ATTACHMENT B4b - Site Visit Checklists

OMB NUMBER: 0584-XXXX

EXPIRATION DATE: XX-XX-20XX

ATTACHMENT B4b: SITE VISIT CHECKLISTS

OBSERVATION CHECKLISTS

FDPIR Warehouses

Date of Site Visit
Site Location (reservation/tribal area/county/city, state)
Name(s) of Researchers

Key Contacts
Name	Title	Phone	Interview (Y/N)

Location (address, distance to Distribution Site(s))
Schedule of operation (days, hours)
Storage capacity (square footage of storage space)	Regular
	Refrigerated
	Freezer
Inventory management system
Schedule of food receipt
Observations on food ordering process

FDPIR Distribution Sites

Date of Site Visit
Site Location (reservation/tribal area/county/city, state)
Name(s) of Researchers

Key Contacts
Name	Title	Phone	Interview (Y/N)

Locations (addresses)		Centralized
		Decentralized (number of sites)
Schedule of operation (days, hours)
Storage capacity	Regular
	Refrigerated
	Freezer
Transportation resources
Delivery capacity	Number and type of vehicles
	Regular
	Refrigerated
	Freezer
Inventory management system
Client Accommodations
Loading Area
Parking
Waiting Area
Children’s Area
Assistance (loading or carrying packages)
Separate area for conducting nutrition education
Related services	What (food demonstrations, nutrition information, well-being seminars, etc.)
	When
	Where
	Frequency

FDPIR Certification Office/Site

Date of Site Visit
Site Location (reservation/tribal area/county/city, state)
Name(s) of Researchers

Key Contacts
Name	Title	Phone	Interview (Y/N)

Location (address, at warehouse &/or distribution site, distance to warehouse/ distribution site)
Collocation with other programs
Distance to residential and business area densities
Schedule of operation (days, hours)
Signage related to program participation
Information about other food-support programs
Facility e.g., sufficient space, waiting area, private space for eligibility interview

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