Checklist template

Customer incident and slip-and-fall response for retailers

A ready-to-use checklist with 120 items in 6 sections, covering Floor inspections, Spill response, Incident response, Documentation, Camera footage, Trends. Use it as-is in Bindy, or adapt it to your own standards in minutes.

  • 6 Sections
  • 120 Items
  • 103 Yes / No checks
  • 6 Scored ratings
  • 133 Points

Use this template How audits work

1. Floor inspections 23 items

  1. Floor walks of the sales floor are done at the interval set by company policy Yes / No 1 pt
  2. Each floor walk is recorded with the time and the initials of the person who walked Yes / No 1 pt
  3. The floor walk log for today is complete up to the time of the visit Yes / No 1 pt
  4. The floor walk log for the last 7 days has no missing intervals Yes / No 1 pt
  5. Floor walk times on the log vary realistically and are not filled in ahead of time Yes / No 1 pt
  6. The walk route covers the entrance, the main aisles, the checkout lanes and the restrooms Yes / No 1 pt
  7. The route includes liquid aisles (beverages, detergent, cooking oil) and refrigerated cases Yes / No 1 pt
  8. The entrance vestibule is checked more often in rain or snow, and the log shows it Yes / No 1 pt
  9. Entrance mats lie flat with no curled edges or ripples Yes / No 1 pt
  10. Entrance mats are long enough that wet footprints stop before the hard floor Yes / No 1 pt
  11. Wet or saturated entrance mats were changed during wet weather Yes / No 1 pt
  12. Umbrella bags or an umbrella stand are provided at the entrance on rainy days Yes / No 1 pt
  13. The floor at the cart corral is free of water dripping from carts Yes / No 1 pt
  14. Refrigerated cases and freezers show no water leaking onto the floor Yes / No 1 pt
  15. The sales floor is free of fallen merchandise, hangers and price tags Yes / No 1 pt
  16. No stocking cart, pallet or empty carton is left unattended in a customer aisle Yes / No 1 pt
  17. Floor tiles are intact with no lifting edges or holes Yes / No 1 pt
  18. Carpet and floor transitions are flat and secured Yes / No 1 pt
  19. Power cords for displays do not cross a customer walkway Yes / No 1 pt
  20. The sidewalk and parking lot walkways are free of potholes, ice and raised concrete edges Yes / No 1 pt
  21. The floor care contractor posts wet floor signs while scrubbing during opening hours Yes / No 1 pt
  22. Hazards found on the floor during the visit Number
  23. Reliability of the floor walk program Rating
    • Walks on time, logged honestly, hazards fixed 5 pts
    • Walks done, log has gaps 3 pts
    • Walks not done or log filled in afterward 1 pt

2. Spill response 20 items

  1. An employee who finds a spill stays with it until it is cleaned or marked Yes / No 1 pt
  2. Employees asked knew to guard the spill and send someone else for supplies Yes / No 1 pt
  3. Spill stations with absorbent, paper towels and wet floor signs are placed around the sales floor Yes / No 1 pt
  4. Every spill station checked during the visit was fully stocked Yes / No 1 pt
  5. Spill stations checked during the visit Number
  6. Wet floor signs are available at the front end Yes / No 1 pt
  7. Wet floor signs are available at each restroom Yes / No 1 pt
  8. A wet floor sign is placed on each side of a spill in a through aisle Yes / No 1 pt
  9. Wet floor signs are removed once the floor is dry Yes / No 1 pt
  10. Spills are dried after mopping, not left damp Yes / No 1 pt
  11. Broken glass is swept with a broom and pan, never picked up by hand Yes / No 1 pt
  12. A spill of cleaning chemical, pool chemical or paint is handled per the safety data sheet Yes / No 1 pt
  13. Cashiers have paper towels or a spill pad at the register for leaks on the belt or floor Yes / No 1 pt
  14. Spill calls are announced by a code or a page that the team recognizes Yes / No 1 pt
  15. The spill call observed or tested during the visit was answered within the time set by company policy Yes / No 1 pt
  16. Minutes taken to answer the spill call observed or tested Number
  17. Spills cleaned are noted on the floor walk log with the time and the location Yes / No 1 pt
  18. Recurring leaks from a roof, a cooler or a dispenser are reported to maintenance with a work order Yes / No 1 pt
  19. A bucket or a cone marks an active roof leak, and the area is checked on every floor walk Yes / No 1 pt
  20. Spill response observed or tested Rating
    • Spill guarded and cleared quickly 5 pts
    • Cleared, but left unguarded or damp 3 pts
    • Slow or no response 1 pt

3. Incident response 19 items

  1. A manager goes to the scene of every customer incident as soon as it is reported Yes / No 1 pt
  2. Employees asked knew to call a manager at once when a customer falls or is hurt Yes / No 1 pt
  3. The injured customer is not moved unless there is immediate danger Yes / No 1 pt
  4. Managers asked knew to have a trained employee offer first aid Yes / No 1 pt
  5. At least one employee trained in first aid is on duty during the visit Yes / No 1 pt
  6. Employees asked knew to call emergency services when the customer asks or the injury appears serious Yes / No 1 pt
  7. Employees asked knew the address of the store to give to the emergency dispatcher Yes / No 1 pt
  8. Managers asked knew to send an employee to the entrance to meet the ambulance Yes / No 1 pt
  9. The first aid kit at the front end is stocked Yes / No 1 pt
  10. The store's AED, where one is provided, shows a ready indicator Yes / No 1 pt
  11. Managers asked knew not to admit fault or promise payment of medical bills Yes / No 1 pt
  12. Managers asked knew to show concern and offer help without discussing the cause Yes / No 1 pt
  13. The scene is kept as found until photos are taken, then the hazard is removed Yes / No 1 pt
  14. The merchandise or object involved (broken bottle, fallen fixture, defective cart) is kept and tagged Yes / No 1 pt
  15. The customer is given the contact for claims set by company policy, not the manager's personal number Yes / No 1 pt
  16. Customers who decline help are still recorded in an incident report Yes / No 1 pt
  17. Incidents in the parking lot or on the sidewalk are handled the same way as incidents inside Yes / No 1 pt
  18. Incidents involving falling merchandise lead to an immediate check of the fixture or top stock Yes / No 1 pt
  19. Manager readiness to respond to a customer injury Rating
    • Clear on every step 5 pts
    • Unsure on some steps 3 pts
    • Does not know the procedure 1 pt

4. Documentation 20 items

  1. A customer incident report is completed for every reported incident, on the day it happens Yes / No 1 pt
  2. Blank incident reports or access to the online report are available on every shift Yes / No 1 pt
  3. The report records the exact location (aisle number, department, entrance) Yes / No 1 pt
  4. The report records the date and the time of the incident Yes / No 1 pt
  5. The report records the customer's own description, in the customer's words Yes / No 1 pt
  6. The report records what the customer was wearing on their feet Yes / No 1 pt
  7. The report describes the floor (wet or dry, substance, size of the spill, footprints or cart tracks through it) Yes / No 1 pt
  8. The report states whether a wet floor sign was in place Yes / No 1 pt
  9. The report states the weather and the lighting at the time Yes / No 1 pt
  10. Names and contact details of witnesses are recorded Yes / No 1 pt
  11. Statements from the employees who were present are written the same day Yes / No 1 pt
  12. Photos of the scene are taken from several angles and attached to the report Yes / No 1 pt
  13. The floor walk log covering the time of the incident is copied and attached Yes / No 1 pt
  14. The report states the time of the last floor walk before the incident Yes / No 1 pt
  15. The report keeps to facts and contains no opinion on fault Yes / No 1 pt
  16. The incident is reported to the claims line or the insurer within the time set by company policy Yes / No 1 pt
  17. Completed reports are kept in a locked file or a restricted system, not at the service desk Yes / No 1 pt
  18. A sample of 3 recent incident reports had every field completed Yes / No 1 pt
  19. Incident reports reviewed during the visit Number
  20. Quality of the incident reports reviewed Rating
    • Complete, factual, with photos and log 5 pts
    • Complete but missing photos or log 3 pts
    • Incomplete or late 1 pt

5. Camera footage 19 items

  1. A camera covers the entrance vestibule Yes / No 1 pt
  2. A camera covers the main aisles Yes / No 1 pt
  3. A camera covers the checkout lanes Yes / No 1 pt
  4. The date and time stamp of the recorder is within one minute of the actual time Yes / No 1 pt
  5. Every camera on the recorder shows a live image Yes / No 1 pt
  6. After an incident, footage is saved before the recorder overwrites it Yes / No 1 pt
  7. Saved footage covers the period before and after the incident that company policy sets Yes / No 1 pt
  8. Footage is saved from every camera that shows the location, the approach and the response Yes / No 1 pt
  9. Footage is saved even when it shows no cause for the fall Yes / No 1 pt
  10. The manager on duty knows how to export footage, or who to call on the same day Yes / No 1 pt
  11. Saved footage is labeled with the incident report number Yes / No 1 pt
  12. Saved footage is sent to the claims or loss prevention department as company policy requires Yes / No 1 pt
  13. Footage is not shown or given to the customer, a lawyer or the media by store employees Yes / No 1 pt
  14. Requests for footage from outside the company are referred to head office Yes / No 1 pt
  15. The recorder keeps footage for the retention period set by company policy Yes / No 1 pt
  16. Days of footage held on the recorder Number
  17. A sample of 3 recent incidents each had saved footage or a note that no camera covered the location Yes / No 1 pt
  18. Cameras not recording at the time of the visit Number
  19. Preservation of footage after incidents Rating
    • Saved every time, labeled and sent 5 pts
    • Saved for most incidents 3 pts
    • Often overwritten or not saved 1 pt

6. Trends 19 items

  1. Customer incidents reported in the last 12 months Number
  2. Slip-and-fall incidents among them Number
  3. The store keeps a log of customer incidents by date, location and cause Yes / No 1 pt
  4. The store manager reviews the incident log at least monthly Yes / No 1 pt
  5. Incidents are grouped by location to find repeat spots (entrance, produce, restrooms, a given aisle) Yes / No 1 pt
  6. Incidents are grouped by time of day and by weather Yes / No 1 pt
  7. A location with more than one incident in 12 months has a documented corrective action Yes / No 1 pt
  8. Corrective actions from past incidents (added mat, repaired leak, changed fixture) are in place today Yes / No 1 pt
  9. Incident results are shared at the store safety committee or team meeting Yes / No 1 pt
  10. The store compares its incident count with the district or company average Yes / No 1 pt
  11. Incidents caused by a contractor (floor care, snow removal, vendor stocking) are raised with that contractor Yes / No 1 pt
  12. The snow and ice removal log is kept for each winter event Yes / No 1 pt
  13. Defective shopping carts are tagged and removed from the corral Yes / No 1 pt
  14. Claims that appear staged or suspicious are flagged to loss prevention Yes / No 1 pt
  15. Floor walk compliance is reported to the district manager on the schedule set by company policy Yes / No 1 pt
  16. Date of the last review of customer incidents Date
  17. Name of the store manager Short text
  18. Overall prevention and response to customer injuries Rating
    • Floor walks, response and reports all reliable 5 pts
    • Response sound, gaps in logs or reports 3 pts
    • Hazards left on the floor or incidents not documented 1 pt
  19. Corrective actions required Comments

About this template

This checklist is part of the Bindy template library. Yes / No checks score 1 point when met; ratings score the points shown for each option. The overall score is the percentage of points earned, with N/A answers excluded. In Bindy you can add photos, assign corrective actions, require sign-off and compare results across sites.

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