

• Is the microwave clean, labeled correctly?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Is the fry station clean, chips salted correctly and are hold times followed?

  Yes

  No

  N/A

• Is the ice machine clean and functioning properly?

  Yes

  No

  N/A

• Is the shake machine cleaned throughout the day as needed?

  Yes

  No

  N/A

• Are the toaster belts and Teflon cleaned frequently? Are the toaster settings correct?

  Yes

  No

  N/A

• Is all refrigerated equipment clean and functioning properly? Gaskets, fan guard, shelving, stocked correctly, no expired products.

  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 travel paths being completed at a minimum of every 30 minutes?

  Yes

  No

  N/A

• Are temperature checks being completed as required?

  Yes

  No

  N/A

• Are beef cookouts being completed as required?

  Yes

  No

  N/A

• Is the command station set up correctly? Is all information up to date?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Are all available headsets in use at all times? Is the MOD wearing a headset?

  Yes

  No

  N/A

• Are both main boards open during peak periods?

  Yes

  No

  N/A

• Is the 1st window open with 5 crew?

  Yes

  No

  N/A

• Do the crew know what today's PCC 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

• 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? (5 -60 degrees C)

  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, all chemicals labeled)

  Yes

  No

  N/A

• Comments:

Goal Achievement

• Is the restaurant meeting or exceeding their sales plan?

  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 labour plan?

  Yes

  No

  N/A

• Is the monthly PCC > 55?

  Yes

  No

  N/A

• What is the monthly PCC?

• Comments:

Administration/Brand Standards

• Are P&L's supplied and up to date ?

  Yes

  No

  N/A

• Is the OHS noticeboard up to date?

  Yes

  No

  N/A

• Is the OHS schedule up to date?

  Yes

  No

  N/A

• Does the store have SICOM chef?

  Yes

  No

  N/A

• Does the store have DMB inside/out?

  Yes

  No

  N/A

• Does the store have Jack's Cafe?

  Yes

  No

  N/A

• Does the store have a merry chef oven?

  Yes

  No

  N/A

• Does the store have kiosks? (min 3 for as FSDT)

  Yes

  No

  N/A

Overall Visit Comments

• FBL Comments:

• FBL Signature

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MOD Comments and Acknowledgement

• Manager On Duty

• Manager on Duty Comments:

• By signing this form you acknowledge that you have been through this report with your FBL.

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