Title Page

  • Conducted on

  • Prepared by

  • Location
  • Self service areas closed off (fountain drink/condiment stations).

  • Plexiglas barriers installed

  • Outside dining tables cleaned after each use

  • Social distancing markings indicating guest<br>where to stand

  • Contactless pick up offered

  • Physical distancing in place

  • Surface cleaning and disinfection<br>(frequently enough and adequate<br>supplies)

  • Hand washing facilities (adequate<br>numbers and supplies)

  • Disinfecting and hand sanitizing solutions<br>being used according to manufacturer<br>instructions

  • Providing guests with sealed utensils

  • All applicable forms posted near entrance<br>(face mask required, social distancing, etc.)

  • All applicable forms posted near entrance (face mask required, social distancing, etc.)

  • PPE (not shared, available and being worn)

  • Face coverings (cleaned sufficiently often)

  • Gloves in use

  • Face shields (as needed)

  • GM Signature

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.