COVID-19 Social Distancing Inspection Reports

July 16, 2020

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily	X
Employees wearing masks		X
Employees wearing gloves	X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit	X
Tables/chairs and equipment at least 6 feet apart			X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile		X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used			X

Notes: High touch surfaces disinfected every hour.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks		X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit		X
Tables/chairs and equipment at least 6 feet apart			X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons		X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile		X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used	X

Notes: Plexiglas divider set up at cash register to separate employees and customers. Gas pumps and handles sanitized hourly. In-door high touch surfaces disinfected regularly/as needed or at least every 2 hours.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily	X
Employees wearing masks		X
Employees wearing gloves	X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted		X
COVID-19 educational signs posted		X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit		X
Tables/chairs and equipment at least 6 feet apart			X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile		X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used			X

Notes: High touch surfaces disinfected 3 times a day. A Plexiglas divider is set up at cash register to separate employee and customer. They are not currently requiring masks to be worn, but they are available for customers to use. The owner thinks that they will make them mandatory starting Monday because they see a lot more businesses leaning that way.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks	X
Employees wearing gloves	X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit	X
Tables/chairs and equipment at least 6 feet apart	X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile		X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used	X

Notes: They are currently operating at 25% capacity. If an employee leaves the state or travels to an area with a high number of COVID-19 cases, they are required to quarantine for 14 days before returning to work. They have a Plexiglas divider set up at cash register to separate employees and customers. They do not have an actual screening process that employees go through daily, but if they are told to stay at home if they are not feeling well.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily	X
Employees wearing masks		X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit		X
Tables/chairs and equipment at least 6 feet apart			X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons		X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile		X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used	X

Notes: Plexiglas divider set up at cash register to separate employees and customers. They have a bucket of bleach water that they use to sanitizer the gas pumps and handles at least every hour. High touch surfaces are disinfected whenever they have a break between customers or at least every hour. They encourage employees to use sanitizer between customers, but it is ultimately up to their discretion.

July 14, 2020

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks	X
Employees wearing gloves	X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit		X
Tables/chairs and equipment at least 6 feet apart			X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons		X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile		X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used			X

Notes:

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks	X
Employees wearing gloves	X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit		X
Tables/chairs and equipment at least 6 feet apart			X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons		X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile		X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used			X

Notes:

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks		X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit		X
Tables/chairs and equipment at least 6 feet apart			X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons		X
Employees washing hands or using sanitizer between customers/patrons		X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile		X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used			X

Notes: Masks are provided to employees to use if they want. Employees are encouraged to sanitize between every customer, but it is at their discretion. Everything is deep cleaned and disinfected nightly, high touch surfaces like door handles and shopping carts are disinfected routinely.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily	X
Employees wearing masks	X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit	X
Tables/chairs and equipment at least 6 feet apart			X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile		X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used			X

Notes: High touch surfaces (door handles, shopping carts, etc.) are disinfected every hour. Hand sanitizer is provided to employees to use at their discretion. The card reader at the checkout counter is disinfected after each use.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks	X
Employees wearing gloves	X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit	X
Tables/chairs and equipment at least 6 feet apart			X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons		X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile		X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used	X

Notes: High touch surfaces are disinfected every 2 hours. Hand sanitizer is encouraged after every customer, but is up to the employees discretion.

Observations	Yes	No
Employees Screened for COVID-19 sign/symptoms daily	X
Employees wearing masks		X
Employees wearing gloves	X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit		X
Tables/chairs and equipment at least 6 feet apart		X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table		X
Customer/Patron waiting turn outdoors or in automobile		X
Customer/Patron waiting indoors at least 6 feet apart		X
Single Service/Single Use items used		X

Notes: 8 hand sanitizer stations are set up throughout the facility. 6 are located in the front area for employees and customers. 2 are located in the kitchen for staff to use. Staff are to use sanitizer between every customer. High touch surfaces are disinfected every 20 minutes. Business has been down, so social distancing has not been an issue. Waitresses seat people 6 feet apart, but all tables are open in case they do get a rush of customers. They will seat people closer only if other options are not available.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily	X
Employees wearing masks		X
Employees wearing gloves	X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit		X
Tables/chairs and equipment at least 6 feet apart			X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile		X
Customer/Patron waiting indoors at least 6 feet apart		X
Single Service/Single Use items used			X

Notes: High touch surfaces disinfected every 2 hours. Employees wash hands and use hand sanitizer between every customer. Hand sanitizer is at the front counter for employees and have bottles at every handwashing sink for employees to use after they wash their hands.

Observations	Yes	No
Employees Screened for COVID-19 sign/symptoms daily	X
Employees wearing masks	X
Employees wearing gloves	X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit	X
Tables/chairs and equipment at least 6 feet apart	X
Hand sanitizer (60% alcohol) available for employees		X
Hand sanitizer (60% alcohol) available for customers/patrons		X
Employees washing hands or using sanitizer between customers/patrons		X
No more than 10 people per table		X
Customer/Patron waiting turn outdoors or in automobile		X
Customer/Patron waiting indoors at least 6 feet apart		X
Single Service/Single Use items used	X

Notes: They do have hand sanitizer, but they have not gotten the dispensers in yet so they cannot use it for customers or employees. They have marks on the floor and on tables to promote social distancing, but customers do not always follow them and it is hard to enforce. They do it to the best of their abilities. Masks are worn on the front line as well a in the back.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily	X
Employees wearing masks	X
Employees wearing gloves	X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit	X
Tables/chairs and equipment at least 6 feet apart		X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile		X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used	X

Notes: High touch surfaces disinfected every hour. No more than 20 customers in building at one time. Most of their business is done “contactless” so they make no contact with customers. If they do have a cash transaction, they are required to sanitize hands between every customer.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily	X
Employees wearing masks	X
Employees wearing gloves	X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit	X
Tables/chairs and equipment at least 6 feet apart			X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons		X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile		X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used	X

Notes: No dine-in allowed. Drive through and carry out only. Restrooms are cleaned and disinfected every 30 Minutes. High touch surfaces (door handles, card readers, countertops, etc.) are disinfected every hour. Temperature checks are taken at the beginning of employees shift.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily	X
Employees wearing masks	X
Employees wearing gloves	X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit		X
Tables/chairs and equipment at least 6 feet apart			X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile		X
Customer/Patron waiting indoors at least 6 feet apart		X
Single Service/Single Use items used	X

Notes: No dine-in available at this time. Carry out and drive through only. Card reader at register is disinfected after every use. Employees sanitize hands between every customer. High touch surfaces are disinfected at least once per hour.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily	X
Employees wearing masks	X
Employees wearing gloves	X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit	X
Tables/chairs and equipment at least 6 feet apart			X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile		X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used	X

Notes: Card reader and counter top is disinfected between every customer. They are currently carry out and drive through only, no dine-in allowed at this time. They are seeing very few people come inside the facility and most business is done through drive-through.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily	X
Employees wearing masks	X
Employees wearing gloves	X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit	X
Tables/chairs and equipment at least 6 feet apart	X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile		X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used	X

Notes: High touch surfaces disinfected after every customer when possible. If they get a rush it is at least every 15 minutes. The drinks are allowed to be refilled, but they must use new cups and employees refill behind the counter. Customers are not allowed to refill themselves. Customers are still seated 6 feet apart and social distancing signs are posted on doors, walls, and floors.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily	X
Employees wearing masks	X
Employees wearing gloves	X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit		X
Tables/chairs and equipment at least 6 feet apart			X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile		X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used	X

Notes: No dine-in allowed at this time. Carry out, drive through, and delivery only. Surfaces are disinfected twice daily. Menu’s are disposable and single service items only are used.

Observations	Yes	N/A
Employees Screened for COVID-19 sign/symptoms daily	X
Employees wearing masks	X
Employees wearing gloves	X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted		X
COVID-19 educational signs posted		X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit		X
Tables/chairs and equipment at least 6 feet apart		X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons		X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table		X
Customer/Patron waiting turn outdoors or in automobile	X
Customer/Patron waiting indoors at least 6 feet apart		X
Single Service/Single Use items used	X

Notes: Masks are required to be worn by employees when making deliveries. No dine-in or carry out available at this time. They are allowed curbside pickup and delivery options only. Employees are required to sanitize hands after every customer interaction.

Observations	Yes	No
Employees Screened for COVID-19 sign/symptoms daily	X
Employees wearing masks		X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit		X
Tables/chairs and equipment at least 6 feet apart	X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table		X
Customer/Patron waiting turn outdoors or in automobile		X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used		X

Notes: Biggest table seats 6. Tables are 6 feet apart. Booths can be set back-to-back, but have large dividers at the top to help separate customers. Sanitize returnable items (plates, utensils, cups, etc.) with 100ppm chlorine in the dish washing machine.

Observations	Yes	No
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks		X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted		X
COVID-19 educational signs posted		X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit		X
Tables/chairs and equipment at least 6 feet apart		X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table		X
Customer/Patron waiting turn outdoors or in automobile		X
Customer/Patron waiting indoors at least 6 feet apart		X
Single Service/Single Use items used		X

Notes: They are back to normal operations. High touch surfaces are disinfected after every visit. No social distancing sings are posted anymore, but hand sanitizer is available for anyone to use. Employees must sanitize hands after every customer at the register.

Observations	Yes	No
Employees Screened for COVID-19 sign/symptoms daily	X
Employees wearing masks	X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit		X
Tables/chairs and equipment at least 6 feet apart	X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table		X
Customer/Patron waiting turn outdoors or in automobile		X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used		X

Notes: Buffet surfaces and utensils are sanitized or changed out every 15 minutes. Social distancing signs are posted. It is recommended that they add a sign to the buffet table telling customers to sanitize hands before going through the buffet line. Manager states that he will add this sign to the buffet. Sanitizer stations are available at the buffet, at the check out counter, and in the kitchen. All tables are spaced out to promote social distancing. Masks are required to be worn by staff, gloves are optional.

Observations	Yes	No
Employees Screened for COVID-19 sign/symptoms daily	X
Employees wearing masks	X
Employees wearing gloves	X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit	X
Tables/chairs and equipment at least 6 feet apart	X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table	X
Customer/Patron waiting turn outdoors or in automobile		X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used		X

Notes: Temperature checks are taken of employees every day. Hand sanitizer is available for employees and customers. Customers are asked to sanitize hands before every trip to the buffet table. High touch surfaces are disinfected with a bleach cleaner every 30 minutes (more if possible). Employees are required to wear masks and gloves. Masks are required to be changed every 3 hours. Tables and booths are separated out to promote social distancing. If they get a group larger than 10 people they move them to the “party room” to separate from others in the facility.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily
Employees wearing masks
Employees wearing gloves
Customers/Patrons wearing masks
Social distancing requirement signs posted
COVID-19 educational signs posted
Cleaning/disinfecting done routinely
Retail sales facility monitoring maximum occupancy limit
Tables/chairs and equipment at least 6 feet apart
Hand sanitizer (60% alcohol) available for employees
Hand sanitizer (60% alcohol) available for customers/patrons
Employees washing hands or using sanitizer between customers/patrons
No more than 10 people per table
Customer/Patron waiting turn outdoors or in automobile
Customer/Patron waiting indoors at least 6 feet apart
Single Service/Single Use items used

Notes:

July 13, 2020

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily	x
Employees wearing masks		x
Employees wearing gloves		x
Customers/Patrons wearing masks		x
Social distancing requirement signs posted	x
COVID-19 educational signs posted	x
Cleaning/disinfecting done routinely	x
Retail sales facility monitoring maximum occupancy limit		x
Tables/chairs and equipment at least 6 feet apart			x
Hand sanitizer (60% alcohol) available for employees	x
Hand sanitizer (60% alcohol) available for customers/patrons		x
Employees washing hands or using sanitizer between customers/patrons		x
No more than 10 people per table			x
Customer/Patron waiting turn outdoors or in automobile		x
Customer/Patron waiting indoors at least 6 feet apart	x
Single Service/Single Use items used			x

Notes: Masks are provided to employees to use if they want. Gloves are required when working with customers. Disinfect counter tops and handles at shift change, but after discussion will increase to every 2 hours. Hand sanitizer is hard to get so they are providing to employees only.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily	X
Employees wearing masks		X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit		X
Tables/chairs and equipment at least 6 feet apart			X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons		X
Employees washing hands or using sanitizer between customers/patrons		X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile		X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used			X

Observations	Yes	No
Employees Screened for COVID-19 sign/symptoms daily	X
Employees wearing masks		X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit		X
Tables/chairs and equipment at least 6 feet apart	X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons		X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table	X
Customer/Patron waiting turn outdoors or in automobile		X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used	X

Notes: They have closed the kitchen and no longer plan to sell food. This will be a bar only and hours are 3pm-1:30PM. Masks are provided to employees to use if they want. Gloves are required when working with customers. Disinfect counter tops and handles at shift change, but after discussion will increase to every 2 hours. Hand sanitizer is hard to get so they are providing to employees only. They try to keep social distancing as much as possible, but is hard to enforce.

Observations	Yes	No
Employees Screened for COVID-19 sign/symptoms daily	X
Employees wearing masks		X
Employees wearing gloves	X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit		X
Tables/chairs and equipment at least 6 feet apart		X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons		X
No more than 10 people per table		X
Customer/Patron waiting turn outdoors or in automobile		X
Customer/Patron waiting indoors at least 6 feet apart		X
Single Service/Single Use items used	X

Notes: They took down their social distancing reminders/signs, but will put them back up after discussion was had. Hand sanitizer is available for customers, but few actually use it. Disinfection of high touch surfaces will be increased to at least once per shift. Items that cannot be disinfected/sanitized regularly (containers for ketchup, mustard, etc.) were taken from the tables and single service items are provided in their place. Washable utensils/plates are allowed and sanitized as normal (100ppm chlorine).

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily	X
Employees wearing masks	X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit	X
Tables/chairs and equipment at least 6 feet apart		X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons		X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile		X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used	X

Notes: High touch surfaces disinfected every 2 hours. Masks are required to be worn by employees. Marks on floor to show 6 foot separation are available, but are getting worn out and more have been ordered. Only allowed to have 10 customers in building at one time.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily	X
Employees wearing masks	X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit	X
Tables/chairs and equipment at least 6 feet apart		X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons		X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile		X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used	X

Notes: High touch surfaces disinfected every 2 hours, other surfaces disinfected every 4 hours. Employees must wear masks. They are only allowing 10 customers in the building at one time. Credit/debit machine is disinfected after customer use.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily	X
Employees wearing masks	X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit	X
Tables/chairs and equipment at least 6 feet apart		X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons		X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile		X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used	X

Notes: High touch surfaces disinfected every 2 hours. Low touch surfaces disinfected every 4 hours. Masks are required to be worn by employees.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily	X
Employees wearing masks	X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit		X
Tables/chairs and equipment at least 6 feet apart		X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons		X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile		X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used	X

Notes: It is recommended that employees use hand sanitizer between every customer, but they do not require it. It is available for employees to use at all times. High touch surfaces disinfected every 2 hours. Low touch surfaces disinfected every 4 hours.

June 19, 2020

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily	X
Employees wearing masks		X
Employees wearing gloves	X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted		X
COVID-19 educational signs posted		X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart		X
Hand sanitizer (60% alcohol) available for employees		X
Hand sanitizer (60% alcohol) available for customers/patrons		X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table	X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart		X
Single Service/Single Use items used	X

Notes: COVID-19 Guidance for Restaurants posted in facility. No COVID-19 educational signs posted in facility. Hand sanitizer is available for patrons & employees. High touch surfaces are disinfected after patron use.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks		X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted		X
COVID-19 educational signs posted		X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart		X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table	X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used		X

Notes: No COVID-19 educational or social distancing signs posted in facility. Tables/chairs are not 6 feet apart. Hand sanitizer available to patrons & employees. No face coverings being worn by customers or employees.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily	X
Employees wearing masks		X
Employees wearing gloves	X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted		X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart			X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used	X

Notes: Hand sanitizer station at entrance door for patron use. No COVID-19 educational signs posted in facility. Employees & patrons not wearing face coverings. Hand sanitizer available to employees & patrons.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily	X
Employees wearing masks	X
Employees wearing gloves	X
Customers/Patrons wearing masks			X
Social distancing requirement signs posted		X
COVID-19 educational signs posted		X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart			X
Hand sanitizer (60% alcohol) available for employees		X
Hand sanitizer (60% alcohol) available for customers/patrons		X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart			X
Single Service/Single Use items used	X

Notes: Lobby closed – No dining in. No hand sanitizer for customers or employees. Employees wearing face coverings & disposable gloves. No COVID-19 educational or social distancing signs posted in facility.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks	X
Employees wearing gloves	X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart	X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table	X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used	X

Notes: Social distancing & COVID-19 educational signs posted in facility. Hand sanitizer available to employees & patrons. Employees wearing face coverings & disposable gloves. Table/chairs spaced at least 6 feet apart.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks	X
Employees wearing gloves	X
Customers/Patrons wearing masks			X
Social distancing requirement signs posted	X
COVID-19 educational signs posted		X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart	X
Hand sanitizer (60% alcohol) available for employees		X
Hand sanitizer (60% alcohol) available for customers/patrons		X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table	X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart			X
Single Service/Single Use items used	X

Notes: No patrons in facility at time of observation. One social distancing sign posted in facility. No COVID-19 educational signs posted. No buffet or salad bar at this time.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks		X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted		X
COVID-19 educational signs posted		X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart		X
Hand sanitizer (60% alcohol) available for employees		X
Hand sanitizer (60% alcohol) available for customers/patrons		X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table	X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart			X
Single Service/Single Use items used		X

Notes: No patrons in facility at time of observation. No social distancing or COVID-19 educational signs posted in facility. Cleaning/disinfecting of high touch surfaces done routinely.

June 18, 2020

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily	X
Employees wearing masks	X
Employees wearing gloves	X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted		X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart	X
Hand sanitizer (60% alcohol) available for employees		X
Hand sanitizer (60% alcohol) available for customers/patrons		X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table	X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used	X

Notes: Social distancing signs posted throughout facility. No COVID-19 educational signs seen in facility. No hand sanitizer available for employees/patrons. Chairs/tables are at least 6 feet apart.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks		X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted		X
COVID-19 educational signs posted		X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart		X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table	X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used	X

Notes: No social distancing or COVID-19 educational signs posted in facility. Hand sanitizer available for employees/patrons. Tables/chairs not at least 6 feet apart. Face coverings not being worn by employees or patrons.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily	X
Employees wearing masks	X
Employees wearing gloves		X
Customers/Patrons wearing masks	X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart			X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used			X

Notes: Very good job at posting social distancing signs at registers/lanes & throughout facility. COVID-19 educational signs posted throughout facility. Employees cleaning/disinfecting high touch surfaces frequently.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily	X
Employees wearing masks	X
Employees wearing gloves	X
Customers/Patrons wearing masks			X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart		X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table	X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used	X

Notes: No customers in facility at time of observation. Some tables/chairs blocked off so patrons cannot use them. COVID-19 educational signs and social distancing signs posted in facility and at front counter. Employees wearing face coverings and disposable gloves.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily	X
Employees wearing masks	X
Employees wearing gloves	X
Customers/Patrons wearing masks			X
Social distancing requirement signs posted	X
COVID-19 educational signs posted		X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart		X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table	X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used	X

Notes: No patrons in facility at time of observation. Empolyees wearing face coverings & disposable gloves. Only 10 patrons allowed in facility at one time. Hand sanitizer available for empolyees & patrons.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily	X
Employees wearing masks		X
Employees wearing gloves	X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted		X
COVID-19 educational signs posted		X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart	X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons		X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table	X
Customer/Patron waiting turn outdoors or in automobile	X
Customer/Patron waiting indoors at least 6 feet apart			X
Single Service/Single Use items used	X

Notes: Picnic tables are 6 feet apart. No social distancing signs posted at walk-up window. No COVID-19 educational signs seen posted. Hand sanitizer available for employees.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily	X
Employees wearing masks	X
Employees wearing gloves	X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart			X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used	X

Notes: No dining in allowed yet in facility. Social distancing signs posted throughout facility. Face covering & disposable gloves being worn by employees. Employees take temp and answer 5 screening questions when starting shift.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily	X
Employees wearing masks	X
Employees wearing gloves	X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted		X
COVID-19 educational signs posted		X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart			X
Hand sanitizer (60% alcohol) available for employees		X
Hand sanitizer (60% alcohol) available for customers/patrons		X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile	X
Customer/Patron waiting indoors at least 6 feet apart			X
Single Service/Single Use items used	X

Notes: No social distancing or COVID-19 educational signs posted in facility. Some employees wearing face coverings. All employees wearing disposable gloves. Employees washing hands frequently & between patrons.

June 17, 2020

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily			X
Employees wearing masks			X
Employees wearing gloves			X
Customers/Patrons wearing masks			X
Social distancing requirement signs posted			X
COVID-19 educational signs posted			X
Cleaning/disinfecting done routinely			X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart			X
Hand sanitizer (60% alcohol) available for employees			X
Hand sanitizer (60% alcohol) available for customers/patrons			X
Employees washing hands or using sanitizer between customers/patrons			X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart			X
Single Service/Single Use items used			X

Notes: Dining room closed. No access to facility at time of observation. Drive through open.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily	X
Employees wearing masks		X
Employees wearing gloves	X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted		X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart	X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table	X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used	X

Notes: COVID-19 Educational signs posted in facility. No social distancing signs seen in facility. All tales/chairs at least 6 feet apart. Hand sanitizer available for employees and patrons.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily	X
Employees wearing masks		X
Employees wearing gloves	X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart	X
Hand sanitizer (60% alcohol) available for employees		X
Hand sanitizer (60% alcohol) available for customers/patrons		X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table	X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart			X
Single Service/Single Use items used	X

Notes: No dining in available yet. Drive-through and to-go options available. Social distancing and COVID-19 educational signs posted in facility. Employees not wearing face coverings during observation. No hand sanitizer available for patrons or employees.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily	X
Employees wearing masks	X
Employees wearing gloves	X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted		X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart	X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table	X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used	X

Notes: Social distancing signs posted throughout the facility. Employees wearing face coverings & vinyl gloves. Hand sanitizer available to employees & patrons. Dining in not yet allowed. All tables/chairs at least 6 feet apart.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks	X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted		X
COVID-19 educational signs posted		X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart	X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table	X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used	X

Notes: No COVID-19 educational or social distancing signs posted in facility. Hand sanitizer available for patrons & employees. Employees wearing face coverings. High touch areas are disinfected hourly. Business does not have dining-in. Take-out or delivery only.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks		X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted		X
COVID-19 educational signs posted		X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart	X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table	X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used	X

Notes: No social distancing or COVID-19 educational sings posted in facility. Hand sanitizer available for use by employees & patrons. Tables/chairs are at least 6 feet apart.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily	X
Employees wearing masks		X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted		X
COVID-19 educational signs posted		X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart	X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table	X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used	X

Notes: Only 1 sign posted on chalkboard regarding social distancing reminder. No COVID-19 educational signs posted. Hand sanitizer available for use for employees and patrons. Face coverings not being worn by employees or patrons.

June 16, 2020

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks		X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted		X
COVID-19 educational signs posted		X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart		X
Hand sanitizer (60% alcohol) available for employees		X
Hand sanitizer (60% alcohol) available for customers/patrons		X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table	X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart			X
Single Service/Single Use items used	X

Notes: No social distancing or COVID-19 educational signs posted in facility. Employees & patrons wot wearing face coverings. Tables/chairs not 6 feet apart. Employees cleaning/disinfecting regularly.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily	X
Employees wearing masks	X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart			X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart		X
Single Service/Single Use items used	X

Notes: Facility is still monitoring maximum occupancy limit (per corporate) COVID-19 educational & social distancing signs posted. Patrons are not social distancing or wearing face coverings.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks		X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted		X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart		X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table	X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart			X
Single Service/Single Use items used	X

Notes: No patrons in facility during observations so could not determine if social distancing was being accomplished. COVID-19 educational signs not posted. Social distancing sings posted in numerous locations throughout facility. Employees not wearing face coverings.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily	X
Employees wearing masks	X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted		X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart			X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons		X
Employees washing hands or using sanitizer between customers/patrons		X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart		X
Single Service/Single Use items used	X

Notes: Social distancing signs posted on front entry doors & throughout facility. No COVID-19 educational signs seen posted in facility.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks		X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted		X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart			X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons		X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used			X

Notes: Social distancing signs posted on front entry door & marks every 6 feet posted on floor near checkout. Cleaning/disinfecting accomplished routinely.

Observations	Yes	No
Employees Screened for COVID-19 sign/symptoms daily	x
Employees wearing masks		x
Employees wearing gloves	x
Customers/Patrons wearing masks		x
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit		x
Tables/chairs and equipment at least 6 feet apart		x
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons	x
No more than 10 people per table	x
Customer/Patron waiting turn outdoors or in automobile		x
Customer/Patron waiting indoors at least 6 feet apart		x
Single Service/Single Use items used	X

Notes: Hand sanitizer stations located throughout facility. Only charge from previous observation is tables/chairs are being used and 6 feet social distancing is not being enforced.

Observations	Yes	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks		X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely		X
Retail sales facility monitoring maximum occupancy limit		X
Tables/chairs and equipment at least 6 feet apart	X
Hand sanitizer (60% alcohol) available for employees		X
Hand sanitizer (60% alcohol) available for customers/patrons		X
Employees washing hands or using sanitizer between customers/patrons		X
No more than 10 people per table		X
Customer/Patron waiting turn outdoors or in automobile		X
Customer/Patron waiting indoors at least 6 feet apart		X
Single Service/Single Use items used		X

Notes: Business was closed at time of observation (open at 3pm). Social distancing & COVID-19 educational signs posted on entry door. Facility still monitoring maximum occupancy limit.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks		X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart		X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table	X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used	X

Notes: COVID-19 educational signs posted at entry door. Cleaning/disinfecting accomplished routinely. Patrons are being spaced at least 6 feet apart during observation.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks		X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart		X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table	X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used	X

Notes: Social distancing signs posted at entry door. Facility cleaning/disinfecting routinely. No COVID-19 educational signs posted.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks		X
Employees wearing gloves	X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart	X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table	X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used	X

Notes: COVID-19 educational & social distancing signs posted throughout the facility. Tables/chairs are spaced at least 6 feet apart. Face coverings are recommended, but optional

May 29, 2020

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks		X
Employees wearing gloves		X
Customers/Patrons wearing masks	X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit
Tables/chairs and equipment at least 6 feet apart			X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons		X
Employees washing hands or using sanitizer between customers/patrons		X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used			X

Notes: COVID-19 educational & social distancing signs posted on front entry doors & throughout facility. 6 foot social distancing marks taped on floor in check-out lanes. Several patrons seen wearing face coverings. Hand sanitizer available for employee use.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		x
Employees wearing masks		x
Employees wearing gloves		x
Customers/Patrons wearing masks	x
Social distancing requirement signs posted	x
COVID-19 educational signs posted	x
Cleaning/disinfecting done routinely	x
Retail sales facility monitoring maximum occupancy limit	x
Tables/chairs and equipment at least 6 feet apart			x
Hand sanitizer (60% alcohol) available for employees	x
Hand sanitizer (60% alcohol) available for customers/patrons		x
Employees washing hands or using sanitizer between customers/patrons	x
No more than 10 people per table			x
Customer/Patron waiting turn outdoors or in automobile			x
Customer/Patron waiting indoors at least 6 feet apart	x
Single Service/Single Use items used			x

Notes: Social distancing & COVID-19 educational signs posted on front entry doors & throughout facility. Facility monitoring maximum occupancy limit (83). 6 foot increments marked on floor at check-out lanes.

May 28, 2020

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		x
Employees wearing masks	x
Employees wearing gloves		x
Customers/Patrons wearing masks	x
Social distancing requirement signs posted		x
COVID-19 educational signs posted		x
Cleaning/disinfecting done routinely	x
Retail sales facility monitoring maximum occupancy limit			x
Tables/chairs and equipment at least 6 feet apart	x
Hand sanitizer (60% alcohol) available for employees	x
Hand sanitizer (60% alcohol) available for customers/patrons	x
Employees washing hands or using sanitizer between customers/patrons	x
No more than 10 people per table			x
Customer/Patron waiting turn outdoors or in automobile			x
Customer/Patron waiting indoors at least 6 feet apart	x
Single Service/Single Use items used	x

Notes: No social distancing or COVID-19 educational signs posted in facility. Hand sanitizer available for employee & patron use. All chairs were 6 feet apart. Employees & patrons wearing face coverings.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		x
Employees wearing masks	x
Employees wearing gloves		x
Customers/Patrons wearing masks	x
Social distancing requirement signs posted	x
COVID-19 educational signs posted	x
Cleaning/disinfecting done routinely	x
Retail sales facility monitoring maximum occupancy limit	x
Tables/chairs and equipment at least 6 feet apart			x
Hand sanitizer (60% alcohol) available for employees	x
Hand sanitizer (60% alcohol) available for customers/patrons	x
Employees washing hands or using sanitizer between customers/patrons	x
No more than 10 people per table			x
Customer/Patron waiting turn outdoors or in automobile			x
Customer/Patron waiting indoors at least 6 feet apart	x
Single Service/Single Use items used			x

Notes: Social distancing & COVID-19 educational signs posted on front entry door. 6 foot spacing marked on floor by front check-out counter. Hand sanitizer & disposable gloves are available for employee & patron use. Only 5 patrons allowed in business at one time.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		x
Employees wearing masks		x
Employees wearing gloves		x
Customers/Patrons wearing masks		x
Social distancing requirement signs posted		x
COVID-19 educational signs posted		x
Cleaning/disinfecting done routinely	x
Retail sales facility monitoring maximum occupancy limit	x
Tables/chairs and equipment at least 6 feet apart			x
Hand sanitizer (60% alcohol) available for employees	x
Hand sanitizer (60% alcohol) available for customers/patrons	x
Employees washing hands or using sanitizer between customers/patrons	x
No more than 10 people per table			x
Customer/Patron waiting turn outdoors or in automobile			x
Customer/Patron waiting indoors at least 6 feet apart	x
Single Service/Single Use items used			x

Notes: Hand Sanitizer available to employees & patrons. No social distancing or COVID-19 educational signs posted in facility.

May 27, 2020

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily	x
Employees wearing masks		x
Employees wearing gloves		x
Customers/Patrons wearing masks		x
Social distancing requirement signs posted	x
COVID-19 educational signs posted	x
Cleaning/disinfecting done routinely	x
Retail sales facility monitoring maximum occupancy limit	x
Tables/chairs and equipment at least 6 feet apart	x
Hand sanitizer (60% alcohol) available for employees	x
Hand sanitizer (60% alcohol) available for customers/patrons	x
Employees washing hands or using sanitizer between customers/patrons	x
No more than 10 people per table			x
Customer/Patron waiting turn outdoors or in automobile			x
Customer/Patron waiting indoors at least 6 feet apart	x
Single Service/Single Use items used			x

Notes: Social distancing & COVID-19 education signs posted on front entry door & throughout business. Hand sanitizer, gloves (disposable), and disposable masks available to employees & patrons.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily	x
Employees wearing masks		x
Employees wearing gloves		x
Customers/Patrons wearing masks			x
Social distancing requirement signs posted		x
COVID-19 educational signs posted		x
Cleaning/disinfecting done routinely	x
Retail sales facility monitoring maximum occupancy limit			x
Tables/chairs and equipment at least 6 feet apart	x
Hand sanitizer (60% alcohol) available for employees	x
Hand sanitizer (60% alcohol) available for customers/patrons		x
Employees washing hands or using sanitizer between customers/patrons	x
No more than 10 people per table			x
Customer/Patron waiting turn outdoors or in automobile			x
Customer/Patron waiting indoors at least 6 feet apart	x
Single Service/Single Use items used			x

Notes: Business does not allow more than 2 people in the facility at one time. If employees are sick, they are told to stay home.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily	x
Employees wearing masks	x
Employees wearing gloves		x
Customers/Patrons wearing masks	x
Social distancing requirement signs posted	x
COVID-19 educational signs posted		x
Cleaning/disinfecting done routinely	x
Retail sales facility monitoring maximum occupancy limit	x
Tables/chairs and equipment at least 6 feet apart			x
Hand sanitizer (60% alcohol) available for employees	x
Hand sanitizer (60% alcohol) available for customers/patrons	x
Employees washing hands or using sanitizer between customers/patrons	x
No more than 10 people per table			x
Customer/Patron waiting turn outdoors or in automobile		x
Customer/Patron waiting indoors at least 6 feet apart	x
Single Service/Single Use items used			x

Notes: Social distancing measures on floor by check-out counter. Face covering signs posted on front entry doors. No COVID-19 educational signs posted in business. Hand sanitizer available for employees and patrons. Business monitoring maximum occupancy limit (23).

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily	X
Employees wearing masks	X
Employees wearing gloves		X
Customers/Patrons wearing masks	X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit	X
Tables/chairs and equipment at least 6 feet apart			X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used			X

Notes: Social distancing & COVID-19 educational signs posted on front entry doors and throughout business. 6 foot social distancing marks on the floor around front counter. Disinfecting is being accomplished every hour on the hour. Face covering is required for employees and patrons.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily	X
Employees wearing masks		X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit	X
Tables/chairs and equipment at least 6 feet apart	X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used			X

Notes: Social Distancing & COVID-19 educational signs posted on front entry doors & throughout facility. Hand sanitizer available for patrons & employees.

May 26, 2020

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks	X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart	X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons		X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table	X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used	X

Notes: Establishment will be using single service items only. All tables/chairs are spaced at least 6 feet apart. Hand sanitizer & disposable masks available for employee use.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily	X
Employees wearing masks	X
Employees wearing gloves		X
Customers/Patrons wearing masks	X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit	X
Tables/chairs and equipment at least 6 feet apart	X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile	X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used	X

Notes: Business is by appointment only. Patrons wait in their car until their turn. Face covering is required at all times. Employees are routinely using hand sanitizer & patrons are required to use hand sanitizer. Chairs/equipment are spaced at least 6 feet apart.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily			X
Employees wearing masks			X
Employees wearing gloves			X
Customers/Patrons wearing masks			X
Social distancing requirement signs posted			X
COVID-19 educational signs posted			X
Cleaning/disinfecting done routinely			X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart			X
Hand sanitizer (60% alcohol) available for employees			X
Hand sanitizer (60% alcohol) available for customers/patrons			X
Employees washing hands or using sanitizer between customers/patrons			X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart			X
Single Service/Single Use items used			X

Notes: Facility is maintaining social distancing requirements between patrons. Chairs/equipment is spaced at least 6 feet apart. Cleaning disinfecting is being done routinely. Only 3 people are allowed inside at one time.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily			X
Employees wearing masks			X
Employees wearing gloves			X
Customers/Patrons wearing masks			X
Social distancing requirement signs posted			X
COVID-19 educational signs posted			X
Cleaning/disinfecting done routinely			X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart			X
Hand sanitizer (60% alcohol) available for employees			X
Hand sanitizer (60% alcohol) available for customers/patrons			X
Employees washing hands or using sanitizer between customers/patrons			X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart			X
Single Service/Single Use items used			X

Notes: Sign on window stated “Due to COVID-19 this location is temporarily closed”

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks	X
Employees wearing gloves		X
Customers/Patrons wearing masks	X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit	X
Tables/chairs and equipment at least 6 feet apart			X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons		X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used			X

Notes: Social distancing & COVID-19 educational signs posted on front entry doors. Social distancing signs posted on floor in checkout lanes. Hand sanitizer available for employees. Facility monitoring maximum occupancy limit.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks	X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit	X
Tables/chairs and equipment at least 6 feet apart			X
Hand sanitizer (60% alcohol) available for employees		X
Hand sanitizer (60% alcohol) available for customers/patrons		X
Employees washing hands or using sanitizer between customers/patrons		X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used			X

Notes: Social distancing & COVID-19 educational signs posted on front entry doors. Social distancing marks taped on floor by front check-out counter. Facility monitoring maximum occupancy limit (12). High touch areas are disinfected routinely.

May 20, 2020

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily	X
Employees wearing masks		X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted		X
COVID-19 educational signs posted		X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart	X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile		X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used			X

Notes: No social distancing or COVID-19 educational signs posted in business. Chairs/equipment was spaced at least 6 feet apart. Hand sanitizer available to employees & patrons. Business screens patrons & employees for COVID-19 signs/symptoms daily.

Observations	Yes	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks		X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely		X
Retail sales facility monitoring maximum occupancy limit	X
Tables/chairs and equipment at least 6 feet apart		X
Hand sanitizer (60% alcohol) available for employees		X
Hand sanitizer (60% alcohol) available for customers/patrons		X
Employees washing hands or using sanitizer between customers/patrons		X
No more than 10 people per table		X
Customer/Patron waiting turn outdoors or in automobile	X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used		X

Notes: Business closed at time of observation. Sign posted on front entry door stated that the business is not taking any walk ins. Appointment only. Social distancing & COVID-19 signs posted on front entry door.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks		X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted		X
COVID-19 educational signs posted		X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit	X
Tables/chairs and equipment at least 6 feet apart	X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile	X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used			X

Notes: Business is by appointment only. 1 Patron per hair stylist is all that is allowed. Masks are available for patron use. Hair stylist was not wearing a mask at time of observation. Cleaning/disinfecting is done after each patron.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks		X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted		X
COVID-19 educational signs posted		X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart	X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used			X

Notes: No COVID-19 educational or social distancing signs posted. Hand sanitizer available for employees & patrons. All chairs & equipment spaced at least 6 feet apart. Disinfection accomplished between patrons.

Observations	Yes	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks		X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted		X
COVID-19 educational signs posted		X
Cleaning/disinfecting done routinely		X
Retail sales facility monitoring maximum occupancy limit	X
Tables/chairs and equipment at least 6 feet apart		X
Hand sanitizer (60% alcohol) available for employees		X
Hand sanitizer (60% alcohol) available for customers/patrons		X
Employees washing hands or using sanitizer between customers/patrons		X
No more than 10 people per table		X
Customer/Patron waiting turn outdoors or in automobile	X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used		X

Notes: Appointment only. No walk-in service. Sign posted on front entry door stated that if sick, must re-schedule. Capacity is 10 people. Patrons were waiting turn in vehicles.

Observations	Yes	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks		X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely		X
Retail sales facility monitoring maximum occupancy limit	X
Tables/chairs and equipment at least 6 feet apart		X
Hand sanitizer (60% alcohol) available for employees		X
Hand sanitizer (60% alcohol) available for customers/patrons		X
Employees washing hands or using sanitizer between customers/patrons		X
No more than 10 people per table		X
Customer/Patron waiting turn outdoors or in automobile		X
Customer/Patron waiting indoors at least 6 feet apart		X
Single Service/Single Use items used		X

Notes: Business is by appointment only. Social distancing & COVID-19 signs posted on front entry door.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks		X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit	X
Tables/chairs and equipment at least 6 feet apart	X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons		X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile	X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used			X

Notes: COVID-19 educational sign & social distancing sign posted on entrance door. No signs posted inside facility. Only 1 patron per hair dresser allowed in facility at one time. Hand sanitizer was available to employees. Cleaning/disinfecting of all equipment is accomplished routinely.

May 19, 2020

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily	X
Employees wearing masks	X
Employees wearing gloves	X
Customers/Patrons wearing masks
Social distancing requirement signs posted		X
COVID-19 educational signs posted		X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit	X
Tables/chairs and equipment at least 6 feet apart	X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile		X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used			X

Notes: No social distancing or COVID-19 educational signs posted in facility. Hand sanitizer available fore employees & patrons. Chairs were at least 6 feet apart.

Observations	Yes	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks		X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted		X
COVID-19 educational signs posted		X
Cleaning/disinfecting done routinely		X
Retail sales facility monitoring maximum occupancy limit	X
Tables/chairs and equipment at least 6 feet apart		X
Hand sanitizer (60% alcohol) available for employees		X
Hand sanitizer (60% alcohol) available for customers/patrons		X
Employees washing hands or using sanitizer between customers/patrons		X
No more than 10 people per table		X
Customer/Patron waiting turn outdoors or in automobile	X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used		X

Notes: Observation could not be accomplished as entry door locked with sign that was posted “We are open, door is locked. Please stay in your vehicle until we come & get you for an appointment.” Several patrons were waiting in their vehicle for appointment time.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks	X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted		X
COVID-19 educational signs posted		X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart	X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile	X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used			X

Notes: Hand sanitizer available for employees & patrons. Chairs were spaced at least 6 feet apart. Employees disinfecting equipment in-between patrons. Face masks were not being worn by employees or patrons.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks		X
Employees wearing gloves	X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted		X
COVID-19 educational signs posted		X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit	X
Tables/chairs and equipment at least 6 feet apart	X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons		X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile	X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used			X

Notes: Walk-in service not permitted – appointment only. 30 minute overlap on appointments to prevent customer interactions. Hand sanitizer available at each work station. Employees wearing gloves (vinyl) while performing hair styling duties. All equipment is cleaned/disinfected between patrons.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks		X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted		X
COVID-19 educational signs posted		X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit	X
Tables/chairs and equipment at least 6 feet apart	X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons		X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used			X

Notes: Hand sanitizer available for employees. No social distancing signs posted in facility. Chairs are spaced at least 6 feet apart. Employees have face masks available, but not using them at time of observation.

May 18, 2020

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks		X
Employees wearing gloves	X
Customers/Patrons wearing masks	X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit	X
Tables/chairs and equipment at least 6 feet apart	X
Hand sanitizer (60% alcohol) available for employees		X
Hand sanitizer (60% alcohol) available for customers/patrons		X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used			X

Notes: Social distancing signs posted on entry door & throughout facility. Social distancing marks on floor at front counter where patrons wait in line. Only 8 patrons are allowed in store at one time & then front door is locked and 1-in 1-out becomes the policy.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks		X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted		X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit	X
Tables/chairs and equipment at least 6 feet apart	X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile	X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used			X

Notes: COVID-19 educational signs posted on front entry door. Facility is monitoring maximum occupancy limit by only allowing 1 patron per 1 stylist inside the facility at one time. Hand sanitizer is available to employees and patrons.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily	X
Employees wearing masks		X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit	X
Tables/chairs and equipment at least 6 feet apart	X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile	X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used			X

Notes: Social distancing signs posted on entry door to business. Social distancing signs posted on floor in waiting area. Facility is monitoring occupancy limit – only 5 customers & 5 stylists allowed in facility at one time. Hand sanitizer available for employees and customers.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily			X
Employees wearing masks			X
Employees wearing gloves			X
Customers/Patrons wearing masks			X
Social distancing requirement signs posted			X
COVID-19 educational signs posted			X
Cleaning/disinfecting done routinely			X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart			X
Hand sanitizer (60% alcohol) available for employees			X
Hand sanitizer (60% alcohol) available for customers/patrons			X
Employees washing hands or using sanitizer between customers/patrons			X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart			X
Single Service/Single Use items used			X

Notes: Business is closed. Sign posted read “Shop for Rent.”

May 15, 2020

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily			X
Employees wearing masks			X
Employees wearing gloves			X
Customers/Patrons wearing masks			X
Social distancing requirement signs posted			X
COVID-19 educational signs posted			X
Cleaning/disinfecting done routinely			X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart			X
Hand sanitizer (60% alcohol) available for employees			X
Hand sanitizer (60% alcohol) available for customers/patrons			X
Employees washing hands or using sanitizer between customers/patrons			X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart			X
Single Service/Single Use items used			X

Notes: Business was closed at time of observation.

Observations	Yes	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks		X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted		X
Cleaning/disinfecting done routinely		X
Retail sales facility monitoring maximum occupancy limit		X
Tables/chairs and equipment at least 6 feet apart		X
Hand sanitizer (60% alcohol) available for employees		X
Hand sanitizer (60% alcohol) available for customers/patrons		X
Employees washing hands or using sanitizer between customers/patrons		X
No more than 10 people per table		X
Customer/Patron waiting turn outdoors or in automobile		X
Customer/Patron waiting indoors at least 6 feet apart		X
Single Service/Single Use items used		X

Notes: Business was closed at time of observation. Sign posted on entry doors stated that doors open at 4PM for Bingo. No reserved seating – Only 2 persons at a table. No moving tables or chairs. Observe “social distancing” when inside. If you are feeling sick, do not come in.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks		X
Employees wearing gloves	X
Customers/Patrons wearing masks	X
Social distancing requirement signs posted	X
COVID-19 educational signs posted		X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit	X
Tables/chairs and equipment at least 6 feet apart			X
Hand sanitizer (60% alcohol) available for employees		X
Hand sanitizer (60% alcohol) available for customers/patrons		X
Employees washing hands or using sanitizer between customers/patrons		X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used	X

Notes: Employee disinfecting pin pad on credit/debit machine after customer use. Several social distancing sings posted in facility. 6 foot distancing was taped on floor throughout facility.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks		X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit	X
Tables/chairs and equipment at least 6 feet apart	X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used			X

Notes: Only 10 customers are allowed in facility at one time. Several social distancing signs posted In facility Employee using hand sanitizer between patrons.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks		X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit	X
Tables/chairs and equipment at least 6 feet apart			X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons		X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used			X

Notes: Only 6 customers are allowed in facility at one time. Several social distancing sings posted in the business. Employee using hand sanitizer between patrons. Recommended 6 food increments on floor to remind customers of social distancing requirements.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks		X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted		X
COVID-19 educational signs posted		X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit	X
Tables/chairs and equipment at least 6 feet apart			X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons		X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile	X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used			X

Notes: Most of business is drive-through. Only 4 customers are allowed inside at once. Recommended social distancing signs posted & marks on floor while customers wait (6 food spacing distances).

May 14, 2020

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks		X
Employees wearing gloves	X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted		X
COVID-19 educational signs posted		X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart		X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons		X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table	X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used	X

Notes: Complaint received on 05/14/2020 regarding business not spacing tables/chairs at least 6 feet apart and patrons not social distancing. Tables/chairs are not 6 feet apart. No social distancing signs posted in facility. Recommended to owner to post social distancing signs, COVID-19 educational signs, spacing tables/chairs/customers at least 6 feet apart.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily			X
Employees wearing masks			X
Employees wearing gloves			X
Customers/Patrons wearing masks			X
Social distancing requirement signs posted			X
COVID-19 educational signs posted			X
Cleaning/disinfecting done routinely			X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart			X
Hand sanitizer (60% alcohol) available for employees			X
Hand sanitizer (60% alcohol) available for customers/patrons			X
Employees washing hands or using sanitizer between customers/patrons			X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart			X
Single Service/Single Use items used			X

Notes: Business was closed at time of observation. Sign on door stated “Closed week of May 11^th. Back open Tuesday May 19^th.”

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks		X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted		X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit	X
Tables/chairs and equipment at least 6 feet apart			X
Hand sanitizer (60% alcohol) available for employees		X
Hand sanitizer (60% alcohol) available for customers/patrons		X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used	X

Notes: 6 foot intervals marked on floor at checkout to remind customers to social distance while waiting.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks		X
Employees wearing gloves		X
Customers/Patrons wearing masks	X
Social distancing requirement signs posted		X
COVID-19 educational signs posted		X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit	X
Tables/chairs and equipment at least 6 feet apart			X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons		X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used			X

Notes: 6 Foot distances are marked on floor in check-out lanes reminding patrons of social distancing. Business monitoring maximum occupancy limit.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks		X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit	X
Tables/chairs and equipment at least 6 feet apart			X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons		X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used			X

Notes: 6 foot intervals marked on floor in check out lanes reminding patrons of safe distance from others. Business is monitoring maximum occupancy limit very well. Occupancy limit is posted on front entry door.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily	X
Employees wearing masks	X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted		X
COVID-19 educational signs posted		X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit	X
Tables/chairs and equipment at least 6 feet apart			X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons		X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used	X

Notes: Social distancing for customers waiting in line marked on floor. Business is monitoring maximum occupancy limit very well.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks	X
Employees wearing gloves	X
Customers/Patrons wearing masks	X
Social distancing requirement signs posted	X
COVID-19 educational signs posted		X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit	X
Tables/chairs and equipment at least 6 feet apart			X
Hand sanitizer (60% alcohol) available for employees		X
Hand sanitizer (60% alcohol) available for customers/patrons		X
Employees washing hands or using sanitizer between customers/patrons		X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used	X

Notes: Business is monitoring maximum occupancy limit. Only one entry/exit door available to general public. Several patrons were wearing face masks. Employees using disinfecting wipes on high touch surfaces routinely.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily			X
Employees wearing masks			X
Employees wearing gloves			X
Customers/Patrons wearing masks			X
Social distancing requirement signs posted			X
COVID-19 educational signs posted			X
Cleaning/disinfecting done routinely			X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart			X
Hand sanitizer (60% alcohol) available for employees			X
Hand sanitizer (60% alcohol) available for customers/patrons			X
Employees washing hands or using sanitizer between customers/patrons			X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart			X
Single Service/Single Use items used			X

Notes: Only drive-thru is open.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily	X
Employees wearing masks	X
Employees wearing gloves		X
Customers/Patrons wearing masks	X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit	X
Tables/chairs and equipment at least 6 feet apart			X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used			X

Notes: Employee disinfecting shopping cart handles in between patrons. Hand sanitizer station located at front entrance door for patrons. Social distancing signs posted throughout store & on floor. Facility practicing good social distancing & education.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks		X
Employees wearing gloves	X
Customers/Patrons wearing masks	X
Social distancing requirement signs posted		X
COVID-19 educational signs posted		X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit	X
Tables/chairs and equipment at least 6 feet apart		X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons		X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table	X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart		X
Single Service/Single Use items used	X

Notes: No social distancing signs seen in facility. One sign on front door stating “do not enter if sick or have a fever”. Very few patrons wearing masks. Employees not wearing face masks. Limited hand sanitizer available for employees.

*Recommend social distancing and COVID-19 educational signs be posted.

May 13, 2020

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks	X
Employees wearing gloves	X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted		X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart	X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons		X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table	X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used	X

Notes: Employees are required to wear face masks per corporate office. Table & chairs are at least 6 feet apart. Cleaning & disinfecting are accomplished routinely. Social distancing signs are posted at front entrance.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks	X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit	X
Tables/chairs and equipment at least 6 feet apart			X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used			X

Notes: Business personnel wear face masks. Hand sanitizer available for employees & patrons. Cleaning/disinfecting of high touch areas done every 20 minutes. Social distancing signs posted in numerous places including floor.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks	X
Employees wearing gloves	X
Customers/Patrons wearing masks	X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit	X
Tables/chairs and equipment at least 6 feet apart	X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons		X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used	X

Notes: Employees wearing masks and gloves as well as using hand sanitizer between patrons. Business is monitoring maximum occupancy limit (10). Social distancing signs posted throughout facility.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily	X
Employees wearing masks		X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart	X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons		X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used	X

Notes: Chairs for customer waiting spaced at least 6 feet apart. Social distancing signs posted on entry door & also on floor. Educational signs posted in several placed.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks		X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted		X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart	X
Hand sanitizer (60% alcohol) available for employees		X
Hand sanitizer (60% alcohol) available for customers/patrons		X
Employees washing hands or using sanitizer between customers/patrons		X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used	X

Notes: COVID-19 educational posters attached to restroom doors. Dining in option not allowed. Chairs are stored on tabletop to prevent patrons from sitting.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks		X
Employees wearing gloves		X
Customers/Patrons wearing masks	X
Social distancing requirement signs posted		X
COVID-19 educational signs posted		X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit		X
Tables/chairs and equipment at least 6 feet apart			X
Hand sanitizer (60% alcohol) available for employees		X
Hand sanitizer (60% alcohol) available for customers/patrons		X
Employees washing hands or using sanitizer between customers/patrons		X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used	X

Notes: Business ran out of hand sanitizer so rinsing hands in bleach disinfectant after handling money. Could not find occupancy limit posted, but employee says business is not allowing more than 10 customers inside at one time.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily
Employees wearing masks		X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted		X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit		X
Tables/chairs and equipment at least 6 feet apart			X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons		X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile		X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used	X

Notes: One social distancing sign posted behind front counter. No 6 foot spacing marked on floor for customers waiting in line. Cleaning/disinfecting being accomplished routinely.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily			X
Employees wearing masks			X
Employees wearing gloves			X
Customers/Patrons wearing masks			X
Social distancing requirement signs posted			X
COVID-19 educational signs posted			X
Cleaning/disinfecting done routinely			X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart			X
Hand sanitizer (60% alcohol) available for employees			X
Hand sanitizer (60% alcohol) available for customers/patrons			X
Employees washing hands or using sanitizer between customers/patrons			X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart			X
Single Service/Single Use items used			X

Notes: Business was closed at time of observation. Sign in window said “No Dining In”.

May 12, 2020

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks		X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted		X
COVID-19 educational signs posted		X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit	X
Tables/chairs and equipment at least 6 feet apart			X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile		X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used			X

Notes: Masks are available for employees and customers to use if they want them. They do not have social distancing signs posted, but they do remind customers if they are not staying 6 feet away from one another. Owner states that customers have been good about distancing themselves on their own. Disinfection of high contact surfaces done at least every 2 hours or immediately after a customer with small children have been in due to their tendency to touch a lot of things.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily	X
Employees wearing masks	X
Employees wearing gloves	X
Customers/Patrons wearing masks	X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart	X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table	X
Customer/Patron waiting turn outdoors or in automobile		X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used		X

Notes: Masks are required to enter the facility. Signs are posted on the entrance doors. Social distancing signs are posted. All visitors and employees are required to be screened upon entrance by answering a questionnaire and taking a body temperature. There is a Plexiglass divider set up to separate employee and client. When food service items (trays, utensils, plates, etc.) are returned to the dishwashing areas from a patients room the dishwashing employees are required to wear gloves when handling these items. The salad bar and buffet are currently self serve, but will be going to pre-packaged and pre-portioned items in single service items to reduce high touch surfaces. Hand sanitizer is available at the entrance of the cafeteria. Tables are 6 feet apart and no more than 3 people are allowed per table and anyone sitting together should be working in the same department. Tables, chairs, and napkin holds are sanitized after each customer. Salt and pepper shakers were on the table at time of inspection, these were removed and single service packages will be provided to reduce high touch surfaces. Social distancing tape has been ordered, but has not arrived yet to place on the ground to show 6 feet distances for patrons to stand. If customer is paying with cash, the employee must sanitize hands after handling.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks		X
Employees wearing gloves	X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit	X
Tables/chairs and equipment at least 6 feet apart			X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons		X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile		X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used			X

Notes: Hand sanitizer station is set up outside of the front door for customers to use before entering. A Divider is set up at the checkout counter to separate customer and employees. Disinfect high touch surfaces every hour. They do not do temperature checks for employees, but if an employee does not feel well they are told to stay at home.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks		X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted		X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart	X
Hand sanitizer (60% alcohol) available for employees		X
Hand sanitizer (60% alcohol) available for customers/patrons		X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table	X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used	X

Notes: Social distancing signs posted in several places. Chairs/tables were at least 6 feet apart.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks		X
Employees wearing gloves	X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit	X
Tables/chairs and equipment at least 6 feet apart			X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons		X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used	X

Notes: Only pre-packaged food sold. Self-service items are not sold. Social distancing sings posted on entry doors & on floor while customers are waiting in line.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks		X
Employees wearing gloves
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted		X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit	X
Tables/chairs and equipment at least 6 feet apart			X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons		X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used	X

Notes: Social distancing signs posted at both entry doors. 6 foot social distancing sings posted on floor for customers while waiting to check out. Cleaning/disinfecting of high touch areas done routinely. Hand sanitizer available for employee.

Observations	Yes	No
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks		X
Employees wearing gloves	X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted		X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit	X
Tables/chairs and equipment at least 6 feet apart	X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons		X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table	X
Customer/Patron waiting turn outdoors or in automobile	X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used	X

Notes: Dine-in at Smokestack BBQ. Chairs/tables are 6 foot apart. Social distancing signs posted at BreakTime #3163 & Smokestack BBQ facilities.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily			X
Employees wearing masks			X
Employees wearing gloves			X
Customers/Patrons wearing masks			X
Social distancing requirement signs posted			X
COVID-19 educational signs posted			X
Cleaning/disinfecting done routinely			X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart			X
Hand sanitizer (60% alcohol) available for employees			X
Hand sanitizer (60% alcohol) available for customers/patrons			X
Employees washing hands or using sanitizer between customers/patrons			X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart			X
Single Service/Single Use items used			X

Notes: Facility was not open at time of observation.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily	X
Employees wearing masks		X
Employees wearing gloves	X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted		X
COVID-19 educational signs posted		X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit	X
Tables/chairs and equipment at least 6 feet apart			X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons		X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used	X

Notes: Facility is monitoring maximum occupancy limit very well. Cleaning/disinfecting is being accomplished routinely. No dinning in is allowed.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks	X
Employees wearing gloves	X
Customers/Patrons wearing masks			X
Social distancing requirement signs posted		X
COVID-19 educational signs posted		X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart			X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile	X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used	X

Notes: Take-out and delivery only. Dining room is closed. No buffet bar available.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily	X
Employees wearing masks		X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted		X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart			X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons			X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile	X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used	X

Notes: Buffet bar closed. No dining in. Take-out and delivery only.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks	X
Employees wearing gloves	X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart			X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile		X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used	X

Notes: Buffet bar open, but for take out only. No dining in. Customers must use hand sanitizer (station set up at facility entrance) before going to the buffet. 6 foot distance between patrons is maintained and enforced by owner. Social distancing signs posted throughout facility.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks		X
Employees wearing gloves	X
Customers/Patrons wearing masks			X
Social distancing requirement signs posted		X
COVID-19 educational signs posted		X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart			X
Hand sanitizer (60% alcohol) available for employees		X
Hand sanitizer (60% alcohol) available for customers/patrons			X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile	X
Customer/Patron waiting indoors at least 6 feet apart			X
Single Service/Single Use items used	X

Notes: No dine-in available. Carry out or delivery only. Entertainment portion of business (live music/dancing) is currently being remodeled and will not re-open until September 2020.

May 11, 2020

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks		X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted		X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit	X
Tables/chairs and equipment at least 6 feet apart			X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons		X
Employees washing hands or using sanitizer between customers/patrons		X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile		X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used	X

Notes: Masks and gloves are available for use, but optional. Disinfection of high touch surfaces are done hourly using bleach water at 100ppm chlorine. Floor tape is used on the floor to mark 6 foot distancing for people standing in line. Restrooms are currently for employee use only and not open to the public.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks	X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted		X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart		X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile	X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used	X

Notes: No dine-in available. Delivery not available. Customers must call in their order and then come in and pick it up. No more than 4 people in the waiting area at a time. If there are 4 people inside, customers must wait outside or in their car until someone leaves. No one can order in person and wait. All orders must be called in. They are currently sanitizing door handles and countertops twice daily. They were told to increase sanitizing of these surfaces to hourly.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks		X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart		X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table	X
Customer/Patron waiting turn outdoors or in automobile		X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used		X

Notes: Tables are not 6 feet apart inside or out on the patio area. Booths are not marked off, but manager states that they stagger booths when in use. They were told to mark them off and separate the tables more to meet the 6 foot requirements. They disinfect tables, chairs, menus, and table items after every customer.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks	X
Employees wearing gloves	X
Customers/Patrons wearing masks	X
Social distancing requirement signs posted	X
COVID-19 educational signs posted		X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit	X
Tables/chairs and equipment at least 6 feet apart			X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile	X
Customer/Patron waiting indoors at least 6 feet apart			X
Single Service/Single Use items used			X

Notes: All visits are appointment only. No one is allowed in the waiting room. They must remain in their car and call in to let employees know they are there. Once they are ready they let the client in and take to their room. High touch surfaces are sainted every 30 minutes in general areas. Patient rooms are sanitized after every patient.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily	X
Employees wearing masks	X
Employees wearing gloves	X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart			X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile		X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used	X

Notes: No dine-in available. Customers can carry out and use the drive through. High touch surfaces are sanitized hourly. Social distancing signs are posted on the door, but there are no labels on the floor to show where customers to stand when carrying out. Hand sanitizer is available for employees and customers.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks		X
Employees wearing gloves	X
Customers/Patrons wearing masks			X
Social distancing requirement signs posted			X
COVID-19 educational signs posted			X
Cleaning/disinfecting done routinely			X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart			X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons			X
Employees washing hands or using sanitizer between customers/patrons		X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart			X
Single Service/Single Use items used			X

Notes: No dine-in available. Drive thru only.

Observations	Yes	No
Employees Screened for COVID-19 sign/symptoms daily	X
Employees wearing masks		X
Employees wearing gloves	X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit	X
Tables/chairs and equipment at least 6 feet apart	X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons		X
No more than 10 people per table	X
Customer/Patron waiting turn outdoors or in automobile		X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used	X

Notes: Dine-in is available, but only 15 people allowed in at a time. Tables are separated by at least 6 feet and tables/areas not used are marked off with caution tape. Masks are optional for cooking staff, but required for front desk staff.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks		X
Employees wearing gloves	X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart	X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table	X
Customer/Patron waiting turn outdoors or in automobile		X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used	X

Notes: All tables are 6 feet or greater apart. Tables, chairs, and all items on table are disinfected between customers. Largest table seats 8 people. 400ppm Quaternary Ammonium is used to sanitize. 100ppm bleach water is also available.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks	X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart			X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons		X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile		X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used	X

Notes: Social Distancing signs on floor showing customers where to stand. Hand-washing signage posted. Social distance reminders posted on door. High touch surfaces sanitized every 2 hours. Sanitizer available for employees and customers to use.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks	X
Employees wearing gloves	X
Customers/Patrons wearing masks			X
Social distancing requirement signs posted			X
COVID-19 educational signs posted			X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart			X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons			X
Employees washing hands or using sanitizer between customers/patrons			X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart			X
Single Service/Single Use items used	X

Notes: No dine-in at this time and only doing Drive-Through. They are unsure when dine-in will be provided, it is up to corporate offices. They have a thermometer ordered to do daily temperature checks of employees, but it has not arrived yet.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks		X
Employees wearing gloves	X
Customers/Patrons wearing masks			X
Social distancing requirement signs posted			X
COVID-19 educational signs posted			X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart			X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons		X
Employees washing hands or using sanitizer between customers/patrons		X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile	X
Customer/Patron waiting indoors at least 6 feet apart			X
Single Service/Single Use items used	X

Notes: Drive through only at this time. Masks are available, but are not required to be worn. A thermometer has been ordered to screen employees when they arrive to work, but it has not arrived yet.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks		X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted		X
COVID-19 educational signs posted		X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart	X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table	X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used	X

Notes: No self-service option available. Individual cups of toppings available for customers. Practicing good social distancing with tables/chairs.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks	X
Employees wearing gloves	X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted		X
COVID-19 educational signs posted		X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart	X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons		X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table	X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used	X

Notes: Practicing good social distancing with tables/chairs & customers.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks		X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted		X
COVID-19 educational signs posted		X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart	X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons		X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table	X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used	X

Notes: Paper menus (disposable) used. Silverware not put on table until customer orders. Glasses are disinfected before being sent to kitchen for washing. Strict 6 foot social distance between customers & tables/chairs enforced.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks		X
Employees wearing gloves		X
Customers/Patrons wearing masks	X
Social distancing requirement signs posted		X
COVID-19 educational signs posted		X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart	X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons		X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table	X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used	X

Notes: One table and chair inside of business. Hand sanitizer is available for employee use.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks		X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted		X
COVID-19 educational signs posted		X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart	X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table	X
Customer/Patron waiting turn outdoors or in automobile		X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used	X

Notes: Business is practicing good social distancing. Tables/chairs are 6 feet apart. Hand sanitizer is available to patrons and employees.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks		X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted		X
COVID-19 educational signs posted		X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart		X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table	X
Customer/Patron waiting turn outdoors or in automobile		X
Customer/Patron waiting indoors at least 6 feet apart		X
Single Service/Single Use items used	X

Notes: Second complaint received on 05/07/2020 regarding social distancing not being met. Owner will either cover up table and chairs or remove them so that 6 feet spacing is achieved. If any more public complaints are received & verified dine-in option will be removed & only carry out or delivery will be available. Tables/chairs have been spaced to at least 6 feet.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks		X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted		X
COVID-19 educational signs posted		X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart	X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons		X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table	X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used		X

Notes: Spacing of tables/chairs were excellent. High touch areas were cleaned/disinfected in between patrons.

May 07, 2020

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily	X
Employees wearing masks		X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart	X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used	X

Notes: COVID-19 information/education signs posted throughout facility. Facility is practicing good social distancing & cleaning/disinfecting is conducted routinely.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily	X
Employees wearing masks		X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted		X
COVID-19 educational signs posted		X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit	X
Tables/chairs and equipment at least 6 feet apart			X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used			X

Notes: Business is really maintaining & monitoring maximum occupancy limit well.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks		X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted		X
COVID-19 educational signs posted		X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart	X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table	X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used	X

Notes: Business is practicing good social distancing with table/chairs/patrons.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks		X
Employees wearing gloves	X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted		X
COVID-19 educational signs posted		X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart			X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons		X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used	X

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily	X
Employees wearing masks		X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted		X
COVID-19 educational signs posted		X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart	X
Hand sanitizer (60% alcohol) available for employees		X
Hand sanitizer (60% alcohol) available for customers/patrons		X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table	X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used	X

Notes: Business is doing an excellent job at spacing tables & chairs to at least 6 feet.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks		X
Employees wearing gloves	X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted		X
COVID-19 educational signs posted		X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart		X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons		X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used	X

Notes: Told owner importance of screening for COVID-19 signs/symptoms daily, chairs being at least 6 feet apart, social distancing, and cleaning/disinfecting high touch areas routinely.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily	X
Employees wearing masks	X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted		X
COVID-19 educational signs posted		X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart	X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile	X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used			X

Notes: Owner stated that no more than 10 people allowed in business at same time including employees.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks		X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted		X
COVID-19 educational signs posted		X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart		X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table	X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used	X

Notes: Indoor tables & chairs are 6 feet apart. Outdoor tables & chairs are not at least 6 feet apart. No social distancing or COVID-19 educational signs posted in business.

May 06, 2020

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks	X
Employees wearing gloves	X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart			X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons		X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile		X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used	X

Notes: Sanitizer at time of inspection 200ppm Quaternary Ammonium and changed at least every 2 hours. Hand-washing signs posted. Social distancing signs posted on front door, fountain machine, and deli display counter. Social distancing marks are on floor to show customers where to stand when waiting in line. High touch surfaces (including gas pumps) done every 2 hours.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily	X
Employees wearing masks		X
Employees wearing gloves	X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart	X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table	X
Customer/Patron waiting turn outdoors or in automobile		X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used		X

Notes: Tables are separated every 6 feet. Tables that are closer than 6 feet are marked off with tape to not be used. Hand sanitizer stations are placed at the entrance and both sides of the buffet for customers to use. Hand sanitizer is at the front desk for employees to use. Social distancing signage is posted on the front door and tape is placed on the floor to show customers where to stand and maintain social distance. Tables, chairs, menus, and all items on table are sanitized after each customer. Signs on buffet tell customers to sanitize hands before getting their food. Utensils are changed out every 30 minutes. Employees are required to wear gloves. They have masks ordered, but will be optional for employees to wear. Employees take temperatures to screen for illness at the start of each shift.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily	X
Employees wearing masks	X
Employees wearing gloves		X
Customers/Patrons wearing masks	X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit	X
Tables/chairs and equipment at least 6 feet apart	X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile	X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used			X

Notes: Chairs, equipment, utensils cleaned and sanitized between patrons. Hand sanitizer located at front desk for patrons and at each employee work station.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily	X
Employees wearing masks		X
Employees wearing gloves		X
Customers/Patrons wearing masks	X
Social distancing requirement signs posted	X
COVID-19 educational signs posted	X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit	X
Tables/chairs and equipment at least 6 feet apart			X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons		X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used			X

Notes: 25% of customers in store wearing masks. Masks & disposable gloves are available for employees to wear, but their use is voluntary.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily	X
Employees wearing masks	X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted	X
COVID-19 educational signs posted		X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit	X
Tables/chairs and equipment at least 6 feet apart	X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons		X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart	X
Single Service/Single Use items used	X

Notes: Cleaning/disinfecting high touch areas conducted every 2 hours. COVID-19 daily cleaning chart was given by corporate for employees to follow.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks		X
Employees wearing gloves		X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted		X
COVID-19 educational signs posted		X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart		X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons	X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table	X
Customer/Patron waiting turn outdoors or in automobile		X
Customer/Patron waiting indoors at least 6 feet apart		X
Single Service/Single Use items used	X

Notes: Recommended employee screening for symptoms daily, wearing masks, glove use, social distancing for customers, 6 foot distance between tables and chairs. Customers waiting outdoors or stay 6 feet apart, educational signs, & social distancing signs.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks	X
Employees wearing gloves	X
Customers/Patrons wearing masks	X
Social distancing requirement signs posted		X
COVID-19 educational signs posted		X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit	X
Tables/chairs and equipment at least 6 feet apart	X
Hand sanitizer (60% alcohol) available for employees	X
Hand sanitizer (60% alcohol) available for customers/patrons		X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table			X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart		X
Single Service/Single Use items used	X

Notes: Employee use of masks is voluntary. Hand sanitizer available to employees, but not customers/patrons.

Observations	Yes	No	N/A
Employees Screened for COVID-19 sign/symptoms daily		X
Employees wearing masks		X
Employees wearing gloves	X
Customers/Patrons wearing masks		X
Social distancing requirement signs posted		X
COVID-19 educational signs posted		X
Cleaning/disinfecting done routinely	X
Retail sales facility monitoring maximum occupancy limit			X
Tables/chairs and equipment at least 6 feet apart		X
Hand sanitizer (60% alcohol) available for employees		X
Hand sanitizer (60% alcohol) available for customers/patrons		X
Employees washing hands or using sanitizer between customers/patrons	X
No more than 10 people per table	X
Customer/Patron waiting turn outdoors or in automobile			X
Customer/Patron waiting indoors at least 6 feet apart			X
Single Service/Single Use items used	X

Notes: Gloves are being worn whenever ready-to-eat foods are handled. Has not been busy enough for customers to wait for a table.