Newrest Health and Safety Survey 2022: Cold Food Production
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First Name
Last Name
Date
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Month
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Day
Year
Date
Seniority Date
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Month
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Hourly Wage:
Job Title:
Department:
Warehouse & Receiving
Cold Food Production
Equipment & Sanitation (ENS)
Transportation
Other
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General Safety Questions
Have you received any safety training from Newrest?
Yes
No
I don't know
If Yes, what types of safety training have you received from Newrest ? (Click all that apply)
In-person
Recorded videos
Newrest safety manual
Other printed material (brochures/pamphlets)
Posters on wall
Newrest Standard Operating Procedures (SOP)
Other
Have you seen any Newrest safety rules written down?
Yes
No
N/A
If Yes, in what forms have you seen Newrest safety rules written down? (Click all that apply)
Posters on wall
Newrest safety manual
Newrest Standard Operating Procedures (SOP)
Other
In the last month, have you been required to do something at work that violated the safety training you’ve received from Newrest?
Yes
No
If Yes, how often?
Once
2-10 times
10-20 times
20+ times
Other
If yes, what were you required to do at work that violated the safety training you received from Newrest?
Have you ever been disciplined for violating any safety rules?
Yes
No
If yes, which rule(s) were you disciplined for violating?
In the last month, were you able to follow all sanitation and food safety rules and procedures?
Yes, I was able to follow all rules
No, I was not able to follow all rules
If No, what sanitation or food safety rules or procedures were you not able to follow?
If No, what prevented you from following all sanitation and food safety rules and procedures? (Click all that apply)
Lack of proper equipment
Lack of training
Pressure to complete work on time
Lack of staff
Instructions from managers, supervisors or leads to skip certain rules or procedures
Other
Since November 2021, have you raised a safety concern to a supervisor or manager?
Yes
No
If Yes, what safety concern have you raised?
If Yes, did Newrest respond effectively to your safety concern?
Yes
No
I don't know
Since November 2021, have you seen the following at work? (Click all that apply)
Standing water on floors
Dirty modules being used to store passenger meals
Evidence of rodents, insects, birds
Mold or fungus on work surfaces, floors or walls
Mud or dirt on floors
Grime or filth on work surfaces
Leaks from ceiling
Garbage on the floor
Do you think enough employees are scheduled to work with you?
Yes
No
Since November 3, 2021, how many times have you come to work when you were sick?
Never
1 time
2 times
3 times
4 times
5 or more times
If you have come into work sick since November 3, 2021, what best describes the reason why? (Click all that apply)
I did not want to miss the chance to earn wages
I was worried about being disciplined
I was not so sick that I could not work
Other
Since November 3, 2021, have you been injured at work?
Yes
No
If Yes, did you report your injury to Newrest?
Yes
No
Other
Did your injury cause you to miss days of work?
Yes
No
Since November 3, 2021, have you or anyone in your household been injured or sick and needed to see a doctor, but couldn't afford to go?
Yes
No
Other
Do you earn enough from your job at Newrest to cover your housing, food and gas?
Yes
No
Other
Have you ever had to skip lunch at Newrest because you had too much work to complete?
Yes
No
If Yes, how often?
Once
2-10 times
10-20 times
20 or more times
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COVID-19 Safety Questions
Have you received any of the following types of training on COVID-19 safety from Newrest? (Click all that apply)
In-person
Recorded videos
Printed materials (pamphlets/brochures)
I received no training
Other
Has a Newrest manager ever asked you any COVID-19 screening questions before coming into work?
Yes
No
If Yes, how often?
Has there been a confirmed COVID-19 case in your workplace since November 3, 2021?
Yes
No
I don't know
If Yes, do you believe Newrest took adequate steps to address this issue?
Yes
No
Please describe what steps Newrest took that you are aware of:
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Cold Food Production
In the last 3 months, have you worked in standing water?
Yes
No
N/A
If Yes, how often?
Once
2-10 times
10-20 times
20+ times
In the last 3 months, have you seen floor drains backed up and overflowing with water?
Yes
No
N/A
If Yes, how often?
Once
2-10 times
10-20 times
20+ times
In the last 3 months, has your work area been dirty (e.g. unclean floors, dirty work surfaces, etc.)?
Yes
No
N/A
If Yes, how often?
Once
2-10 times
10-20 times
20+ times
In the last 3 months, have you seen food products in contact with surfaces that have not been washed, rinsed and sanitized first?
Yes
No
N/A
If Yes, how often?
Once
2-10 times
10-20 times
20+ times
In the last 3 months, did you see cross-contamination occur due to a lack of sanitized or clean equipment? For example, utensils touching raw foods or allergens then touching other types of foods without being sanitized in between.
Yes
No
N/A
If Yes, how often?
Once
2-10 times
10-20 times
20+ times
In the last 3 months, did you leave the sanitized cold room and enter the dish room or trash room to get equipment necessary for your job?
Yes
No
N/A
If Yes, how often?
Once
2-10 times
10-20 times
20+ times
In the last 3 months, did you see food products used past their expiration date?
Yes
No
N/A
If Yes, how often?
Once
2-10 times
10-20 times
20+ times
In the past month, while working in the cold room, have you experienced any of the following symptoms: (Click all that apply)
Muscle pain
Joint pain
Respiratory problems
Overheating
Pain in fingers
Numbness or tingling
Headache
Other
In the last 3 months, have you pushed more than one module at a time?
Yes
No
N/A
If Yes, how often?
Once
2-10 times
10-20 times
20+ times
Is there anything about your job that you would like to change to make it safer?
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