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
1 | P a g e
Reviewer Initials_______ Approval Date__________ 


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