Title Page

  • Store #

  • Location
  • Conducted on

  • Personnel on duty

  • Prepared by

Outside Areas

  • Parking lot/landscaped areas trash free, no spills, oil and fuel residue?

  • Dumpster area clean, trash picked up, odor-free, doors closed, in good repair?

  • Reader board being fully used with no misspellings and proper message displayed?

  • Outside rug, trash cans clean and not overflowing?

  • Front door clean without smudges?

  • Windows and ledges clean?

Inside Areas

  • Are the floors clean?

  • Are the mats clean?

  • Gondola shelves well stocked (with 3 or less out of stocks), priced correctly, fronted, dust free?

  • Are drink dispensers and nozzle/lid dispensers clean?

  • Are counter tops and fronts of cabinets clean and free of trash and spills?

  • Are cooler doors clean?

  • Is cooler stocked well with 3 or less out of stocks/empty rows?

  • Are the following "never outs" in stock?

  • Titus Vodka 1.75L

  • Fireball Cinnn Whisky 100ml

  • Svedka1.75L

  • Bulletin Bourbon 50L

  • Titos Vodka 750 ml

  • Western Son Vodka 50ml

  • Jim Beam Devils Cut 50ml

  • Smirnoff Red 50ml

  • Jack Daniels Whisky 50ml

  • Titos 50ml

  • Dripping Springs 50ml

  • Western Son Blue 50ml

  • Fireball Cinn Whisky 750ml

  • Western Son Lime 50ml

  • Crown Royal 1.75L

  • Are tobacco merchandiser full and the following "never outs" in stock?

  • Marlboro Red

  • Marlboro Gold

  • Marlboro Special Blend

  • Copenhagen Regular

  • Copenhagen Long Cut

  • Copenhagen Wintergreen

  • Grizzly Long Cut Wintergreen

  • Are all employee sodas and food products properly stored?

  • Is enough ice bagged for the business?

  • Are ice machines free of slime and mold?

Restroom - Mens

  • Toilet bowl and/or urinal are sparkling clean.

  • Lid or underneath the toilet lid is clean.

  • Sink is clean.

  • Floor is clean, bug free and litter free.

  • Paper towels are available.

  • Toilet paper is available.

  • Soap (and sanitizer, if applicable) is available.

  • Mirror is clean.

  • There is a pleasant odor in the restroom.

  • Walls and/or stall dividers are clean.

  • Everything is operational (toilets, sinks, soap dispensers, dryer).

  • Trash isn't full and container is clean.

  • No lights are out or bugs in lenses.

  • Vents are not dusty or dirty.

  • Check restroom supplies for outages

Administrative - Safety and Compliance & Customer Service

  • Is the video viewable and manager viewing & logging 15 min/day?

  • Is the yellow Emergency/Safety book by the register?

  • Are all surveillance cameras working and displaying clearly?

  • Is video/register overlay working and displaying properly?

  • Is communication log posted and current?

  • Is the most recent check stuffer posted?

  • Is the most recent Star Savers' transactions info posted?

  • Are all cigarette counts current and within tolerance?

  • Do employees suggestive sell and promote the Loyalty program?

  • Employees fast, friendly, greeting customers, & thanking customers?

  • Are all employees in full uniform?

  • Do employees use proper cash handling procedures?

  • Do employees card customers buying age-restricted items who appear <30?

  • Is "We Card" calendar current and visible to employee?

  • Are walkarounds complete and current?

  • Using manager video log, view a segment that manager has watched to give additional employee feedback.

  • Are deficiencies in employee training log being addressed?

  • Is first aid kit adequately stocked and accessible?

Signature

  • 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.