Version 3.4.1: C.A.F.E. Practices

Opening Meeting – Checklist
Introduction
Confidentiality statement
Inspection plan
Role of guides & observers
Cannot give recommendations
Photography authorization Starbucks Coffee Company
Documents for review
Worker interviews
Review farm map
C.A.F.E. Practices Version 3.4.1
Questions
Field Notes for Medium/Large Farms
Applicant Information
Closing Meeting – Checklist Application number (ID):
Entity name:
Confidentiality statement
Cannot give recommendations Entity code:
Initial findings explained Male
Gender:
ZT‐NCs reported Contact person: Female
Documents not available noted
Age of farm owner:
Last opportunity to present additional evidence
Next steps & reporting Address:
Questions
Email:
Telephone:
GPS Latitude: _____° _____’_____” (N) (S) Note: If farm has

multiple plots, enter
GPS data on next
GPS Longitude: _____° _____’_____” (E) (W) page.
Entity supported the costs Yes, paid directly for the cost
of the verification? Yes, paid indirectly for the cost (e.g., deductions from
sales of coffee; logistical support)
No
Verifier Information
Name of verification
organization:
Inspector(s) for this
inspection:
Date(s) of inspection:
Person responsible for
reviewing the report:
Date(s) of previous
Field Notes for 52 V3.4.1 verification(s) of this entity:
Medium/Large Farms October 2017
Inspected during harvest? Yes No
Farm Information
Farm consists of multiple plots? Yes No If so, number of plots: _______
Name of Size
GPS (if inspected) Inspected?
Plot (ha)
__ _° _ __’_ __” (N) (S) _ _° __ _’_ _ _” (E) (W) Yes No
__ _° _ __’_ __” (N) (S) _ _° __ _’_ _ _” (E) (W) Yes No
__ _° _ __’_ __” (N) (S) _ _° __ _’_ _ _” (E) (W) Yes No
__ _° _ __’_ __” (N) (S) __° __ _’_ _ _” (E) (W) Yes No
Total hectares (including Total hectares of coffee

all plots): production:
Conservation area Number of water

hectares: bodies:
Average distance Average distance
between coffee trees between rows
(meters): (meters):
Total annual
production volume 2 years prior to 1 year prior to Most recent
(Kg) based on most recent most recent completed
inspection: completed harvest completed harvest harvest*
Crop year
(e.g., 2013/2014) _________ _________ _________
Not Available Not Available *required field

Cherry:
Parchment:
Green:
Note: Annual production volume should represent the actual volume of the most recent
completed harvest.
If “Not Available” selected above, please include an explanation for why the information was
missing (e.g., new entity, data unreliable etc.):
__________________________________________________________________________
Field Notes for 2 V3.4.1 Field Notes for 51 V3.4.1

Medium/Large Farms October 2017 Medium/Large Farms October 2017
Name: Age:
Flows:
 Permanent Hours per day: Payment period: Farm sells directly to mill/warehouse Name of collector
___________
 Temporary coffee: to collector(s) (if applicable):
Pay per day: Overtime? Overtime Pay? Total Pay per Day:
  Note: Farm must send at least a portion of
Farm sends coffee outside of
Yes its coffee to an entity listed in the C.A.F.E.
Comments: C.A.F.E. Practices supply
No Practices application in order to be
chain?
considered as part of the supply chain.
Name(s) of mill(s) or
warehouse(s) where
coffee is sent:
Number of kilograms (green
coffee) sent to each entity:
Workers:
Entity uses labor intermediaries? Yes No
Name: Age:
External subcontracting agency
 Permanent Hours per day: Payment period: Type of intermediary Informal worker group leader/agent
 Temporary (if applicable):
Other:_______________________
 
Number of
Comments: Number of workers Number of
Total
Worker Type workers hired contracted workers
Number directly by entity through labor living onsite
intermediaries
Permanent workers:
Temporary/seasonal
workers:
Number of children
Name: Age: living on site:
________
 Permanent Hours per day: Payment period:
 Temporary Number of children of Number of children of
Pay per day: Overtime? Overtime Pay? Total Pay per Day: primary school age: secondary school age:
________ ________
 
Comments:

Name: Age:
Pest and Disease Information. Are any of the following present?  Permanent Hours per day: Payment period:
Rust? Yes No Rust incidence (if present):
lower than 10%  Temporary
higher than 10%
lower than 2%
 
Coffee Berry Borer? Yes No CBB infestation (if present): higher than 2% Comments:
Other? Yes No % of farm (if present): ______
If other pest/disease, please specify: ____________________________________
Which coffee varieties are grown on the farm? Check all that apply:
Blue Mountain Geisha N39 Tabi

Bourbon Icatu Pacamara Tekisisc Name: Age:
Castillo Jackson Pacas Typica  Permanent Hours per day: Payment period:
Catimor Java Pache Colis Venecia  Temporary
Catuai Kent Ruiru 11 Villa Sarchi
 
Catuai 44 Lempira Sarchimor Villalobos Comments:
Caturra Maragogipe SL28 Other:
Colombia Mondo Novo SL34 ____________
Garnica Montecristo Sumatra
What other certifications does the farm have? Check all that apply:
4C Fair Trade Rainforest Alliance

AAA Organic UTZ
Other: _____________
Name: Age:
 Permanent Hours per day: Payment period:

 Temporary
 
Comments:

Worker Interviews Subject Area: Economic Accountability
Name: Age:
 Permanent Hours per day: Payment period: Criterion EA-IS1:

 Temporary Demonstration of Financial Transparency
  C/
Comments: Indicators NC/ Evidence/Justification
NA
Document required
EA-IS1.3
Name: Age:
Entity keeps receipts or invoices for the NC
coffee (cherry, parchment, green) it buys
 Permanent Hours per day: Payment period: or sells.
 Temporary
 
Comments:
NA
C
Receipts for:
coffee purchased
Name: Age:
coffee sold
 Permanent Hours per day: Payment period: EA-IS1.4
Presented documents indicate: date, Documents include:
 Temporary
names of buyer and seller, unit of dates
Pay per day: Overtime? Overtime Pay? Total Pay per Day: NC
measure (volume or weight), price per names of entities buying and selling
 
unit, quantity, type of coffee (cherry, units of measure
Comments: parchment or green). price per unit
quantity of coffee
type of coffee
all of the above
NA
Source of Evidence:
Documentation:____
Interview:____

Subject Area: Social Responsibility
Criterion SR-HP1:
Wages and Benefits
C/
Indicators NC/ Evidence/Justification
NA
SR-HP1.1 Document required
ZERO TOLERANCE: All permanent C
workers are paid the nationally or
regionally established minimum wage. If
minimum wages for permanent workers
have not been established, all permanent
workers are paid the local industry
NC
standard wage.
If workers are paid by production, wages
meet the nationally or regionally
established minimum wage, or, where
minimum wage has not been NA
established, the local industry standard
wage.
Low-High range of payments per hr/day/wk:
SR-HP1.10
EXTRA POINT: All permanent workers
are paid MORE than the nationally or C Lowest payment:________per________
regionally established minimum wage. If
minimum wages for permanent workers Highest payment:________per________
have not been established, all permanent
workers are paid MORE than the local National wage/industry standard:
industry standard wage. NC
If workers are paid by production, wages ________per________
are higher than the nationally or
regionally established minimum wage, Source of Evidence:
or, where minimum wage has not been
NA Documentation:____
wage. Interview:____

ZERO TOLERANCE: All temporary and
seasonal workers are paid the C
nationally or regionally established
minimum wage. If minimum wages for
temporary/seasonal workers have not
been established, all temporary/seasonal
workers are paid the local industry NC
standard wage.
If workers are paid by production, wages
meet the nationally or regionally
established minimum wage, or, where
minimum wage has not been NA
wage. (See next page for related indicator)

Document required
C
SR-HP1.11 Low-High range of payments per hr/day/wk:
EXTRA POINT: All temporary and
seasonal workers are paid MORE than
Lowest payment:________per________
the nationally or regionally established
minimum wage. If minimum wages for
temporary/seasonal workers have not Highest payment:________per________
been established, all temporary/seasonal
workers are paid MORE than the local NC Pay by Productivity? Yes No
industry standard wage.
If workers are paid by production, wages Payment per activity:_____per______
are higher than the nationally or
regionally established minimum wage, National wage/industry standard:
or, where minimum wage has not been
_______per________
wage.
NA
Source of Evidence:
Documentation:____
Interview:____
SR-HP1.4 Document required for SR-HP1.4

C
Management maintains complete written
earning records for at least the past year,
which itemize all: wages, overtime
worked, and deductions. NC
For warehouses and mills, hours AND

days worked must also be included in the NA
records.
SR-HP1.5
Workers have access to their earnings
NC
records, which itemize all wages,
overtime and deductions.
NA
Earnings records itemize:
wages
C overtime worked
deductions
SR-HP1.6
hours & days worked (for farms where
EXTRA POINT: Workers are given
NC piece-rate work is observed)
copies of earnings records, which itemize
all wages, overtime and deductions. Source of Evidence:
Documentation:____
NA
Interview:____

Document required
Criterion CG-CC1:
C Climate Change
C/
SR-HP1.3 NA
ZERO TOLERANCE: Wages are paid Document required
regularly to all workers in cash, cash
NC
equivalent (check, direct deposit), or Type of payment: cash check
through in-kind payments (e.g., food), if other:_______ C
legally permissible. Frequency of payment:
daily weekly
biweekly monthly CG-CC1.1
Source of Evidence: EXTRA POINT: The farm keeps written
NA NC
Documentation:____ records of climate change risks and
impacts on coffee production (e.g., Documentation includes:
Interview:____
change in temperature, rainfall). list of climate change risks
records of climate change impacts
Document required
Source of Evidence:
C
Interview:____
Document required
SR-HP1.7
Employer pays for any national, legally C
required benefits (social security, NC
vacation, disability) for permanent
workers. CG-CC1.2
EXTRA POINT: The farm has developed
and is implementing a written plan to NC
minimize impact of climate change on
NA Source of Evidence: coffee production.
Documentation:____ Source of Evidence:
Interview:____ Documentation:____
NA Interview:____
Document required Observation:____
C
SR-HP1.8
Employer pays for any national, legally
required benefits (social security, NC CG-CC1.3
vacation, disability) for temporary and EXTRA POINT: The farm is participating
seasonal workers. in a formal project to calculate and NC
reduce farm greenhouse gas emissions
over time.
Source of Evidence:
NA Source of Evidence: Documentation:____
Documentation:____ NA Interview:____
Interview:____ Observation:____

Criterion CG-EM3: Document required
Long Term Productivity

C
C/
NA SR-HP1.9
Overtime pay meets national
requirements. If workers are paid by
C production, overtime wages meet the
local/regional/national requirements. If Overtime worked? Yes No
overtime pay has not been established NC
CG-EM3.1 by law, overtime is calculated at 150% of Overtime wages :
The farm implements a coffee pruning regular pay. If workers are paid by ______per______
program to promote new tissue production, wages meet the above
NC requirements.
generation (intended to contribute to National requirement:
increased productivity and coffee _______per______
quality).
Source of Evidence: NA Source of Evidence:
Documentation:____ Documentation:____
NA
Interview:____ Interview:____
Observation:____
Document required
C
SR-HP1.12
C Where in-kind payments (e.g., food) are
legally permissible, in-kind payments are
agreed to by the employee and the NC
CG-EM3.2
employer, and itemized in writing by
EXTRA POINT: On farms older than 25 product, quantity, average price, and Source of Evidence:
years, the farm annually renovates or frequency of distribution. Documentation:____
replants at least 5% of the total coffee NC NA
planted area with coffee varieties Interview:____
that maintain or improve the coffee
quality profile. Document required
Source of Evidence: C
Documentation:____
NA SR-HP1.13
Interview:____
Time spent by workers in any required
Observation:____
trainings and meetings is considered NC
working time and workers are
compensated at their normal rate. Source of Evidence:
C Documentation:____
NA
Interview:____
CG-EM3.3
EXTRA POINT: Farm is developing or
working with a research institute to C
establish alternatives (e.g., new varieties,
NC
graft seedlings, etc.) to reduce nematode SR-HP1.14
infestations and the incidence of soil NC
Financial disciplinary penalties are not
fungus as well as reduce the use of
assessed against workers.
pesticides. Source of Evidence: Source of Evidence:
NA NA
Interview:____ Interview:____
Observation:____

Document required
C
C
SR-HP1.15
The use of continuous short-term
employment contracts or the practice of
terminating and then rehiring workers is NC CG-EM1.18
not permitted as a means to avoid legal Empty chemical containers are rinsed
obligations related to wages and and punctured, or as required by local NC
benefits. Source of Evidence: regulations, and appropriately disposed
Documentation:____ of to prevent further use or injury.
NA
Interview:____ Source of Evidence:
Documentation:____
NA Interview:____
C Observation:____
SR-HP1.16 Criterion CG-EM2:

Workers are not required to pay a Farm Management and Monitoring
NC
recruitment fee as a condition for
employment. C/
Source of Evidence: Indicators NC/ Evidence/Justification
NA Documentation:____ NA
Interview:____ Document required

C
ZERO TOLERANCE: Labor C
intermediaries are only used where
legally permissible. Legal status of the
intermediary can be demonstrated at the CG-EM2.1
time of inspection. All necessary NC Farm managers have developed and
documentation from the labor implemented a written C.A.F.E. Practices NC
intermediary is made available at the work plan AND improvement activities
Source of Evidence: are tracked and documented.
time of the inspection to support
evaluation of relevant Social NA Documentation:____
Source of Evidence:
Responsibility indicators. Interview:____
Documentation:____
NA Interview:____
Criterion SR-HP2: Observation:____
Freedom of Association/Collective Bargaining
Document required
C/
Indicators NC/ Evidence/Justification C
NA
C CG-EM2.2
Farm managers hold at least one annual Frequency of meetings:
SR-HP2.1 meeting with all permanent employees to NC ______meetings per year
Workers have either direct discuss C.A.F.E. Practices improvement
communication or a designated NC plans and activities. Date of last meeting:______
representative to communicate with Source of Evidence:
management or employer. Source of Evidence: Documentation:____
NA Documentation:____ NA Interview:____

C C
CG-EM1.13
SR-HP2.2
Pesticides (not including herbicides) are
NC Workers are able to talk about workplace NC
only applied as a last resort (after cultural Source of Evidence:
and physical controls have failed). Documentation:____ grievances with management or
employer with no fear of reprisal.
Interview:____
NA Observation:____ Source of Evidence:
Document required Interview:____
C Document required
Pesticide application records include:
CG-EM1.14
date product quantity C
Farm maintains records of pesticide
application specifying the date, product, product formulation location
NC Source of Evidence: SR-HP2.3
product formulation, quantity, and
location or area of the farm for each Documentation:____ Management policies recognize the
pesticide application. Interview:____ workers' rights to organize and/or
NC
Observation:____ collectively bargain as allowed by
NA
national laws and international
obligations.
Document required Source of Evidence:
C NA Documentation:____
Interview:____
CG-EM1.15
Farm maintains written records of total
NC Source of Evidence:
toxic load calculation for productive area C
on the farm. Documentation:____
Interview:____
NA Observation:____ SR-HP2.4
A workers' association or committee has
been formed and governed by the NC
employees, independent of management
C influence except where prohibited by law.
CG-EM1.16 Source of Evidence:
EXTRA POINT: Total toxic load is NA Documentation:____
decreased over time by reducing NC Interview:____
Source of Evidence:
pesticide use or selecting less toxic
Documentation:____
alternatives.
Interview:____
NA Observation:____ C
C SR-HP2.5
There are regular meetings between NC
CG-EM1.17 management and employees or worker's
representative to improve working
Spraying equipment is maintained in
NC conditions. Frequency of meetings:
good working order and cleaned in the
agrochemical storage or mixing areas Source of Evidence: _______meeting(s) per________
after use. Documentation:____ NA Source of Evidence:
Interview:____ Documentation:____
NA
Observation:____ Interview:____

Document required Document required
C
CG-EM1.8
C
Agrochemicals are mixed and spraying
equipment loaded in ventilated areas. If
products are mixed in the field, because NC Source of Evidence:
SR-HP2.6 of distance from storage, precautions are Documentation:____
EXTRA POINT: If a workers’ association taken and plans are in place to handle Interview:____
or committee exists, a workers' accidents, spills or contamination.
NC NA Observation:____
association fund has been established to
which management and workers
Document required
contribute matching funds.
C
CG-EM1.9
NA Farm has an Integrated Pest
Management (IPM) plan for monitoring NC
for pests and diseases and symptoms of
nematode infestation.
NA
C
C
CG-EM1.10
SR-HP2.7 There is a written Integrated Pest Plan for monitoring insect and disease
EXTRA POINT: If a workers’ association Management (IPM) plan that is properly problems? Yes No
fund has been established, workers have NC implemented in the field and includes NC Plan implemented? Yes No
access to association fund to finance regular monitoring for pests and Source of Evidence:
projects that improve living conditions for diseases and symptoms of nematode Documentation:____
workers and their families. Workers’ association exists? Yes No infestation. Interview:____
NA
Workers’ association fund? Yes No Observation:____
Equal access to fund? Yes No
NA Source of Evidence:
Documentation:____ C
Interview:____
CG-EM1.11
Document required Farm takes physical action to control NC
Source of Evidence:
sources of infestation.
C Documentation:____
Interview:____
NA Observation:____
SR-HP2.8
If allowed by law, and agricultural worker
organizations are established in the C
NC
coffee sector, a collective bargaining
agreement exists between employees CG-EM1.12
and employer. Pesticides (not including herbicides) are
applied only on a spot-application basis, NC
depending on the type and severity of Source of Evidence:
infestation. Documentation:____

Criterion SR-HP3:
C
Hours of Work
CG-EM1.3
C/
Agrochemicals are stored in a locked
place with controlled access and NC Indicators NC/ Evidence/Justification
separate from food products and living NA
and social areas. Document required
NA C
SR-HP3.1
C All workers do not work more regular
hours (before overtime) per day or week
than allowed by local law. If regular NC
CG-EM1.4
hours are not established, regular hours
Agrochemical storage site has NC
are considered as 8 hours per day, 48
adequate ventilation. hours per week.
NA NA
Agrochemical storage:
locked place
controlled access
C
separate from food and living areas Regular hours per day/week/month/year:
CG-EM1.6
adequately ventilated C
Agrochemical storage site has
safeguards to control spills ____hrs per____ for full-time workers
safeguards to control spills (e.g., physical
NC
barriers to prevent external SR-HP3.3
contamination). Source of Evidence: All workers must not work more total ____hrs per____ for temporary workers
Documentation:____ hours (including overtime) in one day or
NA Interview:____ week than allowed by local laws. If total NC Total hours per day/week/month/year:
Observation:____ hours have not been established by law,
workers do not work more than 60 hours ____hrs per____ for full-time workers
per week, except where a written
C agreement exists between workers and
____hrs per____ for temporary workers
management.
CG-EM1.5
Agrochemicals that are stored have NA Source of Evidence:
original manufacturer’s labels and are NC Documentation:____
Source of Evidence:
clearly organized and separated Interview:____
Documentation:____
according to toxicity and use.
Interview:____
Document required
NA Observation:____
C
Document required
C SR-HP3.2
All permanent workers must have, as a
minimum, the equivalent of one NC
CG-EM1.7
continuous 24 hour period off in each 7
There are contingency plans for handling NC Source of Evidence: day period, or longer if required by law,
pesticide spills and overexposure. Documentation:____ whichever is greater.
# of days off per 7 day period:____
Interview:____
Source of Evidence:
NA Observation:____ NA
Documentation:____
Interview:____

Document required
C C
SR-HP3.4 CG-CB3.10
If overtime work is required as part of the Multiple plant species that contribute to
job, such requirements are clear at the biodiversity have been planted where NC
time of hiring and recorded in writing and space allows within the farm (e.g.,
signed by the employee. borders, roads, trails, paths, etc.). Documentation:____
Source of Evidence:
Interview:____
Documentation:____ NA
NA Observation:____
Interview:____
C
C
SR-HP3.5 CG-CB3.11
Hours worked on potentially hazardous EXTRA POINT: A nursery has been
activities (e.g., pesticide exposure, very established or identified as a source of NC Source of Evidence:
heavy labor, etc.) are limited according to NC # of hours worked per day on potentially native tree and plant species for Documentation:____
the law. If hours have not established by hazardous activities:____ ecological restoration activities. Interview:____
law, the activities are limited to six hours Source of Evidence:
per day. NA Observation:____
Documentation:____
NA
Interview:____
Criterion CG-EM1:
Document required
C Ecological Pest and Disease Control
C/
SR-HP3.6 Indicators NC/ Evidence/Justification
Employer has a paid sick leave program NC NA
for all permanent workers.
Source of Evidence:
Documentation:____ C
NA
Interview:____
CG-EM1.1
Document required ZERO TOLERANCE: Farm does not use
pesticides that are listed by the World NC
C
SR-HP3.7 Health Organization as Type 1A or 1B, or
Employer has an annual leave (vacation) that are banned according to national, Source of Evidence:
program as required by law. If laws have regional, or local laws.
Documentation:____
not been established, annual leave for NC Interview:____
NA
permanent workers is a minimum of ten Observation:____
working days per year (prorated in cases Source of Evidence:
of less than one year of employment). Documentation:____ Document required
NA
Interview:____
C
Document required
C CG-EM1.2
SR-HP3.8 Farm keeps purchase records of Pesticide records specify:
If workers do not take annual leave pesticides, specifying date, product, date product price
NC
(vacation), employer can either allow product formulation, quantity, supplier, quantity supplier
NC and price of purchase for each
vacation time to accrue or can pay product formulation
wages for the equivalent amount of time pesticide. Source of Evidence:
accrued under the regular pay scale, Documentation:____
where permissible by law. Source of Evidence: NA Interview:____
NA Documentation:____ Observation:____
Interview:____

C
Criterion SR-HP4:
Child Labor/Non-Discrimination/Forced Labor
CG-CB3.4
Areas of high conservation value are C/
clearly defined, protected, and managed NC Indicators NC/ Evidence/Justification
to maintain their high conservation Source of Evidence: NA
values. Documentation:____
Interview:____
NA
Observation:____
C
Document required for CG-CB3.5
CG-CB3.5 C
EXTRA POINT: If areas of high SR-HP4.1
conservation value do not exist on the ZERO TOLERANCE: Employer does not
farm, managers have implemented a NC directly or indirectly employ any persons
plan to restore natural habitat or NC
who are under the age of 14 or the legal
conditions on a portion of the farm working age (ILO Conventions 10 and
(ecological restoration). NA
138).
Age of youngest worker:____
Source of Evidence:
CG-CB3.6 C Documentation:____
EXTRA POINT: If areas of high NA
Interview:____
conservation value exist on the farm,
Observation:____
they are protected from future NC Source of Evidence:
development through the declaration of Documentation:____
Document required
private reserves, conservation emphasis Interview:____
areas or legal conservation easements. NA Observation:____ C
C SR-HP4.2
CG-CB3.7 ZERO TOLERANCE: Employment of
At least 5% of the total farm area is set authorized minors follows all legal
NC requirements, including, but not limited Evidence of authorization:
aside as a conservation emphasis area NC
or as required by local law. to, work hours, wages, education, note from parents
working conditions, and does not conflict
NA verbal agreement
with or limit their access to education
(ILO Convention 10). other____
Source of Evidence:
C % of total farm area set aside as a Documentation:____
CG-CB3.8 NA
conservation emphasis area:____ Interview:____
EXTRA POINT: More than 10% of the Source of Evidence: Observation:____
total farm area is set aside as a NC Documentation:____
conservation emphasis area or as
Interview:____
required by local law.
SR-HP4.3
ZERO TOLERANCE: Employer enforces
a policy of prohibiting discrimination on
C
the basis of gender, race, ethnicity, age
CG-CB3.9 or religion (ILO Convention 111). NC
EXTRA POINT: If multiple areas of high
conservation value exist on the farm, NC Written policy required for large/medium
biological corridors are established to Source of Evidence: farms, mills, and warehouses with more Source of Evidence:
connect these conservation value areas. Documentation:____ than 5 employees.
Interview:____
NA Interview:____
Observation:____
Observation:____

Document required
SR-HP4.4 C C
ZERO TOLERANCE: Employer enforces
a policy that prohibits the use of forced, CG-CB2.4
bonded, indentured, convict or trafficked EXTRA POINT: A written wildlife
labor (ILO Conventions 29, 97, 105 and management plan is developed and
NC implemented on the farm (e.g., NC
143).
management and workers are trained, Wildlife management plan? Yes No
action steps are outlined, timeline to Plan implemented? Yes No
Written policy required for large/medium Source of Evidence:
completion, etc.). Source of Evidence:
farms, mills, and warehouses with more Documentation:____
Documentation:____
than 5 employees. NA Interview:____ NA Interview:____
Observation:____
Observation:____
Criterion CG-CB3:
C
Conservation Areas
C/
SR-HP4.5 Indicators NC/ Evidence/Justification
ZERO TOLERANCE: The workplace is NA
NC
free from physical, sexual, and verbal
harassment and abuse.
Source of Evidence: C
Documentation:____
NA Interview:____ CG-CB3.1
Observation:____ ZERO TOLERANCE: No conversion of NC
natural forest to agricultural production
since 2004. Source of Evidence:
Documentation:____
C
NA Interview:____
Observation:____
ZERO TOLERANCE: Workers do not CG-CB3.2
NC C
surrender their identity papers or other Farm has made an assessment of areas
original personal documents or pay of high conservation value (areas with
deposits as a condition of employment. significant intact forest, primary forest
Source of Evidence: canopy cover, rare flora and fauna NC
Documentation:____ communities, important habitat elements,
NA Interview:____ Source of Evidence:
critical watershed values, importance to
Observation:____ local communities’ traditional cultural Documentation:____
identity). NA Interview:____
Observation:____
C Document required
C
SR-HP4.7
All workers are employed, promoted, and NC CG-CB3.3
compensated equally based upon their EXTRA POINT: Farm has had an
ability to perform their job, and not on the NC
assessment completed by ecologists
basis of gender, ethnicity, religious or and/or biologists for areas of high
cultural beliefs. Source of Evidence: Source of Evidence:
conservation value.
NA
Interview:____ NA Interview:____
Observation:____ Observation:____

Criterion SR-WC1:
C
Access to Housing, Potable Water and Sanitary Facilities
CG-CB1.12 C/
Cavity trees and standing and/or fallen Indicators NC/ Evidence/Justification
NC
dead trees are left in the field to naturally Source of Evidence: NA
decay. Documentation:____
Interview:____
Criterion CG-CB2:
SR-WC1.1
Protecting Wildlife Permanent and temporary/seasonal
NC adequate ventilation
C/ workers living onsite have habitable impermeable roof
Indicators NC/ Evidence/Justification housing.
lighting
Documentation:____
NA Interview:____
C
Observation:____
CG-CB2.1
Hunting threatened or rare wildlife
species and unauthorized collection of NC
C
flora and fauna are not allowed on the
Source of Evidence:
property.
Documentation:____
NA Interview:____
SR-WC1.2 water testing
Observation:____
Employer provides workers with NC water boiled
convenient access to safe drinking water. spring/well with concrete cap
Other method of purification:
C
Source of Evidence:
CG-CB2.2 Documentation:____
There are specific implemented NA Interview:____
measures (e.g., 'no hunting' or 'no Specific implemented measures: Observation:____
NC
trespassing’ signs, gates, fences, signs gates fences other:
guards, etc.) to prevent unauthorized Source of Evidence:
hunting and collection of flora and fauna. Documentation:____
Interview:____ C
NA
Observation:____
Document required
SR-WC1.3
C Worker housing has buffer zones, of 10
CG-CB2.3 meters minimum width, from productive
Farm management has created a list of NC
area and agrochemical storage facilities Distance from productive area to worker
wildlife species native to the region and to prevent injury or agrochemical housing:____meters
identified which of those species are exposure to workers and their families. Distance from agrochemical storage facilities
NC
classified as vulnerable, endangered or to worker housing:____meters
critically endangered according to the
Source of Evidence: Source of Evidence:
IUCN red list (http://www.redlist.org) or
Documentation:____ NA Documentation:____
local government source.
NA Interview:____ Interview:____

C
C
CG-CB1.5
Canopy cover in the productive area has NC # tree species in canopy cover:____
a diversity of tree species. Source of Evidence:
SR-WC1.4
Documentation:____
Workers have convenient access to
NC NA Interview:____
sanitary facilities that do not contaminate
the local environment. Observation:____
C
Source of Evidence: CG-CB1.6
NA Documentation:____ Invasive species are not used for canopy NC
Interview:____ cover in the productive area.
Observation:____ NA
C
CG-CB1.7
C Where conditions permit, locally native
epiphytes, lianas and woody vines are NC
retained in the canopy cover in the
productive area.
SR-WC1.5 NA
Garbage from housing and facilities
provided by employer is removed either CG-CB1.10
NC C
to a municipal waste dump or to a waste EXTRA POINT: At least 75% of the % of canopy cover comprised of native
site located at least 25 meters from any canopy cover in the productive area is species:____
worker housing. Distance from waste dump to worker comprised of locally native species Source of Evidence:
NC
housing: ____meters and/or the canopy consists of at least 10
Documentation:____
Source of Evidence: species that are locally native or can be
shown to contribute to the conservation Interview:____
NA Documentation:____ NA Observation:____
of native biodiversity.
Interview:____
Observation:____ CG-CB1.8
C
EXTRA POINT: Canopy cover in the
Criterion SR-WC2: productive area is kept at biologically
Access to Education significant levels (i.e., the level of canopy
cover changes the farm's micro-climate, NC
C/ produces a noticeable leaf layer on the Source of Evidence:
Indicators NC/ Evidence/Justification ground and creates an obvious habitat Documentation:____
NA for a range of plant and animal species, Interview:____
NA
etc.). Observation:____
C
C
SR-WC2.1
ZERO TOLERANCE: Children of legal CG-CB1.11
school age who live onsite or accompany NC EXTRA POINT: Shade canopy in the
NC
family members who are working onsite productive area consists of at least 2 Source of Evidence:
Source of Evidence:
attend school. identifiable canopy layers.
NA Interview:____ Interview:____
NA

Criterion CG-CB1:
C
Maintaining a Coffee Shade Canopy SR-WC2.2
C/ If reasonable access to public education
Indicators NC/ Evidence/Justification does not exist, primary school aged
NA children of workers who live on-site have NC
access to primary education, facilities
and materials equal to national or
C regional requirements.
NA
CG-CB1.1
Native trees are removed only when they NC
constitute a human hazard or when they
significantly compete with coffee plants. C
Source of Evidence:
Interview:____ SR-WC2.3
NA
Observation:____ If reasonable access to public education
does not exist, secondary school aged
CG-CB1.2 Document required for CG-CB1.2 children of workers who live on-site have NC
The farm has a shade management plan C access to secondary education, facilities
Source of Evidence:
including: identifying areas with gaps in and materials equal to national or
regional requirements. Documentation:____
shade, plots where shade is appropriate
or not, plans for replanting invasive NA Interview:____
NC Observation:____
exotic/non-native trees with native
species, identified resources for Shade management plan? Yes No Document required
appropriate shade tree lists, identified
Plan implemented? Yes No
resources from which to source shade NA
trees and a timeline for implementation. Plan includes: C
areas with gaps in shade?
plots where shade is appropriate?
C
replanting with native species?
SR-WC2.4
CG-CB1.3 resources for shade tree lists?
EXTRA POINT: Employer supports local
where to source shade trees? NC
The farm is implementing the shade schools with either in-kind donations or
NC timeline?
management plan according to the plan's financial support.
timeline. Source of Evidence:
Documentation:____ Source of Evidence:
NA Interview:____ Documentation:____
Observation:____ NA Interview:____
Observation:____
C
Document required
CG-CB1.4
At least 10% of the farm (including C
NC
productive AND non-productive area)
has canopy cover.
NA SR-WC2.5
EXTRA POINT: Employer supports
training or workshops for permanent/full- NC
C % of farm with canopy cover:____ time workers on additional skills or trades
CG-CB1.9 % of productive area with canopy cover:____ (i.e. financial literacy, second language).
EXTRA POINT: At least 40% of the Source of Evidence:
productive area of the farm has canopy Documentation:____
Documentation:____
cover. Interview:____ NA Interview:____
NA Observation:____
Observation:____

Criterion SR-WC3: C
CG-SR2.5
Access to Medical Care At least 25% of the productive area is
NC
C/ planted with nitrogen-fixing, leguminous
Indicators NC/ Evidence/Justification trees.
NA
NA
Document required
C
C CG-SR2.6
SR-WC3.1 At least 50% of the productive area is
NC
Employer has a medical care plan which planted with nitrogen-fixing, leguminous
includes transportation or a trained NC trees.
Source of Evidence: NA
medical person (technical expert) is
available in case of medical emergency. Documentation:____
Interview:____ C
NA % of area planted with nitrogen-fixing,
Observation:____ CG-SR2.7 leguminous trees:____
All of the productive area is planted NC Source of Evidence:
with nitrogen-fixing, leguminous trees. Documentation:____
C NA Observation: ____
SR-WC3.2 Document required
Employer provides sufficient, readily C
NC
accessible, well equipped and not Source of Evidence:
expired onsite first aid kits. Documentation:____ CG-SR2.8
Interview:____ Soil analysis is conducted every two
NA years to identify nutrient deficiencies NC
Observation:____
(macro and micro nutrients) and organic
Document required matter content.
C
NA
SR-WC3.3
EXTRA POINT: If there is convenient
and accessible medical care, employer NC
supports these facilities with either in- Source of Evidence: C
kind donations or financial support. Documentation:____
Interview:____ CG-SR2.9
NA
Observation:____ Foliar analysis is conducted every two
NC
years to identify nutrient deficiencies
Document required
(macro and micro nutrients). Soil analysis conducted every____years
C
SR-WC3.4 Foliar analysis conducted every____years.
Employer contributes to the cost of Source of Evidence:
NC NA
general health services for all Documentation:____
permanent workers.
NA
C
C CG-SR2.10
The formula of applied nutrients and non-
SR-WC3.5 synthetic soil amendments is customized NC
EXTRA POINT: Employer contributes to NC in response to results of soil and foliar Source of Evidence:
the cost of general health services for all Source of Evidence: analyses. Documentation:____
temporary/seasonal workers.
NA Interview:____ Observation:____
Observation:____
Document required
Criterion CG-SR2:
C
Maintaining Soil Productivity
SR-WC3.6
C/
Employer pays for all medical costs
Indicators NC/ Evidence/Justification associated with documented work- NC Worker injuries documented? Yes No
NA related injuries and illnesses if not Source of Evidence:
covered by other programs or services.
Documentation:____
C NA Interview:____
CG-SR2.1 Observation:____
At least 25% of the productive area is
covered by a layer of organic matter
NC
Criterion SR-WC4:
(dead and decaying biomass - mulch, Worker Safety and Training
grass, leaves, branches, etc.) and/or
nitrogen-fixing cover crops. C/
NA Indicators NC/ Evidence/Justification
NA
C
C
CG-SR2.2
At least 50% of the productive area is
covered by a layer of organic matter
NC
(dead and decaying biomass - mulch, SR-WC4.1
grass, leaves, branches, etc.) and/or Employer provides appropriate Personal
nitrogen-fixing cover crops. Protective Equipment (PPE) to all
NA applicable workers at no cost.
NC PPE for farm includes:
• For farms: respirators with filters,
goggles, rubber boots, water-proof respirators with filters
gloves, impermeable clothing goggles
• For dry mills: goggles, ear plugs, masks rubber boots
C
water-proof gloves
CG-SR2.3 impermeable clothing
All of the productive area is covered by Source of Evidence:
a layer of organic matter (dead and NA Documentation:____
NC % of productive area covered by organic
decaying biomass - mulch, grass, leaves, matter layer and or/nitrogen-fixing cover Interview:____
branches, etc.) and/or nitrogen-fixing crops:____ Observation:____
cover crops.
Source of Evidence:
NA Observation:____
SR-WC4.2
C
Anyone handling or applying
agrochemicals and operating machinery
C uses the appropriate protective
equipment.
• When applying pesticides, workers use NC
CG-SR2.4 respirators with filters, goggles, rubber
Pruned branches, twigs, leaves and boots, water-proof gloves, and
other live barrier materials are mulched impermeable clothing (SR-WC4.1).
and/or left as a soil amendment. Documentation:____
• When applying chemical fertilizers,
workers use rubber boots, and if Interview:____
Source of Evidence: NA Observation:____
NA appropriate, gloves and protective
Observation:____ goggles.

Document required
C
SR-WC4.3 C
Health and safety training occurs for all
workers at least once a year, free of
NC CG-SR1.9
charge, and during regular working
hours. Training is documented including Herbicides are not used to control
instructors, agendas and attendance. ground vegetation or cover crops and are NC
NA only used in spot applications for
aggressive weeds.
Source of Evidence:
C
SR-WC4.4 Health & safety training occurs_____times NA Documentation:____
Training covers, at a minimum: use of per year. Interview:____
protective equipment, safe handling of Observation:____
hazardous materials, operation of
equipment and personal safety and Documentation:____
hygiene. Interview:____ C
NA Observation:____
Document required
CG-SR1.10
At least 50% of roads or frequently used
SR-WC4.5 C
trails or footpaths are protected from
For all enclosed work areas, there is a NC
erosion through proper drainage ditches
documented fire and emergency and/or other control measures (including
evacuation plan. NC cover vegetation, etc.).
Source of Evidence:
Applicable to farms, mills, and Documentation:____ NA
warehouses. NA Interview:____
Document required
C C
SR-WC4.6 CG-SR1.11
Management maintains written injury All roads or frequently used trails or
reports. The written injury reports include footpaths are protected from erosion by
NC NC
the type of injury, name of worker, time proper drainage ditches and/or other
and date, and location of the accident. control measures (including cover % of roads or frequently used trails or
Source of Evidence:
occurrence. vegetation, etc.). footpaths that are protected from
Documentation:____
erosion:____
Interview:____
NA NA Source of Evidence:
Observation:____
Interview:____
Observation:____
Document required
C C
SR-WC4.7 CG-SR1.12
Management reviews accident and injury EXTRA POINT: Areas in which the risk
records at least annually and updates of landslides is very high (consider
NC
safety procedures and training materials factors such as slope, soil, and including NC
to prevent accident and injury re- slopes greater than 60%) are not
occurrence. cultivated and are restored with native
Source of Evidence: vegetation where possible.
Source of Evidence:
NA Documentation:____ NA Interview:____

C
C
CG-SR1.5
In addition to the soil erosion prevention
measures included in CG-SR1.3-1.4,
contour lines and/or bench terraces are NC SR-WC4.8
established on at least 50% of Anyone who handles, mixes, or applies
productive area with slopes between agrochemicals has convenient access
NC
20% and 30%. to eye baths, soap, sinks for hand
washing, showers, and clothes washing
NA facilities.
Source of Evidence:
C Interview:____
Observation:____
CG-SR1.6
In addition to the soil erosion prevention % of productive area with slopes between
measures included in CG-SR1.3-1.4, 20% and 30% with contour lines and/or C
NC bench terraces:____
contour lines and/or bench terraces are SR-WC4.9
established on all productive area with Contour lines and bench terraces
Authorized minors (minors older than 14)
slopes between 20% and 30%. established at intervals appropriate for site
and pregnant women are prohibited from
conditions? Yes No NC
handling or applying agrochemicals,
NA Source of Evidence: operating heavy machinery and/or heavy Source of Evidence:
Observation:____ lifting. Documentation:____
NA Interview:____
Observation:____
C
CG-SR1.7
C
physical barriers (e.g., pruned branches, SR-WC4.10
NC
rocks) and/or living barriers (e.g., Entrance is prohibited to areas where
NC
grasses, shrubs) are established on at pesticides were applied 48 hours prior
least 50% of productive area with slopes without protective equipment. Source of Evidence:
over 30%. Documentation:____
NA NA Interview:____
Observation:____
C
C
SR-WC4.11
CG-SR1.8
For all enclosed work areas, there is a
sufficient number of emergency exits that NC
are clearly marked, unobstructed at all
physical barriers (e.g., pruned branches, NC
times, unlocked when workers are
rocks) and/or living barriers (e.g., Source of Evidence:
present or have latches that do not
grasses, shrubs) are established on all % of productive area with slopes over 30% Documentation:____
require special operation.
productive area with slopes over 30%. with physical and/or living barriers:____ NA Interview:____
NA Source of Evidence: Observation:____
Observation:____

C Criterion CG-SR1:
Controlling Surface Erosion
SR-WC4.12 C/
Employees are provided with a safe NC NC/
Source of Evidence: Indicators Evidence/Justification
working environment.
Documentation:____ NA
Interview:____
NA
Observation:____ C
CG-SR1.1
Farm managers demonstrate knowledge
C of farm areas at risk to erosion and are
able to communicate and/or identify on a NC
map areas at high risk of erosion Source of Evidence:
SR-WC4.13
(considering such factors as slope, soil Documentation:____
All equipment used by workers is NC
Source of Evidence: type, and concavity).
properly maintained and safe to use. Interview:____
NA
Documentation:____ Observation:____
Interview:____
NA
Observation:____ Document required
C
Criterion SR-MS 1:
Management Systems CG-SR1.2
Farm has a written soil management
C/ NC
plan that includes measures to minimize
Indicators NC/ Evidence/Justification surface erosion. Source of Evidence:
Interview:____
NA
Observation:____
C
SR-MS 1.1
ZERO TOLERANCE: Entity provides C
transparency into their operations,
policies, processes, and relevant records NC CG-SR1.3
to Starbucks or its designated third party. At least 50% of productive area with
Payroll records and time cards provided slopes of less than 20% is covered by NC
by management are true and accurate. Source of Evidence: shade trees and/or cover
Documentation:____ crops/vegetation.
NA Interview:____
Observation:____ NA
C
C
SR-MS1.2 CG-SR1.4
ZERO TOLERANCE: Money and/or gifts All productive area with slopes of less
NC NC
of any type are not offered to Starbucks than 20% is covered by shade trees
or its designated third party % of productive area with slopes of less than
and/or cover crops/vegetation. 20% with shade trees and/or cover
Source of Evidence:
crops/vegetation:____
Documentation:____
NA NA Source of Evidence:
Interview:____
Observation:____
Observation:____

Criterion CG-WR2: Subject Area: Environmental Leadership -
Water Resources and Irrigation Coffee Growing
C/
Criterion CG-WR1:
NA Water Body Protection
Document required C/
C NA
CG-WR2.1 CG-WR1.1 C
If mechanical (pumps, etc.) irrigation is Buffer zones exist next to more than
used, quantity of water used is tracked NC 50% of permanent water bodies;
Documentation includes: buffers are at least 5 meters in width
and recorded in writing: liters per Kg of NC
green coffee AND liters per hectare. liters per Kg of green coffee (measured horizontally from the high
liters per hectare water mark to the base of any coffee
Source of Evidence: tree), exclude all cultivation and are
NA Documentation:____ composed of vegetation. NA
Interview:____
Observation:____
C
CG-WR1.2 # of buffer zones < 5 meters:____
C Buffer zones exist next to all permanent # of buffer zones ≥ 5 meters:____
water bodies; buffers are at least 5 % of water bodies with adjacent buffer
meters in width (measured horizontally NC zones:____
CG-WR2.2 from the high water mark to the base of
Source of Evidence:
EXTRA POINT: If mechanical irrigation is any coffee tree), exclude all cultivation
Interview:____
used, the farm management NC and are composed of vegetation.
NA Observation:____
demonstrates an understanding of local
water conditions or stress factors.
Source of Evidence:
Documentation:____ CG-WR1.3 C
NA Interview:____ Buffer zones exist next to more than
Observation:____ 50% of seasonal and intermittent
(temporary) water bodies; buffers are
at least 2 meters in width (measured NC
horizontally from the high water mark to
C the base of any coffee tree), exclude all
cultivation and are composed of
vegetation. NA
CG-WR2.3 NC C
EXTRA POINT: Farms that use CG-WR1.4
Buffer zones exist next to all seasonal # of buffer zones < 2 meters:____
mechanical irrigation monitor and try to
minimize total water usage. and intermittent (temporary) water # of buffer zones ≥ 2 meters:____
NC % of water bodies with adjacent buffer
bodies; buffers are at least 2 meters in
width (measured horizontally from the zones:____
Source of Evidence: high water mark to the base of any Source of Evidence:
NA Documentation:____ coffee tree), exclude all cultivation and Interview:____
Interview:____ are composed of vegetation. NA Observation:____
Observation:____

Document required
C C
CG-WR1.5
Farm has a plan to restore native NC CG-WR1.9
vegetation within the buffer zones. No agrochemicals are applied within 5 NC
meters of any permanent water body.
Source of Evidence:
Documentation:____ Distance of permanent water body from
NA agrochemical application:____ meters
Interview:____
Observation:____ Source of Evidence:
NA Interview:____
Observation:____
C
CG-WR1.6
C
More than 50% of permanent water
NC
body buffer zones are composed of
native woody vegetation.
NA CG-WR1.10
Nematicides are NOT applied within 20 NC
meters of any permanent water body.
C
Distance of permanent water body from
nematicide application:____meters
CG-WR1.7 NA Source of Evidence:
All permanent water body buffer Interview:____
NC
zones are composed of native woody Observation:____
% of permanent water body buffer zones
vegetation.
composed of native woody vegetation:____
Source of Evidence:
NA Interview:____
C
Observation:____
C
CG-WR1.11
Farm waste or garbage sites are located NC
CG-WR1.8
NC at least 100 meters from any water body.
EXTRA POINT: All water crossings are
protected by the use of bridges, culverts Distance of water body from farm waste or
or sufficient means to prevent garbage site:____meters
degradation. Source of Evidence:
Source of Evidence: Documentation:____
NA NA Interview:____
Interview:____


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Opening Meeting – Checklist

GPS Latitude: _____° _____’_____” (N) (S) Note: If farm has

__ _° _ __’_ __” (N) (S) _ _° __ _’_ _ _” (E) (W) Yes No

__ _° _ __’_ __” (N) (S) _ _° __ _’_ _ _” (E) (W) Yes No

__ _° _ __’_ __” (N) (S) __° __ _’_ _ _” (E) (W) Yes No

Total hectares (including Total hectares of coffee

Conservation area Number of water

Not Available Not Available *required field

Field Notes for 2 V3.4.1 Field Notes for 51 V3.4.1

Field Notes for 50 V3.4.1 Field Notes for 3 V3.4.1

Other? Yes No % of farm (if present): ______

If other pest/disease, please specify: ____________________________________

Blue Mountain Geisha N39 Tabi

4C Fair Trade Rainforest Alliance

 Permanent Hours per day: Payment period:

Field Notes for 4 V3.4.1 Field Notes for 49 V3.4.1

 Permanent Hours per day: Payment period: Criterion EA-IS1:

Field Notes for 48 V3.4.1 Field Notes for 5 V3.4.1

SR-HP1.2 Document required

Field Notes for 6 V3.4.1 Field Notes for 47 V3.4.1

SR-HP1.4 Document required for SR-HP1.4

For warehouses and mills, hours AND

Field Notes for 46 V3.4.1 Field Notes for 7 V3.4.1

Field Notes for 8 V3.4.1 Field Notes for 45 V3.4.1

Long Term Productivity

Field Notes for 44 V3.4.1 Field Notes for 9 V3.4.1

SR-HP1.16 Criterion CG-EM2:

SR-HP1.17 Document required

Field Notes for 10 V3.4.1 Field Notes for 43 V3.4.1

Field Notes for 42 V3.4.1 Field Notes for 11 V3.4.1

Field Notes for 12 V3.4.1 Field Notes for 41 V3.4.1

Field Notes for 40 V3.4.1 Field Notes for 13 V3.4.1

Field Notes for 14 V3.4.1 Field Notes for 39 V3.4.1

Field Notes for 38 V3.4.1 Field Notes for 15 V3.4.1

Field Notes for 16 V3.4.1 Field Notes for 37 V3.4.1

Field Notes for 36 V3.4.1 Field Notes for 17 V3.4.1

Field Notes for 18 V3.4.1 Field Notes for 35 V3.4.1

Field Notes for 34 V3.4.1 Field Notes for 19 V3.4.1

Field Notes for 32 V3.4.1 Field Notes for 21 V3.4.1

Field Notes for 22 V3.4.1 Field Notes for 31 V3.4.1

Field Notes for 30 V3.4.1 Field Notes for 23 V3.4.1

Field Notes for 24 V3.4.1 Field Notes for 29 V3.4.1

Field Notes for 28 V3.4.1 Field Notes for 25 V3.4.1

Field Notes for 26 V3.4.1 Field Notes for 27 V3.4.1

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GPS Latitude: ___° _’___” (N) (S) Note: If farm has

__ _° _ __’_ ” (N) (S) ° __ _’_ _ _” (E) (W) Yes No