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THIS FORM SHOULD BE FILLED IN BY THE RESTAURANT MANAGER
Name *
Restaurant 530
Date *
Section 1: TRAINING
Please walk through the restaurant as you look at the areas outlined, please check Safe or Not Safe to mark your restaurant's compliance. If any areas are Not Safe please fill out the comment section to explain why and outline the plan to get it to Safe.
Copy of Workplace Safety Policy posted where it is visible to employees? *
Copies of job aids/safe work procedures are available in the restaurant *
WHMIS: All employees are educated about hazardous material and safe use of cleaning products. WHMIS training is completed and recorded within 1 week of hiring. Employees are retrained in WHMIS near each one year anniversary of employment. *
Are employees aware of reporting and response procedures for incidents such as first aid or workplace violence? *
Please comment on any NOT SAFE areas
Section 2: KITCHEN
Floor (must be free of slipping hazards) *
Vents working properly *
Lights working properly
Refuse facilities not overflowing
Fire Equipment - Auto / Portable *
Date Checked - WHMIS labels satisfactory *
Exit signs working *
Hand Washing Facility (dispensing soap / single use towels) *
Section 3 : DINING ROOM
Entrance Area/Doors Vestibules (must have good visibility to deter intruders/assailants) *
Floor (must be free of slipping hazards) *
Vents working properly *
Lighting (lighting must be sufficient to discourage use as a hiding place) *
Exit Signs (lights) working properly *
Section 4 : GUEST WASHROOMS - MENS
If windows, they must prevent potential intrusions *
Floor (must be free of slipping hazards) *
Lights - all working and bright enough to deter intruders *
Toilet Seats - all firmly attached to toilet bowls *
Section 4 : GUEST WASHROOMS - WOMENS
If windows, they must prevent potential intrusions *
Floor (must be free of slipping hazards) *
Lights - all working and bright enough to deter intruders *
Toilet Seats - all firmly attached to toilet bowls *
Section 5 : EXTERIOR
Garbage Area (where possible, seen from inside restaurant) *
Landscaping (free from unmarked tripping hazards) *
Lot Cleanliness and Appearance (no hiding places for intruders/assailants) *
Building Lights/Lot Lights (well-lit to deter intruders/assailants) *
Condition of Fence (must be intact) *
Shed or Outside Storage Area (well-lit access from restaurant) *
Curbs/Sidewalks (free from unmarked tripping hazards) *
Section 6 : STORAGE/BASEMENT
Floors must be free of tripping hazards *
CO2 tanks secured *
"Materials stored for safe lifting and handling (no bag-in-box above shoulder height)" *
Stairs must be free of tripping hazards *
Furnace Room must be clean and free from tripping hazards *
Section 7 : STAFF MANAGEMENT AREAS
First Aid Kit contents meets provincial requirements *
First Aid Kit / Accidental Record Book complete and up-to-date *
"Staff Room : (appearance and cleanliness) must be free of tripping hazards" *
Office : (appearance and cleanliness) must be free of tripping hazards *
"Staff Washroom : (cleanliness: soap/single use towels) must be free of tripping hazards" *
Section 8 : WHMIS
All controlled products are labelled *
Staff have access of MSDS for all products *
"All controlled products and other chemicals are inventoried" *
"Cleaning supply storage (away from food, on lower shelves)" *
"Appropriate personal protective equipment available & being used" *
Chemicals from Approved National Supplier *
Thank you!