Standard Operating Procedure [sop] Worksheet printable pdf download

Standard Operating Procedure [sop] Worksheet

STANDARD OPERATING PROCEDURE [SOP] WORKSHEET

Facility Name:

Instructions: Answer all questions. Use additional pages if needed. If a question does

not apply, mark the section as “N/A”.

1. Personal Hygiene

A. Complete the following – Initial to verify agreement to comply:

Employees will report to work clean and in clean clothes:

Employees will use proper hair restraints (describe restraint used.)

Employees will not eat in the food areas.

Employees will drink only from covered cups with a straw, or equivalent, in the

food area.

Employees will cover all cuts with waterproof bandages.

Employees will cover cuts on hands with a bandage and a proper glove.

Employees will not wear nail polish/artificial nails or will cover the nails with

gloves. Nails will be kept trimmed and clean.

Employees will not wear hand/wrist jewelry, with the exception of a plain

wedding band.

Soap, paper towels, waste receptacle and a reminder notice will be provided

at each hand washing location

B. Hand Washing: Indicate how employees will wash their hands, and when:

C. Employee Health: Describe the method of complying with the below requirements.

(Note: Guidance documents, including posters and forms, are available from the local

licensing agency.)

Employee health information collection,

such as using FDA-provided forms or

equivalent:

1 | P a g e

Reviewer Initials_______ Approval Date__________

Standard Operating Procedure [sop] Worksheet