Title Page

  • Store #

  • Location
  • Conducted on

  • Personnel on duty

  • Prepared by

Outside Areas

  • Register does not show paper jams nor paper out?

  • Are pump surfaces clean and polished? Including the tops?

  • All pumps working? If not, is pump bagged/out of order, email report been sent, and note in communication log?

  • Squeegees in place in good condition, windshield cleaner full and fresh and No bugs?

  • Plastic gloves/Towels/Sanitizer stocked

  • 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?

  • Check for an air chuck on water/air machine AND claw on vacuum?

  • Is air/vacuum/mat washer operational? Test all.

  • Are the vacuum's getting emptied and cleaned?

  • Is air/vacuum/mat washer area clean?

  • Is the car wash working? (Watch a vehicle go through and inspect.)

  • Car wash cameras have been cleaned that are accessible?

  • Are all car wash chemicals stocked?

  • Car wash is clean?

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

  • Outside rug and/or entry way clean and swept? Is it appealing to customers?

  • Trash can surfaces clean and not overflowing?

  • Front door clean without smudges?

  • Windows and ledges clean? Inside and Out?

Inside Areas

  • Are the floors clean?

  • Are the mats clean?

  • Are all inside lights working and music audible?

  • Are all touch free(blue tissue) dispensers up and filled

  • Are all TV's working?

  • Are all hand sanitizer units filled, clean and working?

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

  • Gondola shelves fronted and dust free?

  • Are drink dispensers and nozzle/lid clean?

  • Are ice dispensers clean no slime or mold?

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

  • Is fountain area fully stocked and clean?

  • Is coffee area fully stocked and clean?

  • Are the coffee products fresh/available/clean?

  • Is at least one flavor of coffee available and fresh?

  • Is underneath and behind all machines clean and trash free?

  • Are cooler doors clean?

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

  • Are the following "never outs" in stock?

  • Milk

  • Ozarka/NPL 20 oz and 1 liters

  • Coke

  • Diet Coke

  • Dr Pepper

  • Diet Dr Pepper

  • Mountain Dew

  • Red Bull

  • Monster

  • Gatorade - top 3

  • Bud Ice - 24

  • Nat Light - 24

  • Keystone - 24

  • Corona - 6 pack

  • Bud - 6 pack & 12 pack

  • Coors Light - 6 pack & 12 pack

  • Are scratch offs fully stocked?

  • 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 CO2 level above 25%

  • Is enough ice bagged for the business?

  • Are ice machines at least half full?

  • Are ice machines free of slime and mold?

Back Room and Cooler

  • Back room swept and mopped?

  • Back room clean and organized?

  • Sinks clean and empty of products?

  • Chemicals stored properly and labeled?

  • Areas around electrical boxes free of obstructions and nothing in yellow areas?

  • Ladders/ Step stool good condition and proper labels

  • Damages organized and separated by vendor?

  • Cooler's swept and mopped?

  • Cooler's clean and organized?

  • Nothing under racks in cooler's?

Restroom - Mens

  • Toilet bowl and/or urinal are sparkling clean.

  • Lid or underneath the toilet lid is clean.

  • Base of toilet is clean ?

  • Brill is working and not empty?

  • Sink is clean.

  • Floor is clean, bug free and litter free.

  • All corners and behind everything is swept and clean?

  • Paper towels are available.

  • Toilet paper is available.

  • Diaper changer liners are 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

  • Is Royal Restroom checklist being used and posted?

Restroom - Womens

  • Toilet bowls are sparkling clean.

  • The lid and underneath the toilet lid is clean.

  • Base of all toilets are clean?

  • Brill is working and not empty?

  • Sink is clean.

  • Floor is clean, bug free, litter free.

  • All corners and behind everything is swept and clean?

  • Paper towels are available.

  • Toilet paper is available.

  • Diaper changer liners are available.

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

  • Mirror is clean.

  • There is a pleasant odor in the restroom.

  • Walls and/or stalls 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

  • Is Royal Restroom checklist being used and posted?

Deli/Roller Grill Area

  • Are all hand wash sinks accessible and stocked(soap and paper towels)?

  • Are all food products labeled and stored correctly? Creamer, Bag-in-the-Box, Nacho Cheese dated (and not expired)?

  • Are all food products in freezers dated and FIFO being used?

  • Are microwaves/ovens/holding units lighted, in good repair and clean?

  • (Where applicable) Are tables/chairs/dining floor clean?

  • Is there an appropriate amount of hot dogs on the grill that look fresh and buns available?

  • Is there an appropriate amount of taquito's on grill that look fresh?

  • Are condiments fully stocked?

  • Is the hot box full and clean?

  • Are time,temp and waste logs being used?

  • Do the rollers, sneeze guards, tongs, and tray on the grill look clean?

  • Areas around,under and behind all roller grills, hot boxes and condiment areas clean?

  • Filters on slush machines clean?

  • Is there at least one bucket with fresh sanitizer and a towel available?

  • Is air cooler stocked and full, with no out of dates and everything priced?

Administrative - Safety and Compliance & Customer Service

  • Is the video viewable and manager viewing & logging 15 min/day not more than 3 days behind?

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

  • Is environmental checklist current and up front in blue folder?

  • 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 news letter posted?

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

  • Are all cigarette counts current and within tolerance?

  • Are customers greeted as they enter the store?

  • Do employees suggestive sell and promote the Star Savers/7 Rewards program?

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

  • Are all employees in full uniform?

  • Is team members properly wearing a mask

  • 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 walk around's complete and current and verified by manager and issues corrected ?

  • 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?

  • Is Manager verifying employee clock in/out time daily?

  • Is Manager tracking and posting content about Team Member Contests?

  • Are cashier averages up to date and posted?

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.