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Checklist template, with five checklists already filled in

A checklist is a short list of things to confirm, in a fixed order, with a space to record each one. It is for tasks where missing one step costs more than the minute it takes to read the list. A good one fits on one page, has 8 to 15 items, phrases each item as something you can confirm ("walk-in at 38°F", not "check walk-in"), says what to do when an item fails, and is signed by the person who did it. The template below has that layout. The five checklists after it are filled in and in use on real sites; change the limits and the names to match your site.

What is in the template

One page. The parts, and why each is there:

PartWhat goes in itWhy
TitleThe task and the place: "Line 2 start-up", "Walk-in and reach-ins, opening"People pick the sheet by its title. "Daily checklist" gets the wrong one used.
HeaderDate, shift or time, location, name of the person doing itA checklist with no name is nobody's record.
When and how long"Before the first order"; "5 minutes"Tells the person when it fits and tells the manager when it was skipped.
ItemsOne line per thing to confirm, in the order you would walk itThe order is the route. If the sheet jumps around, the person jumps around and misses one.
Record columnA tick, a number, or N/A; the item says whichA number (38°F, 320 ppm, 4,112 hours) cannot be pencil-whipped the way a tick can.
If-not-OK columnWhat to do when the item fails: fix, tag out, report, stopA failed item with no instruction gets ticked anyway. This column is the reason to have a checklist at all.
Sign-offSignature, time finished; a second line for whoever checks itA signature is the difference between a reminder and a record.
RetentionHow long the completed sheet is kept and whereWritten on the form so the pile in the office has a reason to exist.

Two kinds of checklist

Atul Gawande's distinction in The Checklist Manifesto, borrowed from aviation, is the one that matters when you design one. A read-do list is read aloud and followed item by item, like a recipe: the hotel room inspection and the fire walk below are read-do, because the order is the route. A do-confirm list is used after the task, from memory, to confirm nothing was missed: the opening checklist and the forklift check are do-confirm, because an experienced person does the job from habit and the sheet catches the one thing habit skipped. Decide which yours is, and say so at the top; a do-confirm list used as read-do takes twice as long and a read-do list used as do-confirm misses steps.

Five checklists, filled in

All five are in the download, each on its own page, with the blank. They are written for a real site, so some limits will be wrong for yours. Change them; do not delete the column.

  1. Restaurant opening checklist
  2. Forklift pre-use inspection
  3. Hotel room inspection
  4. New-hire first-day checklist
  5. Weekly fire safety walk

Restaurant opening checklist

WhenEvery morning, before the first order. 20 minutes.
WhoOpening cook; manager on duty initials at the end
TypeDo-confirm
#ConfirmRecordIf not OK
1Walk-in and every reach-in: temperature read from the unit's thermometer, not the dialWrite the °FAbove 41°F: move TCS food to a working unit, note the time, call the technician
2Freezer holding frozen; no thaw-and-refreeze signs (ice crystals, misshapen packs)Write the °FTag suspect product, manager decides
3Hot-holding units switched on and at 135°F before any food goes inWrite the °FDo not load until at temperature
4Handwash sinks: soap, paper towels, bin, water reaches 100°F, nothing stored in the sinkTick each sinkRestock before service; an unstocked sink is the first thing the inspector photographs
5Sanitiser buckets made up and tested with the strip: chlorine 50–100 ppm or quat 200–400 ppm (per label)Write the ppmRemake and retest
6Dish machine: final rinse at 180°F (high-temp) or sanitiser strip in range (low-temp)Write the °F or ppmHand-wash three-sink method until fixed; call the technician
7Date labels: nothing past its day-7 (or your limit) in any fridge; FIFO order on the shelvesTickDiscard and record on the waste log
8Thawing: only in the fridge, under running cold water, or as part of cooking. Nothing on the counterTickMove it; note who put it there
9Allergen matrix on the pass is the current version; special-order board cleanTickReplace with the current copy from the manager
10Pest check: traps, under the dish machine, dry store floor, back door sealTickRecord on the pest log; call the contractor if there is activity
11Back door locked, deliveries not yet at the door, bin area cleanTick
12Float counted and matches the sheet; till logged inWrite the amountCount again with the manager

Sign-off. Opening cook signs; manager initials after a walk-through. Kept 90 days with the temperature logs.

Forklift pre-use inspection

WhenStart of every shift, every truck, before the first lift. Five minutes.
WhoThe operator who will drive it
TypeDo-confirm; truck stays parked until the sheet is complete
#ConfirmRecordIf not OK
1Hour meter readingWrite the number
2Tyres and wheels: cuts, chunks missing, bolts tight; pneumatic tyres at the pressure on the plateTickTag out
3Forks: no cracks at the heel, no bends, tips level with each other, locking pins in placeTickTag out. A cracked fork heel is a dropped load
4Mast, chains, hoses: no kinks, no frayed strands, no leaks; chain tension evenTickTag out
5Hydraulic oil, engine oil, coolant, fuel or battery charge; LPG cylinder seated and strap tight, no smell of gasTickTag out if any leak or smell
6Overhead guard and load backrest: no cracks, no bent members, no missing boltsTickTag out
7Data plate present and legible; attachment listed on the plate if fittedTickTag out
8Engine or motor started: horn, lights, reverse alarm, hour meter, warning lights offTickTag out
9Service brake, parking brake, steering (both directions), lift, tilt, side-shift tested with no loadTickTag out
10Seat belt latches and retracts; seat switch stops the truck when you lift off the seatTickTag out
11Any fault found, or the word "none", in wordsWrite itTag out and report; never drive a tagged truck

Sign-off. Operator signs. Supervisor spot-checks the sheet against the truck weekly. Kept 12 months (OSHA 1910.178(q)(7) requires the inspection; keeping the record is how you show it happened).

Hotel room inspection

WhenEvery checkout room, after the attendant marks it clean and before it is released to the desk. Five minutes.
WhoFloor supervisor
TypeRead-do; the supervisor walks the room in the order on the sheet
#ConfirmRecordIf not OK
1Door: lock, latch, peephole, DND sign and fire-escape card presentTickMaintenance slip
2Lights: every lamp and switch works, including the bathroom and wardrobeTickMaintenance slip; room not released if the bathroom light is out
3Bed: linen fresh, no hair or marks, corners tight, pillows to standard, nothing under the bedTickBack to the attendant
4Surfaces: desk, headboard, lamps, skirting, window sill, top of the wardrobe: wiped, no dust lineTickBack to the attendant
5Remote and phone: cleaned, working, phone displays the room numberTickBack to the attendant / maintenance
6Bathroom: toilet clean inside, outside and behind; basin and plug; shower screen no streaks; grout; no hair anywhereTickBack to the attendant
7Amenities at par; towels folded to standard; toilet roll folded; bin liner freshTickBack to the attendant
8Minibar restocked and logged; kettle and tray clean; glassware polishedTickBack to the attendant
9Safe open and empty; wardrobe drawers empty; hangers to countTickLost property if anything found
10Air conditioning set to the standard temperature; curtains to standard; no odour; window closedTickMaintenance slip for AC
11Carpet vacuumed into the corners and under the deskTickBack to the attendant

Sign-off. Supervisor initials the room on the floor sheet and changes the status. Items sent back to the attendant are counted: three in a week is a retraining conversation, not a disciplinary one.

New-hire first-day checklist

WhenDay one, before the new person does any work. One hour.
WhoSupervisor or trainer; HR for the paperwork lines
TypeDo-confirm; kept in the personnel file
#ConfirmRecordIf not OK
1Right-to-work documents checked and recorded (US: Form I-9 section 2 within 3 business days of the start; UK: right-to-work check before the start)Date and initialsThe person does not start until this is done
2Tax and payroll forms completed; bank details taken on the company form, not by textDate and initials
3Emergency contact and any medical condition the person wants the first-aider to knowDate and initials
4Site induction walked, not told: fire exits, assembly point, nearest extinguisher, first-aid kit, AED, where to report a near missTick each itemNot finished until every item is walked
5PPE issued, sized and signed for: list each itemWrite the itemsNobody works on the floor in the wrong size
6Hazards of this job explained from the risk assessment; the three rules that get people hurt here named out loudTick
7Chemicals used in this job: labels and where the SDS is, shown at the shelfTick
8Buddy assigned by name for the first week; shift pattern and break times written downWrite the name
9Logins created and tested: time clock, scanner or till, LMSTick
10First SOP video watched in the person's language and the quiz passed; printed training sheet signedScore and dateWatch again with the trainer
11Questions asked: "What are you unsure about?" Answer written downWrite it

Sign-off. New hire and supervisor both sign. HR files it. The same sheet is reviewed at the end of week one.

Weekly fire safety walk

WhenSame day each week, whole building. 20 to 40 minutes.
WhoFire warden or facilities
TypeRead-do, in a fixed route so nothing is skipped
#ConfirmRecordIf not OK
1Every exit route clear from the furthest point to outside: nothing stored in corridors, stairwells or outside the final doorTick per routeMove it now; name who put it there on the sheet
2Every exit door opens freely from inside without a key, closes and latches; no chains, no wedgesTick per doorReport the same day. A locked exit is an immediate stop
3Exit signs lit; emergency lights test button pressed and the lamp comes on (monthly function test; log it)TickReport; replace battery or fitting
4Extinguishers: in place, visible, pin and tamper seal intact, gauge in the green, nothing in front of them, monthly tag initialled (NFPA 10 monthly check)Tick per unitReplace from spares; book service
5Fire doors: close fully on their own, intumescent strips intact, no holes or wedgesTickMaintenance
6Alarm panel: no fault or isolation lights; weekly call-point test done and logged (UK) or per your inspection scheduleTickCall the alarm contractor
7Sprinkler heads: nothing stored within 18 in (450 mm) below them; control valves open and lockedTickMove stock
8Electrical panels: 36 in (900 mm) clear in front; no damaged leads; no extension leads daisy-chainedTickClear it; report leads
9Flammables in the cabinet, cabinet closed; waste bins emptied, nothing against the external wall near the binsTickMove it
10Assembly point sign in place; the evacuation plan on the wall is the current versionTickReplace

Sign-off. Warden signs. Open items are listed with an owner and a date and carried to next week's sheet until closed. Kept with the fire log book; in the UK this is evidence under the Fire Safety Order 2005.

Checklist, SOP, form, log

DocumentQuestion it answersExample
SOPHow is this task done, and why that way?Opening the kitchen, step by step, with the reasons for the order
ChecklistWas each part of it done? (ticks and values, signed)Opening checklist
LogWhat was the value, over time?Temperature log, hour-meter log
FormWhat happened, this once? (free text)Incident report, maintenance slip

The usual mistake is one document trying to be all four. A checklist with explanations in it is an SOP nobody can tick; an SOP with tick boxes is a checklist nobody can read. Keep them separate and cross-reference by number. The SOP template is the matching document for the how.

Where checklists go wrong

Ticks in one pen, all at once

Twelve ticks in the same ink, in a straight column, at 6:02 am, is a checklist filled in before the walk. Inspectors and auditors recognise it instantly and treat the whole sheet as missing. The design fix is to make some items values rather than ticks (a temperature, a reading, a count, a word) so the sheet cannot be completed from a chair. The management fix is to spot-check one item against reality each week and say so.

Items that are tasks, not checks

"Check the fridge" can be ticked without opening the door. "Walk-in at ___°F (limit 41)" cannot. Write every item as the state you want to confirm, with the number, and the tick means something.

Too long to read

A 40-item sheet is read for the first week and ticked from the second. If the list has to be long, split it by stage, by area, or into a read-do core of ten items and a monthly longer version.

No instruction for a failure

The item fails, the person does not know what to do, so they tick it and mention it to someone later, maybe. The if-not-OK column exists so that "tag out", "do not load until at temperature", "call the contractor today" is on the sheet in front of them at the moment it matters.

Nobody reads the completed sheets

If the sheets go in a drawer and nobody looks, the team learns within a month that the checklist does not matter. One person reads them every week and asks one question about one line. Nothing more is needed.

The order on the sheet is not the order on the floor

Items listed by category ("all fridges", "all sinks") send the person back and forth across the kitchen. Lay the sheet out as the route you would actually walk, and the sheet becomes the route.

Paper or screen

Paper works where hands are wet, gloved or cold and where the record is read by a visiting inspector. A screen works where values need to feed a log or trigger a message when they are out of range. Most sites run both: paper on the floor, with the values typed in once a day, or a tablet app with the paper version in a drawer for the day the Wi-Fi goes. Either way the design rules above do not change. A bad checklist is just as bad in an app.

Getting the walk right

The checklist records the walk; it does not teach it. The forklift check, the opening routine, the room inspection: each is a two-minute physical sequence that is easiest to learn by watching someone do it in order. A short video of your walk, in the languages your team speaks, shown on day one, is what makes the sheet the same from every person's hand. The forklift safety talk, the food safety talk and the fire extinguisher talk cover three of the five checklists above.

Questions

Should I use the Word or the Excel version?

Word if it will be printed and filled in by hand, which is most floor checklists. Excel if someone will type into it, or if you want the recorded values (temperatures, ppm, hour-meter readings) to feed a log. Both have the same five examples and the blank.

How many items should a checklist have?

Enough that nothing important is missing and few enough that people read every line. Eight to fifteen is the range that works on a floor. The WHO surgical safety checklist has 19 items in three pauses; airline normal checklists are usually shorter than that. Beyond 20, split it by stage (opening / mid-shift / closing) or by area.

Does a checklist need to be signed?

If it is a record (a temperature log, a pre-use inspection, an induction), yes, by the person who did it, with the date and time. A signature is what turns a tick into evidence, and what makes the person think before ticking. A reminder list for yourself needs no signature.

How long do we keep completed checklists?

Long enough to answer the question that will be asked. Food temperature logs: 90 days is common; some health departments ask for longer. Forklift inspections: 12 months. Fire safety records: the life of the building or the regulator's period. Induction checklists: the whole employment plus a few years. Write the period on the form.

What is the difference between a checklist and an SOP?

The SOP explains how to do the task: the steps, the warnings, the why. The checklist confirms the task was done: the items, the result, the signature. One SOP often produces one checklist. If your checklist is trying to teach the task, it is too long; move the explanation to the SOP and leave the checklist as the record.

Can I make a checklist a video?

The checklist stays on paper or a screen, because it is the record. What works as a video is the walk-through behind it: the opening routine, the forklift check, the room inspection, shown once in the worker's language so every person does the same walk in the same order. Send us the checklist and we will make the walk-through.

Sources

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