Title Page
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Conducted on
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Prepared by
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Location
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List the date and time you’re completing the survey
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What is your name?
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What store are you in?
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1. Is the exterior perimeter clean?
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2. Is the retail sales floor swept and free of debris?
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3. Is the toy bagwall 80% full?
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4. Is the hardgoods bagwall 80% full?
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5. Is the showcase/boutique/queue area 80% full and merchandised?
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6. Replenishable goods - SHEETS 80% full?
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7. Replenishable goods - JEWELRY 80% full?
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8. Replenishable goods - BATTERIES 80% full?
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9. Replenishable goods - READERS/SUNGLASSES 80% full?
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10. Replenishable goods - PHONE ACCESSORIES 80% full?
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11. Replenishable goods - TOOLS 80% full?
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12. Is furniture full and in a designated aisle?
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13. Are the gondola shelves 80% full?
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14. Are the endcaps 80% full?
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15. Is kaizen evident in the production room?
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16. Are the production workstation clean and organized?
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17. Is the donation area clean?
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18. Is the managers office clean and orderly?
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19. Is the break room clean and orderly?
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20. Are the bathrooms clean with supplies, check off sheet in place and used?
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21. Are employees wearing their uniform?
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22. Did you observe the 10' rule?
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Additional comments?