9.4.7.21

Appendix 10: Commission for the blind business enterprise program review of location:

Location________________ Stand No._________

Date ______________Licensed Manager’s Name _______________________

(Check applicable items only)

Very Standard Improvement

Good Needed

1. GENERAL APPEARANCE

a. Floor ................ ( ) ( ) ( )

b. Walls and ceilings ( ) ( ) ( )

c. Counters.............. ( ) ( ) ( )

d. Display equipment ( ) ( ) ( )

2. SANITATION AND SAFETY

a. Refrigerators….. ( ) ( ) ( )

b. Dishwashing and

utensil washing....... ( ) ( ) ( )

c. Storage of clean dishes.... ( ) ( ) ( )

d. Food handling....... ( ) ( ) ( )

e. Food storage........ ( ) ( ) ( )

f. Working area.......... ( ) ( ) ( )

g. Food temperatures..... ( ) ( ) ( )

h. Vermin control........ ( ) ( ) ( )

i. Cleaning of equipment

(slicers, grinders, choppers, etc.)... ( ) ( ) ( )

j. Cleaning tables,

chairs, etc........ ( ) ( ) ( )

k. Disposal of garbage;

grease disp. and rubbish ( ) ( ) ( )

l. First aid facilities. ( ) ( ) ( )

3. MERCHANDISING

a. Display............... ( ) ( ) ( )

b. Appearance............ ( ) ( ) ( )

c. Quality.............. ( ) ( ) ( )

d. Quantity.............. ( ) ( ) ( )

e. Variety............... ( ) ( ) ( )

f. Other................. ( ) ( ) ( )

4. CUSTOMER RELATIONS

a. Personality........... ( ) ( ) ( )

b. Work habits........... ( ) ( ) ( )

5. EQUIPMENT CARE AND MAINTENANCE

a. Counters.............. ( ) ( ) ( )

b. Refrigeration......... ( ) ( ) ( )

c. Dishwashing........... ( ) ( ) ( )

d. Coffee urns........... ( ) ( ) ( )

e. Ranges................ ( ) ( ) ( )

f. Hoods................. ( ) ( ) ( )

g. Consumables........... ( ) ( ) ( )

h. Lighting, plumbing

and electrical........ ( ) ( ) ( )

i. Fire protection....... ( ) ( ) ( )

6. OPERATION

a. Customer service...... ( ) ( ) ( )

b. Courtesy.............. ( ) ( ) ( )

c. Attitude.............. ( ) ( ) ( )

d. Speed................. ( ) ( ) ( )

e. Accuracy.............. ( ) ( ) ( )

f. Other................. ( ) ( ) ( )

7. OPERATOR HYGIENE

a. Clothing.............. ( ) ( ) ( )

b. Body odor............. ( ) ( ) ( )

c. Hair.................. ( ) ( ) ( )

d. Breath................ ( ) ( ) ( )

e. Proper shoes.......... ( ) ( ) ( )

f. Professional dress.... ( ) ( ) ( )

8. EMPLOYEE HYGIENE

a. Clothing............... ( ) ( ) ( )

b. Body odor.............. ( ) ( ) ( )

c. Hair................... ( ) ( ) ( )

d. Breath................. ( ) ( ) ( )

e. Proper shoes........... ( ) ( ) ( )

f. Uniformity............. ( ) ( ) ( )

(REPORT BELOW ANY PROBLEMS OR REACTIONS RECEIVED)

REMARKS: (Please print) Any items checked “IMPROVEMENT NEEDED” must be explained in full below:

IF EQUIPMENT OR

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Licensed Operator BEP Manager

[4/15/97; Recompiled 10/01/01]