Title Page
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Site conducted
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Time Period
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Conducted on
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Store Email
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Full Name
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Signature of the PIC who completed this audit
Critical Deficiency Checklist (QA Checklist)
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Critical Deficiency is to be completed at each day part in line of temperature checks. Critical deficiency is designed to eliminate food safety hazards and must be completed by the PIC.
For any item that is marked as fail you will be required to upload an image -
Abbreviations
TILT - Time In Lieu Of Temperature
TCS - Time/Temperature Control for Safety
RTE - Ready to Eat Foods
PHF - Potentially Hazard Food
BEVERAGE / SHAKE STATION
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BEVERAGE STATIONS: Drink nozzles, diffusers, tea nozzles and inside of ice chute clean/no mold/no overnight soaking nozzles, diffusers washed, rinsed, sanitized, and air dried
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SHAKE STATION: Shake spindle and rinse cup clean, chart filled out at required times
BACK LINE
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HOT HOLDING: PHU Temperature ≥60°C (TCS)
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CHICKEN TENDERS STATION: Raw chicken & egg wash temperature 1-5°C (TCS), chart filled out at required times.
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PREPPED TILT FOODS: TCS product not expired/produce, pickles, and sliced cheese tagged 4hrs.
DISHES, HANDS & GLOVES
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PROPER WASH SINK SET-UP: Wash water (43°C), rinse, submerged in sanitizer for 60 seconds.
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HAND SINKS: Hand sink is not blocked, used only for hand washing & fully stocked
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HAND WASHING/HYGIENE: Hands washed when changing duties and between glove changes
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HAND WASHING/HYGIENE: Proper hand washing- hot water, soap, wash for 20 sec, paper towel used to turn off sink, hand sanitiser used as the final step.
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DISPOSABLE GLOVES: Gloves worn when HANDLING RTE FOODS, changed when required
FOOD PREP/STORAGE
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PREP SINKS/TABLES: Usage - Food prepped on cleaned/sanitised prep table/sink
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PREP SINKS/TABLES: Usage - Prep sink used only for food prep
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UTENSILS/PANS: Utensils, pans, spatulas, cutting boards, ice scoop, sink sprayer, clean and in good repair
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PRODUCE SLICER/DICER: Equipment stored clean – no food debris or buildup
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PRODUCE SLICER/DICER: Dicer black block in good repair - no pieces missing
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PRODUCE SLICER/DICER: Slicer cutting blade in good repair – no chips or dents
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DRIVE-THRU ICE BIN/ICE CHUTE: Drive thru bin interior is clean and free of rust/mold/pink slime, lid closed when not in use
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ICE MACHINE: Ice machine is clean and free of rust/mold/pink slime, lid closed when not in use
COLD STORAGE
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WALK-IN COOLER, REACH-INS, PRODUCTS ON ICE BATHS: Product temperature ≤5°C (TCS) - Proper cooling (<2” depth)
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WALK-IN COOLER, REACH-INS, PRODUCTS ON ICE BATHS: TCS product not out of date/stored protected from contamination
SAFE COOKING
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RAW PRODUCT TEMPS: Raw beef (74ºC) and raw chicken products (74ºC)
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REHEAT PRODUCT TEMPS: Reheat all products to (74ºC)
GENERAL SANITISATION
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PESTS: No roaches/flies/rodents/pests evidence present
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CHEMICAL: Chemicals properly labeled/not stored above or next to Food, Utensils, Single-Service Items
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SANITISER AVAILABILITY & USAGE: Quat sanitizer concentration dispensed at 24°C between 200-400ppm and while in use at 3- part sink, front line, backline, feeder station and chicken station
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RESTROOMS
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RESTROOMS FULLY STOCKED: Soap, paper towels/working hand dryer, toilet paper and 1 functional toilet in each restroom
DOCUMENTATION
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QA DAILY TEMP TRACKING FORM: Properly completed with calibrated thermometer & corrective action for the previous 30 days
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If there are any missing or incomplete audits for the previous 30 days, contact the Restaurant General Manager immediately
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ACTIONS: Do you have any outstanding ACTIONS on I-Auditor for the store? <br>If you are unaware of how to action or require further training, please contact Carmen Jenner.
In the NSF Folder, check the below documentation is stored in the folder and easily accessible (provide evidence that the document exists and is located in a folder)
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DOCUMENT 1 | Employee Illness Policy
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DOCUMENT 2 | Previous NSF Audit & Corrective Action Plan
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DOCUMENT 3 | Previous Council Inspection
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DOCUMENT 4 | Food Safety Supervisor Certificate
CORRECTIVE ACTIONS
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ACCOUNTABILITY: Confirm you have added a photo and a corrective action in the notes for any item that has been marked as a Fail
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Ensure all corrective actions have been entered before completing the audit.
Daily Temperature Tracking Form
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PRIOR TO TRACKING TEMPERATURES
► Check calibration of thermometers
► Use sanitised probe to take product temperature(s)
► Sanitise probe for each different product to avoid potential cross contamination
► Any failed temperatures, a corrective action must be attached via the note section
THERMOMETER CALIBRATION: Range between -0.5°C to 0.5°C
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Thermometer Calibration Temperature
SANITISER
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Test & Record Sanitiser strength for each bucket
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3 Compartment Sink
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Cookline
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Chicken Station
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FOH
REFRIGERATION: Range between 0°C to 5°C
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DO YOU HAVE A: Walk-in Cooler
Raw Chicken Temperature
Air Verification
Raw Angus
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DO YOU HAVE A: Cook's Reach-in
Raw Chicken Temperature
Air Verification
Raw Angus
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DO YOU HAVE A: Tender Reach-in
Raw Chicken Temperature
Air Verification
Raw Angus
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DO YOU HAVE A: Side Reach-in
Raw Chicken Temperature
Air Verification
Raw Angus
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DO YOU HAVE A: Front Reach-in
Raw Chicken Temperature
Air Verification
Raw Angus
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DO YOU HAVE A: Counter Cooler
Raw Chicken Temperature
Air Verification
Raw Angus
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DO YOU HAVE A: Standing Cooler
Raw Chicken Temperature
Air Verification
Raw Angus
FREEZER: Range between -12° to -18°
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DO YOU HAVE A: Standing Freezer
Raw Chicken Temperature
Air Verification
Raw Angus
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DO YOU HAVE A: Walk-in Freezer
Raw Chicken Temperature
Air Verification
Raw Angus
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DO YOU HAVE A: Reach-in Freezer
Raw Chicken Temperature
Air Verification
Raw Angus
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DO YOU HAVE A: Ice Cream Bin
Raw Chicken Temperature
Air Verification
Raw Angus
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DO YOU HAVE A: Meat Bin Freezer
Raw Chicken Temperature
Air Verification
Raw Angus
FRYERS
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Fryers meet oil quality standards
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Vat 1
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Vat 2
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Vat 3
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Vat 4
EQUIPMENT
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DO YOU HAVE A: Dishwasher
Sanitise Temp
Fryer - Oil temp
Grill Surface
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Char Time
MEAT CODE TRACKING LOG
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Enter code date info under type of protein (Expiry date from Consumer)
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Large Meat Patty
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Small Meat Patty
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Chicken Breast Fillets
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Chicken Tenders
WATER TEMPERATURES
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3 Compartment Sink
Handwash Sink 1
Handwash Sink 2
Restroom Handwash Sink 1
Restroom Handwash Sink 2
CHARBROILER TEMPERATURES
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Large Patty
Small Patty
Raw Angus Patty
LTO
FRYER TEMPERATURES
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HB Chicken Tenders
HB Chicken Fillets
Star Nuggets
LTO
HOLDING TEMPERATURES
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Large Meat Patty
Small Meat Patty
AngusMeat Patty
HB Chicken Fillet
HB Chicken Tenders
Grilled onion
Chili
Bacon
LTO
LTO
HAND BREADED CHICKEN STATION
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Chicken Tenders
Chicken Fillets
Buttermilk Batter
HEAT TO TEMPS FROM MICROWAVE
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Chili
Grilled Onion
Bacon
LTO
LTO
PRODUCE IN TIME ON MAKE LINE (4HOUR)
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Lettuce
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Tomato
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White Onion
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Red Onion
COLD LINE TEMPERATURES
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Grated Cheese
Guacamole
Fresh Salsa
Liquid Egg
Pancake Mix
LTO
CORRECTIVE ACTIONS
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ACCOUNTABILITY: Confirm you have added a corrective action in the notes for any item that has been marked as a Fail or did not reach temperature
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Ensure all corrective actions have been entered before completing the audit.
Delivery Temperatures
SUPERIOR FOODS
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Did you receive SUPERIOR FOODS during the shift?
Raw Chicken Temperature
Raw Beef Temperature
Ice Cream Temperature
Cheese Temperature
SIMPLY FRESH
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Did you receive SIMPLY FRESH during the shift?
Lettuce Temperature
Tomato Temperature
BEGA MILK
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Did you receive BEGA MILK during the shift?
Full Cream Milk Temperature
Accountability
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DECLARATON:
1. I hereby confirm that I have diligently and accurately completed all sections of the Daily Temperature Tracking Form and the Critical Deficiency Checklist, ensuring the utmost integrity in the process. I further confirm that there are no Food Safety Critical issues present.
2. I understand and acknowledge that I will be held personally accountable for any violations or breaches of food safety standards that may arise from inaccuracies or failures in the tracking and checklist processes.
3. I am aware that audits are an essential part of maintaining food safety standards, and I accept that they are mandatory.
4. I am prepared to undergo audits during my shifts and upon request by management, recognizing the importance of these audits in ensuring ongoing compliance with food safety regulations. -
Full name
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Signature of the PIC who completed this audit
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Time and Date audit was finished
