Lumiform Mobile audits & inspections
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Restaurant Visitation Report Template

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Time and date of visit:
Drive Thru Experience
Did the order taker use the script?
Did the order taker try to up sell?
Did you "hear" a smile at the OCU?
Did you see a smile at the window?
Did the employee say thank you?
Was a parting phrase used?
Was the drive thru time 2:30 or less? Record actual time.
Product Observations
What product(s) did you order?
Was your sandwich build correct?
What was the temperature of your sandwich?
We're your fries properly salted?
What was the temperature of your fries?
Exterior Cleanliness
Does appear to be clean and in good repair?
Is the drive thru menu board clean and in good repair? No light gaps.
Is the correct POP in place and properly priced?
Is the drive thru lane clean and free of litter? No gum, cigarette butts or build up along the curbs or under windows.
Does the drive thru window area appear to be clean and free of clutter? No fingerprints.
Does the landscaping appear to be clean and well maintained?
Do the sidewalks appear to be clean and in good condition?
Does the building appear to be clean and in good condition?
Interior Cleanliness
Are the restrooms clean and stocked? Free of odor? Seats Secure?
Are the floors, tables and seating clean and in good condition?
Are the trash containers clean and in good condition? Liners tucked? No odors?
Is the beverage area clean, stocked and clutter free?
Is the front counter clean and clutter free?
Is all lighting working and in good repair?
Are the highchairs clean ready to use with crowns and bibs in place?
Are the highchairs in good condition with functioning safety belts?
Is the playground area clean and well maintained?
Is the playground area in good condition and safe to use?
Team Image
Are all employees wearing a complete uniform. Hat, shirt, name tag, belt, black pants, dark socks, slip-resistant shoes. No excessive jewelry. Hair restrained. Good hygiene and grooming standards are practiced.
Are all managers wearing a complete uniform?
Are all open sores and wounds properly covered with blue bandages?
Are all food handlers wearing gloves?
Kitchen Cleanliness
Are the floors, walls and baseboards clean and in good condition?
Is the broiler being properly cleaned and maintained? Are the reverberator screens free of large holes?
Is all lighting working and in good repair? No bugs, dust or cracked lenses.
Are PHU's clean and free of grease build up?
Is the Kitchen Minder programed and used as it is intended?
Are all beef products properly shingled with au jus in the PHU pans?
Is the microwave clean, labeled correctly and tested weekly?
Are the fryers clean and free of carbon and grease build up?
Are the fryers being filtered twice daily?
Is the fry station clean, fries salted correctly and are hold times followed?
Is the ice machine clean and functioning properly?
Is the shake machine cleaned throughout the day as needed?
Are the toaster belts and Teflon cleaned frequently? Are the toaster settings correct?
Is all refrigerated equipment clean and functioning properly? Gaskets, fan guard, shelving, stocked correctly, no expired products.
Are the boards clean and well maintained? Stainless, wrap holders, condiment holders, shelves.
Is the prep area and equipment clean and well maintained?
Is the break/training area clean and organized?
Are all storage areas clean and organized? Box flaps, shelving labeled.
Restaurant Systems
Are travel paths being completed every 30 minutes?
Are leaders paths being completed as required?
Is waste being tracked in the QSC book and entered by day part?
Are temperature checks being completed as required?
Is the 12 critical checklist being completed as required?
Is the cleaning calendar being utilized as intended on a daily basis?
Are beef cookouts being completed as required?
Are gravy temperature logs being completed as required?
Is the communication board set up and used correctly? Is all information up to date?
Is the command station set up correctly? Is all information up to date?
Is the FGP board set up correctly? Is all information up to date?
Is the restaurant following a build to when completing orders? Have the build to's been recently updated?
Are crew schedules completed and posted at least 1 week in advance?
Are all available headsets in use at all times? Is the MOD wearing a headset?
Are both main boards open during peak periods?
Is the 1st window open during peak periods?
Does the crew know what today's Guest Trac goal is? Do they know what the score is MTD?
Does the crew know what today's SOS goal is? Do they know what the average is for the month?
Are table touch's being completed frequently?
Is the team doing "window wow's" consistently?
Top 12 Critical Safety Factors
Are hand washing procedures being properly executed correctly and consistently at a properly stocked hand washing sink?
Are all health inspection violations corrected within 10 days of the citation?
Do all sinks meet the minimum hot water requirement and are they in good repair?
Is food product temperature not in the danger zone? (41-139 degrees)
Does sanitizer meet the correct PPM at all sinks and open stations with properly labeled spray bottles and buckets?
Are approved, clean shake brushes available and stored properly? Are they in good condition and free of rust? Is the restaurant using the green pack sanitizer? Are carburetor tubes free from build-up?
Is the restaurant only using approved products?
Are items held at room temperature marked with proper holding times and discarded when expired?
Is cross-contamination not apparent In any stations or storage areas?
Is the restaurant free of any rodent, insect and pest activity?
Are cookouts and temperature checks Recorded consistently and correctly?
Is the restaurant free of other critical food safety violations? (drains backed up, reverberator screens, all chemicals labeled)
Goal Achievement
Is the restaurant meeting or exceeding their sales plan?
Is the restaurant within 1% variance to theoretical FGP?
Is food waste at or below 0.4% of sales?
Is the restaurant at or under their labor plan?
Is the restaurant meeting or exceeding their ROPO plan?
Is the restaurant SOS average at or below 150 seconds for the current month?
Is the restaurants Guest Trac score equal to or greater than 70% for the current month?
Overall Visit Comments
Auditor Comments:
Auditor Signature
MOD Comments and Acknowledgement
MOD Comments:
By signing this form you acknowledge the following; that you have reviewed this report with the auditor, that you have 10 days to correct any of the negative findings in this report. Failure to correct negative findings within the specified time will result in disciplinary action up to and including termination of employment.
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Please note that this checklist template is a hypothetical appuses-hero example and provides only standard information. The template does not aim to replace, among other things, workplace, health and safety advice, medical advice, diagnosis or treatment, or any other applicable law. You should seek your professional advice to determine whether the use of such a checklist is appropriate in your workplace or jurisdiction.
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