12 Critical Check

• Conducted on

  Date

• Prepared by

• Location
  Address

Personal Hygiene Practices meet Standard

• Hands are washed when required

  Yes

  No

  N/A

• Handwashing procedure is executed properly

  Yes

  No

  N/A

• Paper towel, soap, and hand sanitizer dispensers are stocked and easily dispensed

  Yes

  No

  N/A

• No evidence of Team Members working while ill

  Yes

  No

  N/A

• Team Member observed with uncovered uncovered sore on hand/arm

  Yes

  No

  N/A

• Gloves (if required) are available and used appropriately

  Yes

  No

  N/A

• At least one handwashing sink in the back of house is functional

  Yes

  No

  N/A

Personal Hygiene Practices meet Standard

• Handwashing sinks are free from obstruction

  Yes

  No

  N/A

• Handwashing sinks in kitchen meet a minimum of 100F/38C

  Yes

  No

  N/A

• Blue Band-Aids are available

  Yes

  No

  N/A

Cooking Practices are adequate

• Manager is able to perform proper Cook-Out procedures

  Yes

  No

  N/A

Contamination Protections are in place

• Proper use of tongs observed

  Yes

  No

  N/A

• Cooked and raw products are kept separate, with no potential for contamination

  Yes

  No

  N/A

• Physical Contamination is not observed

  Yes

  No

  N/A

• Allergen Guidelines and Procedures are properly followed

  Yes

  No

  N/A

• Back of House areas are free from roof leaks

  Yes

  No

  N/A

• All chemicals present are labeled and stored properly

  Yes

  No

  N/A

Contamination Protections are in place

• Restaurant is free from drainage back up

  Yes

  No

  N/A

• Dented, Rusted, Swollen, or Leaking cans are segregated and marked "Do Not Use"

  Yes

  No

  N/A

Holding Practices are implemented appropriately

• Hot PHFs meet the requisite minimum temperature guidelines

  Yes

  No

  N/A

• Cold PHFs meet the requisite minimum temperature guidelines

  Yes

  No

  N/A

• No expired PHF items held at room temperature are observed

  Yes

  No

  N/A

• All PHF items held at room temperature are properly marked

  Yes

  No

  N/A

• Old and new PHFs are not mixed

  Yes

  No

  N/A

• Soft serve and Shake mix in hopper meets requisite mimimum temperature guidelines

  Yes

  No

  N/A

Equipment Protected from Contamination

• Sanitizing solution strength meets minimum strength requirement

  Yes

  No

  N/A

• Sanitizer solutions are in properly labeled and approved containers

  Yes

  No

  N/A

• Sanitizing buckets/bottles available for all stations and/or not close to open food containers

  Yes

  No

  N/A

• Approved clean cloths are submerged in sanitizing solution

  Yes

  No

  N/A

• No evidence of build-up or Cross Contamination in the soft serve vat

  Yes

  No

  N/A

• All required shake/soft serve brushes are present, clean, in good condition, and stored properly

  Yes

  No

  N/A

• Soft serve machine sanitizer and approved lube is available

  Yes

  No

  N/A

• Smallwares and PHU pans are properly maintained and not burned, no evidence of cracks on the food contact surface

  Yes

  No

  N/A

• Food contact surfaces of Vegetable Slicers, PHU Pans, and Tongs are properly cleaned before storage with no build-up observed

  Yes

  No

  N/A

• Wash/Rinse/Sanitize procedure is properly followed

  Yes

  No

  N/A

Equipment Protected from Contamination

• Non-handwashing sinks in kitchen areas meet a minimum of 110F/42C

  Yes

  No

  N/A

• Food Contact surfaces of the Ice Machine are free of mold

  Yes

  No

  N/A

• Soda nozzles are properly cleaned with no build-up observed

  Yes

  No

  N/A

• All equipment and prep washing sinks are functional

  Yes

  No

  N/A

Purchases are from Approved Sources

• All food present is approved

  Yes

  No

  N/A

• All equipment, smallwares, and tools present are approved

  Yes

  No

  N/A

• All chemicals present are approved

  Yes

  No

  N/A

Purchases are from Approved Sources

• All packaging and paper supplies are approved

  Yes

  No

  N/A

• Employee food is properly stored and not prepared on/with restaurant equipment

  Yes

  No

  N/A

Pest Issues are not observed

• Live or Dead rodents are not observed

  Yes

  No

  N/A

• Rodent droppings are not observed

  Yes

  No

  N/A

• Live or dead cockroaches are not observed

  Yes

  No

  N/A

• Flies are not observed landing on food

  Yes

  No

  N/A

• Birds and/or bats are not nesting inside the restaurant

  Yes

  No

  N/A

• Excessive fly activity is not observed

  Yes

  No

  N/A

Pest Issues are not observed

• Ant trails are not observed in the back of house

  Yes

  No

  N/A

• Pest Control report is on file in the restaurant

  Yes

  No

  N/A

Food Safety Systems are in place and implemented appropriately

• Critical issues on the Health Department Inspection are corrected within 10 days or the timeline specified on the inspection

  Yes

  No

  N/A

• Daily Planner/Quality Check Logs are completed for the last 30 days

  Yes

  No

  N/A

• Approved calibrated thermometer is available

  Yes

  No

  N/A

• Registered temperatures in the Cook-Out Log are within proper range

  Yes

  No

  N/A

• Sanitizer test strips are available

  Yes

  No

  N/A

• Cook-Out Logs are completed for the last 30 days

  Yes

  No

  N/A

• ServSafe Certificate is available and unexpired for the person in charge

  Yes

  No

  N/A

Food Safety Systems are in place and implemented appropriately

• Most recent Health Department Inspection is Available

  Yes

  No

  N/A

• Non-Critical issues on the Health Department Inspection are corrected within the necessary timeline

  Yes

  No

  N/A