Safety Inspection ID800107

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Car Park, Building and Corral

• Surfaces (Including Car Park)<br>- No Tripping Hazards identified<br>- Wet Floor signs displayed if necessary<br>- All steps & pathways are free from all debris & are in good condition<br>

  Yes

  No

  N/A

• Pedestrian Routes<br>- All pedestrian routes are clearly marked<br>- In the drive thru, signs for drivers warn them of pedestrian as required<br>- Overhead clearance sign correctly placed and in good condition

  Yes

  No

  N/A

• Traffic Routes<br>- It is clear to drivers where they should stop, giveway, etc<br>- Handrail in place to stop people from walking out directly onto drive thru lane

  Yes

  No

  N/A

• Car Park Lighting<br>- Lighting in car park is operating. No globes are blown (Turn on to check)

  Yes

  No

  N/A

• Corral<br>- Corral is locked from outside when not in use & nothing obstructs back door exit<br>- All visible plugs & outlets are in good condition & weatherproof if external<br>- Bulk waste oil container has a filter/strainer fitted whenever oil is pumped into tank<br>- Combustible materials in corrals are stored at a minimum distance of 1.5 metres from outside eaves<br>- Red otto bin available for litter patrol & in good working condition

  Yes

  No

  N/A

• Signage<br>- All hanging signs, awnings & other exterior accessories are safely secured

  Yes

  No

  N/A

• Menu Boards<br>- Tri menu boards lock & secure

  Yes

  No

  N/A

• Drive Thru Windows<br>- Drive Thru Windows are closed & locked during non peak periods.<br>- Locks are operational and in good working order<br>- Security Window fitted (if required)<br>- No Walk Up Service Sticker posted

  Yes

  No

  N/A

Customer Toilets

• Water<br>- Wash basin water is hand hot (<40*c)

  Yes

  No

  N/A

• Doors/ Floors<br>- Door closers - swing the door open & observe as it closes the last few centimetres, does it have a buffer? (Doesn't slam shut)<br>- Restrooms floors are free from trash. Floors are dry

  Yes

  No

  N/A

• Baby Change Units<br>- Baby change unit is securely mounted<br>- Clip and strap are in good condition<br>- Unit only opens to 90*

  Yes

  No

  N/A

• Syringe Disposal Units<br>- Syringe disposal units supplied & maintained (including approved collection) if there is a recognised syringe problem<br>- Stickers available on front of all units

  Yes

  No

  N/A

PlayLand

• Equipment & Signage<br>- Play Land equipment is in good working condition<br>- Poles are padded<br>- Play Land is shaded and closed if wet<br>- No climbing signs are displayed if needed<br>- Correct Play Land rules are displayed

  Yes

  No

  N/A

• Fencing<br>- Fences and gates surrounding play land are in good condition, securely locked & child proof, 1.8m high

  Yes

  No

  N/A

Dining Areas, Patio, Café Areas

• High Chairs<br>- Approved high chairs with child restraint straps & clips are in good condition & stored out of traffic areas<br>- Wheels & tray clips are in good condition

  Yes

  No

  N/A

• Chairs and Tables <br>- All fixed tables & chairs are secure<br>- Freestanding tables & chairs show no signs of wear & tear<br>- All free stand chairs have rubber tips on the chair legs<br>- Granite table tops are secured

  Yes

  No

  N/A

• Walkways<br>- Walkways are dry& clear of any trash or obstruction<br>- All floors are in good condition/repair & free from grease

  Yes

  No

  N/A

• Wet Floor Signs<br>- Adequate stock of wet floor signs (Min 1 in express & 2 in other stores)<br>- If in use, enough are placed in hazardous area to identify hazards<br>- No faded signs<br>- Signs are removed when not needed

  Yes

  No

  N/A

• Mopping Procedures<br>- *QSR Quarry Floor Tile Cleaner (Floor Care) is being used<br>- Mops & Buckets clean and in good condition<br>- Red mop bucket used in dining room

  Yes

  No

  N/A

• Ceiling Ties, Light Defuser & Vent Covers<br>- Ceiling Tiles, light diffusers & vent covers appear secure (Visual Inspection Only)

  Yes

  No

  N/A

• Lighting<br>- Décor lighting is in good working order & lanyards attached if necessary (Visual Inspection Only)

  Yes

  No

  N/A

• Power Points<br>- All visible power points are in good condition<br>- Extension leads/adaptors not used<br>

  Yes

  No

  N/A

• Doors<br>- Door closers - swing the door open & observe as it closes the last few centimetres, does it have a buffer? (Doesn't slam shut)<br>- Sliding glass doors (and panels) have some indication to highlight glass (Eg. Stickers)<br>- Automatic doors' sensors are positioned correctly for safe door speed<br>- Security height measurement sticker positioned on the inside of the door frame<br>- Rubber strips fitted where required

  Yes

  No

  N/A

McCafé

• Top Of Display Cabinet<br>- Ensure canisters are plastic and not glass

  Yes

  No

  N/A

• Utensils <br>- Check McCafé utensils are stored in utensil holder when not in use

  Yes

  No

  N/A

• Crockery/Glass Breakages<br>- Ask McCafé employee how they handle crockery/glass breakages?

  Yes

  No

  N/A

• Tiles<br>- Tiles in good condition and free of grease

  Yes

  No

  N/A

• Electrical Cables <br>- Cables are tagged & tested & positioned so that they do not dangle/obstruct walkways

  Yes

  No

  N/A

• Inspection Date:

  Date

• Plugs & Sockets<br>- All visible plugs & outlets are in good condition<br>- Extension leads/adaptors not used

  Yes

  No

  N/A

• Equipment <br>- All equipment being used is in good working condition (eg. No broken fittings/switches)<br>- Any defective equipment is tagged correctly and not in use

  Yes

  No

  N/A

• Ceiling Lights and Vents<br>- Ceiling lights & vents are secure (Visual Checks Only)

  Yes

  No

  N/A

Counter & Kitchen Areas

• Walkways<br>- All walkways are dry, and free from grease<br>- All walkways clear of trash and any obstructions

  Yes

  No

  N/A

• Hustle<br>- No running under any circumstances

  Yes

  No

  N/A

• Footwear<br>- All employees on shift comply with Appearance SOC<br>- Heel not greater than 5cm on footwear

  Yes

  No

  N/A

• Tiles<br>- Non slip surface in front of grills, vats & sink<br>- Tiles in good condition and free from grease

  Yes

  No

  N/A

• Electrical Cables<br>- Cables are tagged & tested & positioned so that they do not dangle/obstruct walkways

  Yes

  No

  N/A

• Inspection Date:

  Date

• Plugs & Sockets<br>- All visible plugs & outlets are in good condition<br>- Extension leads/adaptors not used

  Yes

  No

  N/A

• Vat Covers/Fry Funnel <br>- Fryer covers for all vats available in the kitchen/wash area<br>- Handles on vat covers present & secure<br>- Fry Funnel Mandatory (McOpCo Only)

  Yes

  No

  N/A

• Equipment <br>- All equipment being used is in good working condition (eg. No broken fittings/switches)<br>- Any defective equipment is tagged correctly and not in use

  Yes

  No

  N/A

• Tomato Slicer<br>- Tomato Slicer in good working condition<br>- Rubber feet on all legs for stability<br>- Handles and blades secure

  Yes

  No

  N/A

• Ceiling Lights and Vents<br>- Ceiling lights & vents are secure (Visual Checks Only)

  Yes

  No

  N/A

• Filters and Troughs<br>- Filters are secure above vats and grills with spring locks<br>- No overhead storage racks above vats<br>- Filters & troughs in good working condition (eg. All handles in place & no sharp edges)

  Yes

  No

  N/A

• Equipment Locks & Castors<br>- Fryer & Grill restraint cables fitted to equipment & used <br>- Locks are in position

  Yes

  No

  N/A

• Exhaust Units<br>- Exhaust stacks turned on & are in good working order (smoke directed into hood)<br>- Nothing is placed on exhaust hoods<br>- Ask an employee how they clean exhaust hoods (no standing on top)

  Yes

  No

  N/A

• Bun Crates <br>- All empty & full bun crates stored internally & stacked out of the way & do not pose a trip hazard or block emergency exits

  Yes

  No

  N/A

Back Area

• Freezer <br>- Freezer release latches have reflective signage, can be be opened easily from the inside if locked & have clear access to exit<br>- Product does not obstruct release latches<br>- Door bell & light are working<br>- Floors are clean and free from ice<br>- Storage complies with Delivery SOC<br>- Good lighting

  Yes

  No

  N/A

• Walk-in<br>- Walk-in release latches have reflective signage, can be opened easily from the inside if locked & have clear access to exit<br>- Products does not obstruct release latches<br>- Door bell & lights are working<br>- Floors are clean and free from debris<br>- Storage complies with Delivery SOC<br>- Good lighting

  Yes

  No

  N/A

• Ice Machine<br>- Warning sticker attached to ice machine

  Yes

  No

  N/A

• Personal Protective Equipment - PPE<br>- All PPE must be clean, available, in good condition & stored correctly <br>- Freezer jacket & delivery gloves<br>- Faces<br>- Gloves: Wash-Up, Grill, Filtering & Mesh Glove<br>- Multi purpose apron (wash-up & filtering)<br>- Safety Vest <br>- Spares of all PPE equipment available

  Yes

  No

  N/A

• Ladder & Safety Step<br>- 1.8 m non-conductive ladder available <br>- All ladders & safety steps available, in good condition & used correctly ( If ladders are in use ensure employee is not standing on the top 2 steps & ladder fully extended)

  Yes

  No

  N/A

• Bulk CO2 (If located internally)<br>- Leak detector fitted & working<br>- All managers know actions if alarm sounds (Verify written record of training)<br>

  Yes

  No

  N/A

• CO2 & Helium Cylinders<br>- All cylinders a chained up<br>- Cylinders stored in well-ventilated areas

  Yes

  No

  N/A

• CO2 System (Bulk) <br>- Pressure vessel tags/certificate attached for compliance

  Yes

  No

  N/A

• Date of Compliance: (5 year Compliance Tag)

  Date

• Hot Water Service<br>- No flammable materials stored nearby

  Yes

  No

  N/A

• Piped Helium<br>- Valves in OFF position when not in use

  Yes

  No

  N/A

• Oil Trolley<br>- Oil transfer trolley, fryer cleaning tool & grill cleaning tools available & in good condition

  Yes

  No

  N/A

• Electrical Switchboard Panel<br>- Electrical switchboards are labelled, unobstructed, legends are in place & accessible

  Yes

  No

  N/A

• Electrical Isolation<br>- Electrical Isolation Kit fully stocked (min. 5 tags of each red & yellow, 2 narrow & 2 wide clamps)<br>- Posters - ' Procedures For Use' & Flipchart positioned on Electrical Switchboard<br>- Trip Log inside panel of switchboard

  Yes

  No

  N/A

• Roof Access<br>- Roof ladders have instructions & hook, & ladder is locked (if applicable)

  Yes

  No

  N/A

• Roof Condition<br>- Nothing is stored in the roof<br>- Only HVAC filters & exhaust fans stored on/in roof<br>- Roof edge protected to guard against falls<br>- Walkways clean & clear from debris<br>- Wooden boards in good condition and not greasy

  Yes

  No

  N/A

• Plugs & Sockets<br>- All visible plugs & outlets are in good condition<br>- Extension leads/adaptors not used

  Yes

  No

  N/A

• Crew Facilities<br>- Crew Room & change room facilities available and clean<br>- Storage available for personal belongings

  Yes

  No

  N/A

• Torch<br>- A torch readily available in the event of a blackout with spare batteries

  Yes

  No

  N/A

Wash-Up

• Wash-Up Area & Litter Tools<br>- Heavy items (eg. Bulk chemicals, garbage bag dispenser) are positioned between mid-thigh & chest height<br>- Bulk Chemicals containers display: Correct chemical label (including name of substance & instructions for use), labels are not removed, defaced, modified or altered<br>- Trash masher & litter pick up tool available & in good working condition<br>- Spray hose in good condition, not leaking

  Yes

  No

  N/A

Storage Areas

• Stock Room<br>- No stock on floor, aisles are clear<br>- Storage complies with Delivery SOC<br>- Very Heavy items (>16kg) stored between mid thigh & mid chest<br>- Racking in good condition

  Yes

  No

  N/A

• Stock<br>- No heavy items (>12kg) above 2 metres

  Yes

  No

  N/A

• Trolleys<br>- Trolleys for moving heavy items available

  Yes

  No

  N/A

• Manual Handling<br>- Observe an employee's manual handling technique or ask them to demonstrate

  Yes

  No

  N/A

Chemical Supplies & Storage

• Chemical Storage & Labels<br>- Stored securely & neatly in locked cupboard (separate to food products)<br>- Labels (including name of substance & instructions for use) are attached & able to read clearly<br>- Labels are not defaced, modified, or altered on spray bottles<br>

  Yes

  No

  N/A

• Store specific chemicals MSDS Register<br>- Non-approved chemicals have the following: individual MSDS for the substance, a generic risk assessment for the substance<br>- If substance is classified as hazardous substance risk assessment is to be completed

  Yes

  No

  N/A

Fire Prevention

• Fire Doors<br>- All fire doors are kept shut except it they have automatic release mechanisms fitted

  Yes

  No

  N/A

• Fire Exit Routes<br>- Minimum 1m width of fire exit route from each storey and aspect of the building & is clear of blockages<br>- Evacuation plan is displayed on each level

  Yes

  No

  N/A

• Fire Exit Signage<br>- Fire exit signs are illuminated & readily visible from all areas in the building

  Yes

  No

  N/A

• Assembly Point<br>- Ask 2 employees where the assembly point is (ensure answers are correct)

  Yes

  No

  N/A

• Evacuation Exercise<br>- The last evacuation exercise (including drill/walk-through) is recorded (completed every 12 months) . (Template available on metime) <br>

  Yes

  No

  N/A

• Date of last exercise:

  Date

• Portable Fire Extinguishers<br>- All portable fire extinguishers a mounted on a bracket, not obstructed, labelled, tagged within the last 6 months & unit is charged for use (dial is in green area)

  Yes

  No

  N/A

• Kitchen

  Date

• McCafé

  Date

• Stock Area

  Date

• Fire Blanket<br>- Fire blanket is tagged (inspected by technician within last 6 months) , readily available , a label is fixed to the wall & is accessible in the kitchen area

  Yes

  No

  N/A

• Date:

  Date

• ANSUL System<br>- MRC T118 Fire Suppression Equipment Service completed (verify)<br>- Handle accessible & in good condition<br>- Caps on all ANSUL discharge points

  Yes

  No

  N/A

First Aid

• First Aid Kit<br>- Kit is accessible, not locked & visible<br>

  Yes

  No

  N/A

• Supplies<br>- Supplies are neat & tidy<br>- Requirements detailed on sticker inside kit

  Yes

  No

  N/A

• Unauthorised Items<br>- No 'unauthorised' items (eg. Aspirin, Savlon, Burn Spray, nail polisher remover, shaving foam etc)

  Yes

  No

  N/A

• Sharps Disposal Kit<br>- At least 2 unopened syringe disposal kits are available (order from McKey).

  Yes

  No

  N/A

Compactor

• Training<br>- Instructions for use displayed near controls<br>- All relevant staff have been trained in safe use of equipment<br>- Ask crew if they have been trained<br> It must be noted on the Restaurant Basics Checklist in the restaurant specific section

  Yes

  No

  N/A

• Equipment Condition<br>- Machine & power lead in good condition<br>- Front & rear guards in good condition

  Yes

  No

  N/A

• Emergency Stop Button<br>- Emergency stop button s accessible & clearly labelled<br>- Lid is closed at all times during use<br>- Interlock switch cannot be overridden

  Yes

  No

  N/A

• Storage<br>- Bundles of cardboard are stored away from entry and exit points

  Yes

  No

  N/A

Restaurant Lifts

• Training<br>- Instructions for use displayed near controls<br>- All relevant staff have been trained in safe use of equipment<br>- Ask crew if they have been trained, it must be noted on the Restaurant Basics Checklist in the restaurant specific section<br>- Ask crew to tell you how lift is used, answer should include: not stepping in lift & not carrying items likely to cause a jam (eg. Mops)

  Yes

  No

  N/A

• Equipment Condition<br>- Check that lift & runners are clean (Only open the doors wen the lift is in place - never enter the lift shaft

  Yes

  No

  N/A

• Certificate & Signage<br>- A valid lift certificate is present (issued within the last 12 months)<br>- A lift notice is displayed on each landing, giving basic instruction and precautions<br>- The motor room is locked with a notice displayed

  Yes

  No

  N/A

Conveyors

• Training<br>- Instructions for use displayed near controls<br>- All relevant staff have been trained in safe use of equipment<br>- Ask crew if they have been trained, it must be noted on the Restaurant Basics Checklist in the restaurant specific section<br>- Ask crew to tell you how lift is used, answer should include: not stepping in lift & not carrying items likely to cause a jam (eg. Mops)

  Yes

  No

  N/A

• Equipment Condition<br>- Check that conveyor is clean & in good working order<br>

  Yes

  No

  N/A

• Emergency Stop Button<br>- An emergency stop button is readily accessible at conveyors top & base<br>- Conveyor can be readily isolated

  Yes

  No

  N/A

Posters & Display Materials

• Safety & Injury Management Policy<br>- Safety & Injury Management Policy displayed<br>- Policy signed by Licensee if applicable <br>- In QLD & SA, a rehabilitation coordinator has been appointed & trained

  Yes

  No

  N/A

• Evacuation Plan <br>- Evacuation plan is displayed stating 'In the event of an emergency evacuation, the shift manager will take control of the situation.' Template available on metime.<br>- Key legend - identifies emergency exits / first aid kit, fire extinguishes & assembly point and location on plan

  Yes

  No

  N/A

• Manual Handling Posters<br>- Safe Lifting & Carrying Posters displayed on the Walk in door, Freezer door & stockroom, cage<br>- Collecting Bun Crates poster displayed in bun area<br>- Moving the dumpster bin poster displayed near back door or dumpster area

  Yes

  No

  N/A

• Emergency Procedures Flip Chart<br>- Posted is readily visible position in kitchen area

  Yes

  No

  N/A

• Kay Chemicals First Aid Chart<br>- Posted in readily visible position in kitchen (A4 laminated sheet)

  Yes

  No

  N/A

• Kay Chemicals Flip Chart <br>- Kay Chemicals Product Flip Chart Posted in readily visible position in kitchen

  Yes

  No

  N/A

• State Legislative Requirements<br>- NSW-WorkCover Watching Out For You<br>- VIC-If You're Injured<br>- ACT-Summary Of Act<br>- TAS-Summary Of Act

  Yes

  No

  N/A

• Litter Patrol Plan<br>- Litter Patrol Plan completed with restaurant specific details and displayed on crew noticeboard<br>- *Template available on McSource/metime

  Yes

  No

  N/A

Restaurant Essentials Workbook (REW)

• Monthly Workplace Safety System Checklist<br>- All areas of the checklist 100% complete monthly by Restaurant Manager<br>- Verification sign off by Licensee/McOpCo Consultant (check 3 months of records- use the columns in the comment section to record month verified)

  Yes

  No

  N/A

• Monthly Workplace Safety System Checklist - Action Plan<br>- All 'NO' answers on the checklist have an action plan completed & signed off

  Yes

  No

  N/A

• WPS Inspection Checklist<br>- Inspections completed every month (not by same Safety Team Member) (Check past 3 months of records)

  Yes

  No

  N/A

• WPS Inspection Checklist Action List<br>- All 'NO' answers are adequately described & resolved immediately or written up in Hazard Log

  Yes

  No

  N/A

• Electrical Inspection Checklist<br>- Monthly Electrical Inspection 100% complete (Check 3 months of records)

  Yes

  No

  N/A

• Electrical Inspection Checklist Action List<br>- All 'NO' answers given are adequately described & written up in Hazard Log

  Yes

  No

  N/A

Security System Minimums

• Security Risk Analysis Tool<br>- Security Risk Analysis Tool has been completed for the restaurant and available in the Health and Safety Toolbox<br>- Document the date completed and the rating at the time of audit<br>- Security Risk Analysis Tool available on metime/McSource<br>- Security Risk Analysis Tool completed every 6 months

  Yes

  No

  N/A

• Security Checklist (System Minimums & Recommendations)<br>- Security Checklist completed and on file in the Health and Safety Toolbox<br>- Document the date completed <br>- An action plan has been developed and items implemented and signed off Licensee/McOpCo Consultant<br>- Security Checklist completed every 6 months

  Yes

  No

  N/A

Restaurant Workplace Safety Audit (RWSA)

• Completion of RWSA<br>- The Restaurant Workplace Safety Audit has been completed by the Consultant within the last 6 months

  Yes

  No

  N/A

• Action Plan<br>- An action plan has been developed and items implemented and signed off

  Yes

  No

  N/A

Preventative Maintenance

• Planned Maintenance Schedule<br>- Ask a manager to tell you what equipment has been maintained recently & check that PM Schedule has been completed (Black Tasks)<br>- 'Technician Only' (red) tasks performed only by a technician & signed off by manager

  Yes

  No

  N/A

• PM Manual<br>- Australian Planned Maintenance Manual is available in the restaurant (yellow March 05)<br>- Training Record Card - check current PM manager/person has been trained

  Yes

  No

  N/A

• Electrical Inspections <br>- MRC T120 completed within last 6 months & records kept

  Yes

  No

  N/A

Contracting Management System

• Contractor Management Manual<br>- Contractor Management Manual available in the restaurant <br>- Safety Requirements for Contractors & Suppliers Pocket Guide available

  Yes

  No

  N/A

• Contractor Induction Checklist & Risk Assessment Forms<br>- Check the last 5 Contractor visits and ensure the following has been completed 100%- Contractor Induction checklist- Tab 1 - Contractor Risk Assessment - Tab 2<br>- Any loose risk assessment must be stapled

  Yes

  No

  N/A

• Contractor Training & Orientation Record<br>- Contractors performing same or similar duties as crew or managers must be trained using McDonald's training materials- Contractor Training & Orientation Record completed- Restaurant Basics Checklist & Quiz (Workplace Safety & Electrical Isolation) needs to be completed annual- Work station training (eg. cleaning behind the grill SOC)

  Yes

  No

  N/A

Hazard Log

• Hazard Log<br>- Ask 1 crew person to explain how & when to use the Hazard Log<br>- Hazard Log is accessible to all employees<br>- At least 2 entries made in the past month<br>- Hazard rating table completed for every entry

  Yes

  No

  N/A

• Hazard Control<br>- All controls written on blue copy<br>- All entries signed off by Restaurant Manager / Licensee & Safety Team<br>

  Yes

  No

  N/A

• Management Knowledge<br>- Ak the shift running manager where the Hazard Log is found<br>- Ask him/her about what to do when an entry is made on his/her shift<br>- Ask him/her to explain 'hazard' , ' hazard rating' & 'hazard controls'

  Yes

  No

  N/A

Restaurant Specific Risk Assessments

• Risk Assessment<br>- Check the restaurant has conducted Restaurant Specific Risk Assessment (template located in the REW).

  Yes

  No

  N/A

• Restaurant Specific Task:

• Date Completed:

  Date

• Litter Patrol

• Roller Shutters

• Moving Chairs

• Mechanical aids eg. Leaf Blower

• Restaurant Specific Task SOC<br>- Check the control measures from the risk assessment have been transferred to the Restaurant Specific Task SOC (Restaurant SpecificTask SOC located in the CPD)<br>- Verify relevant employees have been trained to completed Restaurant Specific Task SOC (on the back of SOC)

  Yes

  No

  N/A

• 24Hour Operation<br>- Check the 'Security and Workplace Safety Restaurant Minimums Checklist & 24hour Trading Risk Assessment' in the 24Hour Trading Guide (*full copy in toolbox)

  Yes

  No

  N/A

• Date completed: (date and signed off)

  Date

Hazardous Materials

• Hazardous Materials Management (Only for affected restaurants - Asbestos)<br>- Hazardous Material Management video available in the restaurant <br>- Hazardous Materials Management Plan (HMMP) - filed in the Health & Safety Toolbox<br>- Baseline Hazardous Material Audit Report - filed in the Health & Safety Toolbox (This is an individual restaurant report on the front cover) <br>- Noticeboard- Hazardous Materials Information poster (laminated sheet)

  Yes

  No

  N/A

Incident Managemnt

• Incident/ Visit Reports<br>- Available & accessible to all employees<br>- Used to record incidents, not hazards<br>- Ask crew: when do you port and incident & how do you do it? Incident/Visit Report to be completed by shift manager only (Check last 3 months' entries for correct completion)

  Yes

  No

  N/A

• Action Already Taken By Restaurant and Future Actions<br>- Corrective actions are written in both areas 'Action already taken by restaurant' to prevent a similar incident from happening again

  Yes

  No

  N/A

• Management Knowledge<br>- Ask a manager who's responsibility is it to complete the corrective section?<br>- Ask a manager: what incidents would you port to Head Office?

  Yes

  No

  N/A

Safety Team

• Safety Manager & Safety Team<br>- Safety Manager - ask crew 'Who is the Safety Manager'?<br>- Ask 2 crew who is on the Safety Team & how would they become a member

  Yes

  No

  N/A

• Last Meeting<br>- Meetings a being held minimum of quarterly

  Yes

  No

  N/A

• Meeting Notes<br>- Minutes are on file from last meeting<br>- Minutes are dated<br>- All issues /hazards from previous meeting have been followed-up & completed<br>- Minutes include discussions about Safety Alerts, Hazard Log entries, inspections, incidents, etc

  Yes

  No

  N/A

• Noticeboard<br>- Summary minutes from previous meeting at displayed on noticeboard<br>- Safety team members' names listed on noticeboard<br>- Safety team chairperson is a crew person

  Yes

  No

  N/A

• Safety Team Training<br>- Randomly check 2 Safety Team member files and confirm 'Safety Team Member Development Workbook' has been 100% completed and signed off<br>- Safety Team Member Development Workbook- Trainers Notes available in the restaurant

  Yes

  No

  N/A

Safety Team Training Verification

• Name & Position:

• Metime/Restaurant:

• Safety Team Development Workbook:

• Name & Position:

• Metime/Restaurant:

• Safety Team Development Workbook:

Management Training, Verification & Tools

• Management Orientation<br>- Verify the Shift Manager has Restaurant Basics completed<br>- Syringe Management procedure verified<br>- Emergency Procedures verified<br>- Check if Restaurant Specific Hazards have been identified (eg. Panic alarms)<br>* Workplace Safety & Security section completed annually

  Yes

  No

  N/A

• Fire Fighting Training<br>- Verify the shift manager has attended fire fighting training<br>- Copies of certificates in H&S Toolbox<br>- QLD Fire Safety Adviser Training Certificate (Valid for 3 years)

  Yes

  No

  N/A

• First Aid Training <br>- Verify the Shift Manager has a current First Aid Certificate<br>- Copies of certificates in H&S Toolbox

  Yes

  No

  N/A

• Injury Management System<br>- McDonald's Australia Injury Management System available in the Health & Safety Toolbox with Management Verification (McOpCo Only)

  Yes

  No

  N/A

• WHSO (Qld Only)<br>- WHSO nominated, name displayed & trained within past 5 years

  Yes

  No

  N/A

• Electrical Isolation Procedures<br>- Managers to demonstrate attaching clamps & tags<br>- Ask crew what the Yellow & Red isolation tags mean?

  Yes

  No

  N/A

• AccessMCD/Australia Intranet MSDS Safety Alerts Restaurant Operating Standard<br>- MSDS available on AccessMCD, Manager to demonstrate access. Manager to explain how and when to use the MSDS?<br>- Safety Alerts - Last 12months Safety Alerts available in the Health & Safety Toolbox. All previous Safety Alerts since 1996 available online, Manager to demonstrate access<br>- Restaurant Operating Standards - Manager to demonstrate access

  Yes

  No

  N/A

• Policies and Procedures Manual <br>- Policies & Procedures Manual available in the crew room (Black folder / Latest Version - October 2009)

  Yes

  No

  N/A

Crew Training & Verification

• Crew Orientation<br>- Check 5 employee files. Select 4 X Crew files are currently rostered on the shift & 1 X maintenance/contract cleaner or closer file<br>- Files must contain, metime orientation, restaurant specific orientation checklist printed from metime<br>- Restaurant basics checklist & quiz, check if restaurant specific hazards have been identified (eg. Panic alarms)(Workplace Safety & Security section completed annually)<br>- Current rostered station SOC

  Yes

  No

  N/A

Training Verification

• Name & Position:

• Metime/Restaurant Basics:

• Rostered Station:

• Name & Position:

• Metime/Restaurant Basics:

• Rostered Station:

• Name & Position:

• Metime/Restaurant Basics:

• Rostered Station:

Signatures

• Shift Supervisor:

  Sign

• Safety Inspector:

  Sign