Food Store Survey

Date: Store Name: Store Address: (City/Neighborhood) Store ID No. Store Type: t t t t Supermarket Large Grocery Small Grocery Farmers Market t t t t Convenience Gas/Grocery Ethnic/Specialty Other (Zip Code) Store Phone No. Day of the Week:

Square Footage of Store:

READ THE FOLLOWING TO THE STORE MANAGER PRIOR TO CONDUCTING THE STORE SURVEY: We are doing a market survey of all grocery stores in (county) (neighborhood) on the availability of selected food items and their prices. Foods selected for this survey are based on USDAs thrift food plan market basket list. The information we are collecting will help create a profile of food availability and costs. The information will only be used for this purpose and data collected from stores in each study site will be combinedno data will be linked to any specific store. TO THE DATA COLLECTOR: Please complete the following tables by walking through the store and recording the price and weight of the least expensive item for each food listed. The table includes the unit of measure that should be selected for each food. For example, potatoes are measured in pounds, eggs are measured by the dozen. It is important that the prices recorded are for the specific food item in the table with no substitutions. If a food item is unavailable on the day you visit the store, but is usually in stock, check with the manager for the normal price. If a food is not ever in stock, mark the pricing box with an NA (for not available). If a food is on sale, place an S next to the price.
May 2002

This survey template was prepared by the Iowa State University Community Food Assessment Team, Lois Wright Morton, Mary Jane Oakland, Annette Bitto, and Mary Sand. 2002. For more details regarding survey items and administration please contact Lois Wright Morton, Department of Sociology, 303 East Hall, Ames, Iowa 50011 lwmorton@iastate.edu

Food Item

Brand/Variety

Item Weight/ Unit (desired)

Item Weight/ Unit (actual)

Price (lowest cost)

Quality 1=Not ripe/fresh 2=Ripe/edible 3=Overripe/spoiled

FRUITS FRESH
Apples, any variety (bagged or loose) Bananas Grapes (green or red) Melons (cantaloupe) Melons (watermelon) Oranges, any variety (bagged or loose) per pound per pound per pound

per pound per pound per pound

VEGETABLES - FRESH
Bok choy Broccoli, bunch Cabbage, head Carrots, unpeeled (bagged or loose) Celery, bunch Collard greens Green pepper Lettuce, leaf (green or red)

per bunch per pound per pound per pound per bunch per pound each per pound

Food Item

Brand/Variety

Item Weight/ Unit (desired)

Item Weight/ Unit (actual)

Price (lowest cost)

Quality 1=Not ripe/fresh 2=Ripe/edible 3=Overripe/spoiled

Mushrooms Onions, yellow (bagged or loose) Potatoes (any variety) Spinach Squash (seasonal) Sweet potatoes Tomatoes (any variety)

per pound per pound 5 pound bag per pound per pound per pound per pound

FRUIT - CANNED
Applesauce Raisins (box or bag) Fruit cocktail Peaches, any variety (light syrup) Pears Pineapple Oranges, mandarin (juice or light syrup)

per ounce per ounce per ounce 29 ounce can per ounce per ounce 15 ounce can

Food Item

Brand/Variety

Item Weight/ Unit (desired)

Item Weight/ Unit (actual)

Price (lowest cost)

Quality 1=Not ripe/fresh 2=Ripe/edible 3=Overripe/spoiled

VEGETABLES - CANNED
Beets Corn Green beans Mushrooms, pieces Peas Pumpkin Spaghetti sauce (any variety) Spinach Tomato sauce (any variety) Tomatoes-whole

per ounce per ounce per ounce 4 oz can per ounce per ounce 26 oz jar per ounce 8 oz can per ounce

FRUITS AND VEGETABLES FROZEN

Apple juice, concentrate Broccoli, chopped French friesany variety Grape juice, concentrate Green beans (any variety)

per ounce 16 oz bag 32 oz bag per ounce 16 oz bag

Food Item

Brand/Variety

Item Weight/ Unit (desired)

Item Weight/ Unit (actual)

Price (lowest cost)

Quality 1=Not ripe/fresh 2=Ripe/edible 3=Overripe/spoiled

Green peas (any variety) Mixed vegetables Orange juice, concentrate Spinach, chopped Strawberries

16 oz bag per ounce 12 oz can per ounce per ounce

BREADS, CEREALS, AND OTHER GRAIN PRODUCTS, FRESH

Bagels, plain, enriched Bread, white, enriched Bread, whole wheat French or Italian bread, enriched Hamburger buns, enriched Rolls, dinner, enriched

package of 6 1 pound loaf 24 oz loaf 1 pound loaf package of 8 package of 12

BREADS, CEREALS, AND OTHER GRAIN PRODUCTS, DRY

Bread crumbs, plain Cornmeal, yellow Crackers, saltine (soda crackers)

10 ounce can per ounce per ounce

Food Item

Brand/Variety

Item Weight/ Unit (desired)

Item Weight/ Unit (actual)

Price (lowest cost)

Quality 1=Not ripe/fresh 2=Ripe/edible 3=Overripe/spoiled

Flour, white, all-purpose, enriched Flour, whole wheat Graham cracker Grits Macaroni, elbow-style, enriched Noodles, egg, enriched Noodles, yolk free, enriched Popcorn, microwave (any variety unpopped) Popcorn, regular Ready-to-eat cereal, Corn Flakes Ready-to-eat cereal, Kix Ready-to-eat cereal, Raisin Bran Ready-to-eat cereal, Toasted Oats (Cheerios) Ready-to-eat cereal, Wheaties

5 pound bag 5 pound bag per ounce per ounce 1 pound box 1 pound bag 1 pound bag 9 ounce package per ounce 18 ounce box 18 ounce box 18 ounce box 20 ounce box 18 ounce box
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Food Item

Brand/Variety

Item Weight/ Unit (desired)

Item Weight/ Unit (actual)

Price (lowest cost)

Quality 1=Not ripe/fresh 2=Ripe/edible 3=Overripe/spoiled

Ready-to-eat cereal, Whole Grain Total Rice, white, long-grain, enriched Rice, wild Rice, brown Rolled oats (oatmeal) Spaghetti, enriched (any variety)

18 ounce box 5 pound bag per ounce per ounce per ounce l pound box

DAIRY PRODUCTS, FRESH

Cheese, cheddar (any variety) Cheese, cottage (any variety) Cheese, mozzarella Milk, 1% low fat Milk, 2% Milk, buttermilk Milk, skim Milk, whole

per pound 16 ounce carton 16 ounce package 1 gallon 1 gallon per fluid ounce 1 gallon 1 gallon

Food Item

Brand/Variety

Item Weight/ Unit (desired)

Item Weight/ Unit (actual)

Price (lowest cost)

Quality 1=Not ripe/fresh 2=Ripe/edible 3=Overripe/spoiled

Yogurt

8 ounce individual serving

DAIRY PRODUCTS, OTHER

Evaporated milk, canned (any variety) Nonfat dry milk

12 ounce can Per oz

MEAT AND MEAT ALTERNATIVES, FRESH

Beef, ground, lean Bologna Chicken, fryer, cut-up or whole Chicken, thighs Eggs, grade A, large Pork, ground Pork, ham Tofu Turkey ham (packaged luncheon meat) Turkey, ground

per pound per ounce per pound per pound 1 dozen per pound per pound per ounce per pound per pound

Food Item

Brand/Variety

Item Weight/ Unit (desired)

Item Weight/ Unit (actual)

Price (lowest cost)

Quality 1=Not ripe/fresh 2=Ripe/edible 3=Overripe/spoiled

MEAT AND MEAT ALTERNATIVES, FROZEN AND CANNED

Beans, baked with pork Beans, baked, vegetarian Beans, dried Beans, garbanzo (ckickpeas), canned Beans, kidney, canned Beef, ground, frozen Chicken, canned Chicken, frozen Fish, catfish, frozen Fish, flounder or cod, frozen Fish, perch, frozen Peanut butter, smooth Tuna fish, chunk-style, water pack

per ounce 16 ounce can per ounce 15 ounce can 15.5 ounce can per pound per ounce per pound per pound per pound per pound 18 ounce jar 6 ounce can

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Food Item

Brand/Variety

Item Weight/ Unit (desired)

Item Weight/ Unit (actual)

Price (lowest cost)

Quality 1=Not ripe/fresh 2=Ripe/edible 3=Overripe/spoiled

FATS AND OILS

Butter Margarine, stick Oil, canola (any variety) Oil, vegetable (any type) Salad dressing, mayonnaise-type Shortening, vegetable

1 pound package 1 pound box per ounce 48 ounce bottle 32 ounce jar 3 pound can

SUGARS AND SWEETS

Chocolate chips, semisweet Coke Fruit drink, refrigerated, any flavor Fudgsicles, ice milk Ice cream, low fat, vanilla Ice cream, regular, vanilla Jelly, grape Molasses, any type

12 ounce package Per 2 liter 1 gallon box of 12 Per gallon Per gallon 32 ounce jar 12 ounce bottle

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Pudding, snack pack Sugar, brown (dark or light) Sugar, powdered Sugar, white, granulated Syrup, pancake, any type Yogurt, frozen

Per pack 1 pound bag or box 1 pound bag 5 pound bag 24 ounce bottle Per gallon

PREPARED FOODS
Hot pockets, ham & cheese Macaroni & cheese, box Pizza, cheese Soup, tomato TV dinner

Per oz Per oz Per oz Per oz Per oz

OTHER FOOD ITEMS, OPTIONAL

Baking powder Baking soda Black pepper, ground Bouillon, chicken, reduced sodium, cubes Catsup, any type

10 ounce can 16 ounce box 4 ounce jar 3.75 ounce jar 28 ounce bottle

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Food Item

Brand/Variety

Item Weight/ Unit (desired)

Item Weight/ Unit (actual)

Price (lowest cost)

Quality 1=Not ripe/fresh 2=Ripe/edible 3=Overripe/spoiled

Chili powder Cinnamon Cumin Drink mix, chocolate, powdered Garlic powder Gelatin, powdered, unflavored Italian herb seasoning Lemon juice, bottled Onion powder Oregano Paprika Salt, any type Soy sauce, reduced sodium Vanilla, any type

3.25 ounce jar 3 ounce jar 2 ounce jar 32 ounce can 4.25 ounce jar box of 4 envelopes 2 ounce jar 32 ounce bottle 3.5 ounce jar .56 ounce jar 2.9 ounce jar 26 ounce carton 10 ounce bottle 6 ounce bottle

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