Checklist template

Slip, trip and fall prevention for convenience stores

A ready-to-use checklist with 114 items in 6 sections, covering Entrances, Beverage area, Coolers, Spill response, Exterior, Logs. Use it as-is in Bindy, or adapt it to your own standards in minutes.

  • 6 Sections
  • 114 Items
  • 97 Yes / No checks
  • 6 Scored ratings
  • 127 Points

Use this template How audits work

1. Entrances 18 items

  1. A walk-off mat is in place inside each customer entrance Yes / No 1 pt
  2. Entrance mats are long enough for a customer to take at least 3 steps on them in the direction of travel Yes / No 1 pt
  3. Entrance mats lie flat, with no curled corners or rippled edges Yes / No 1 pt
  4. Entrance mats have a non-slip backing and do not slide when pushed with the foot Yes / No 1 pt
  5. Saturated mats are swapped for dry ones during rain or snow Yes / No 1 pt
  6. Spare dry mats are kept at the store for wet weather Yes / No 1 pt
  7. A scraper mat is in place outside the entrance in winter or wet seasons Yes / No 1 pt
  8. The floor just beyond the entrance mat is dry at the time of the visit Yes / No 1 pt
  9. A wet floor sign stands at the entrance whenever rain or snow is being tracked in Yes / No 1 pt
  10. The entrance threshold is flush, with no raised strip or loose plate Yes / No 1 pt
  11. Automatic or manual entrance doors open fully without dragging on the mat Yes / No 1 pt
  12. No floor display, shipper or stack of baskets stands in the walking path just inside the entrance door Yes / No 1 pt
  13. Umbrella bags or a stand are available at the entrance in wet weather, where the company supplies them Yes / No 1 pt
  14. The floor tile at the entrance has no cracked, loose or missing pieces Yes / No 1 pt
  15. The curb ramp or step at the entrance is marked in a contrasting color Yes / No 1 pt
  16. Lighting at the entrance leaves no dark patch on the floor at night Yes / No 1 pt
  17. Entrance mats with curled or damaged edges Number
  18. Condition of the entrance floor at the time of the visit Rating
    • Dry, with mats flat 5 pts
    • Damp, or one mat defect 3 pts
    • Wet floor or mats creating a trip hazard 1 pt

2. Beverage area 19 items

  1. A mat or slip-resistant flooring is in front of the fountain machine Yes / No 1 pt
  2. The floor in front of the fountain and ice dispenser is dry Yes / No 1 pt
  3. The floor in front of the coffee bar is dry Yes / No 1 pt
  4. The floor in front of the frozen beverage machine is free of syrup and sticky residue Yes / No 1 pt
  5. Drip trays on the fountain are draining, not overflowing Yes / No 1 pt
  6. Drip trays on the frozen beverage machine were emptied before they could overflow Yes / No 1 pt
  7. No ice cubes are on the floor around the ice dispenser Yes / No 1 pt
  8. The ice chute closes after dispensing without continuing to drop ice Yes / No 1 pt
  9. No leak is visible from under the fountain cabinet or the coffee brewers Yes / No 1 pt
  10. Supply lines and drain hoses under the beverage counter are not dripping onto the floor Yes / No 1 pt
  11. A trash can within reach of the beverage counter is not overflowing Yes / No 1 pt
  12. Lids and straws are within reach, so customers do not carry open cups across the store Yes / No 1 pt
  13. Paper towels or napkins are available at the beverage counter for customers' small spills Yes / No 1 pt
  14. A spill kit or mop is stored within a few steps of the beverage area Yes / No 1 pt
  15. The floor in the beverage area is checked at the interval set by company policy during rush hours Yes / No 1 pt
  16. Mats in the beverage area are lifted and the floor beneath cleaned daily Yes / No 1 pt
  17. Bag-in-box syrup racks in the back room are not leaking onto the floor Yes / No 1 pt
  18. Wet or sticky spots found on the beverage area floor during the visit Number
  19. Floor condition in the beverage area Rating
    • Dry and clean 5 pts
    • Minor drips being managed 3 pts
    • Standing liquid, ice or sticky residue 1 pt

3. Coolers 19 items

  1. The floor in front of the cold vault doors is free of condensation and puddles Yes / No 1 pt
  2. Cold vault door gaskets seal, with no water running down the glass onto the floor Yes / No 1 pt
  3. No water is leaking from under the open-air cooler or the ice cream freezer Yes / No 1 pt
  4. Condensate drain lines from the coolers run to a drain, not onto the floor Yes / No 1 pt
  5. The walk-in cooler floor is dry, with no pooled water Yes / No 1 pt
  6. The walk-in freezer floor is free of ice build-up Yes / No 1 pt
  7. The freezer threshold has no ice ridge at the door Yes / No 1 pt
  8. Floor mats or grating inside the walk-in cooler lie flat Yes / No 1 pt
  9. Cases in the walk-in cooler are on shelves or dunnage racks, leaving a clear walking path Yes / No 1 pt
  10. The aisle behind the cold vault shelves is clear of empty cartons and shrink wrap Yes / No 1 pt
  11. Leaking or broken bottles and cans in the cold vault are removed and the shelf wiped Yes / No 1 pt
  12. The beer cave floor is dry at the door, where the store has one Yes / No 1 pt
  13. The plastic strip curtain of the walk-in or beer cave hangs clear of the floor Yes / No 1 pt
  14. Lighting inside the walk-in cooler works Yes / No 1 pt
  15. The ice merchandiser door closes fully, with no meltwater on the pavement or floor in front of it Yes / No 1 pt
  16. Bags of ice are not leaking where customers carry them to the register Yes / No 1 pt
  17. Employees stocking the walk-in wear closed-toe, slip-resistant shoes Yes / No 1 pt
  18. Puddles or ice patches found in or in front of the coolers during the visit Number
  19. Floor condition in and around the coolers Rating
    • Dry and clear 5 pts
    • Minor condensation or clutter 3 pts
    • Pooled water, ice or blocked path 1 pt

4. Spill response 18 items

  1. Wet floor signs are kept at the counter or the beverage area, not locked in the back room Yes / No 1 pt
  2. The store has at least the number of wet floor signs set by company policy Yes / No 1 pt
  3. An employee stays at a spill, or blocks it with a sign, until it is cleaned Yes / No 1 pt
  4. A spill made or found during the visit was cleaned within the time set by company policy Yes / No 1 pt
  5. The mop, bucket and wringer are clean enough to use Yes / No 1 pt
  6. A dry mop or squeegee is passed over a walking path after a spill is wet-mopped Yes / No 1 pt
  7. Absorbent powder or pads are on hand for oily or sticky spills Yes / No 1 pt
  8. Floor cleaner is diluted through the dispenser or to the label's ratio, so no slippery film is left Yes / No 1 pt
  9. Mopping is done in sections, leaving a dry path for customers Yes / No 1 pt
  10. Wet floor signs are removed once the floor is dry Yes / No 1 pt
  11. Broken glass is swept up with a broom and dustpan, never by hand Yes / No 1 pt
  12. The employee on duty can describe the steps for a spill: guard, sign, clean, dry Yes / No 1 pt
  13. A lone employee serving customers places a sign on a spill before finishing the sale Yes / No 1 pt
  14. Fuel or oil tracked into the store from the forecourt is cleaned with degreaser Yes / No 1 pt
  15. Routine mopping is scheduled outside rush hours Yes / No 1 pt
  16. Wet floor signs available in the store Number
  17. Minutes taken to guard and clean a spill observed during the visit Number
  18. Response to spills, observed or described Rating
    • Guarded at once and cleaned promptly 5 pts
    • Cleaned after a delay 3 pts
    • Left unattended 1 pt

5. Exterior 19 items

  1. The sidewalk in front of the store has no slab raised or sunken by more than 0.5 in (1.3 cm) Yes / No 1 pt
  2. Potholes in the parking lot and at the fuel islands have been filled Yes / No 1 pt
  3. Wheel stops are intact, anchored and painted in a contrasting color Yes / No 1 pt
  4. Curbs and island edges at the fuel dispensers are painted in a contrasting color Yes / No 1 pt
  5. Fuel hoses hang on their retractors or hooks, not across the walking surface Yes / No 1 pt
  6. The air and vacuum hoses are coiled on their hangers Yes / No 1 pt
  7. Fuel drips and oil spots at the islands are treated with absorbent and swept up Yes / No 1 pt
  8. Windshield washer buckets are not leaking onto the pavement Yes / No 1 pt
  9. Snow is cleared from the walkways before the store's morning rush Yes / No 1 pt
  10. Ice melt is applied to the walkway and the fuel islands in freezing weather Yes / No 1 pt
  11. A stock of ice melt and a shovel are kept at the store through winter Yes / No 1 pt
  12. Downspouts do not discharge across the walkway Yes / No 1 pt
  13. Outdoor displays (propane cage, firewood, washer fluid pallets) leave a clear walkway at least 3 ft (1 m) wide Yes / No 1 pt
  14. No hose, extension cord or strapping lies across the walkway Yes / No 1 pt
  15. The path to the dumpster is even and free of debris Yes / No 1 pt
  16. Exterior steps and ramps have a secure handrail where one is fitted Yes / No 1 pt
  17. Painted curbs and pavement markings in the walking path have a gritted or textured finish Yes / No 1 pt
  18. Trip hazards counted on the sidewalk and lot during the visit Number
  19. Condition of exterior walking surfaces Rating
    • Even, clear and treated for the weather 5 pts
    • Minor defects 3 pts
    • Hazards a customer could fall on 1 pt

6. Logs 21 items

  1. A floor inspection log is kept with the time and initials of each check Yes / No 1 pt
  2. Floor checks were logged at the interval set by company policy on each of the last 7 days Yes / No 1 pt
  3. The log for today is filled in up to the time of the visit Yes / No 1 pt
  4. Wet-weather mat changes are noted in the log Yes / No 1 pt
  5. Snow and ice treatments are recorded with the time and the product used Yes / No 1 pt
  6. Each customer fall in the last 12 months has an incident report Yes / No 1 pt
  7. Each fall report notes the condition of the floor where the person fell (dry, wet, mat, defect) Yes / No 1 pt
  8. Each fall report notes the footwear of the person who fell Yes / No 1 pt
  9. Photos of the scene were taken at the time of each fall Yes / No 1 pt
  10. Video of each fall was saved before the recorder overwrote it Yes / No 1 pt
  11. Employee slips and falls are reported, including those with no injury Yes / No 1 pt
  12. Floor and pavement defects are reported to maintenance with a work order number Yes / No 1 pt
  13. No reported floor or pavement defect has been open longer than the time set by company policy Yes / No 1 pt
  14. Slip and fall prevention was covered in employee training in the last 12 months Yes / No 1 pt
  15. Each employee has signed the slip-resistant footwear policy, per the personnel files Yes / No 1 pt
  16. Customer falls reported in the last 12 months Number
  17. Employee falls reported in the last 12 months Number
  18. Date of the most recent fall on the premises Date
  19. Name of the person completing this inspection Short text
  20. Overall slip, trip and fall prevention Rating
    • Strong 5 pts
    • Partial 3 pts
    • Weak 1 pt
  21. 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.

Categories

Related templates

← All templates

Brand standards

At every site, every time

Start Free Contact us