2019 QA Checklist

• Conducted on

  Date

• Prepared by

• Location
  Address

• Beverage Station - Drink nozzles, tea nozzles and inside of ice chute clean/no mold

  Yes

  No

  N/A

• Dipper Well/Shake Station - Spindle clean, timing of water cup and cleaning procedures followed

  Yes

  No

  N/A

Backline

• Hot Holding - Temperature > 135 degrees (PHF)

  Yes

  No

  N/A

• Chicken Tenders Station - Raw chicken temperatures < 41 degrees (PHF)

  Yes

  No

  N/A

• Tempered/Prepped Foods - PHF product used is in date. Produce tagged 4 hours.

  Yes

  No

  N/A

Dishes, Hands & Gloves

• Wash Sinks - Sinks set up properly when washing dishes. Wash (110 degrees F), rinse, sanitize (200-400ppm)

  Yes

  No

  N/A

• Hand Sinks - Hand sink is not blocked, used only for hand washing & fully stocked

  Yes

  No

  N/A

• Hand Washing/Hygiene - Hands washed when changing duties and between glove changes

  Yes

  No

  N/A

• Hand Washing/Hygiene - Proper hand washing using soap, hot water, and washing for 20 seconds

  Yes

  No

  N/A

• Disposable Gloves - Disposable gloves worn when handling RTE foods

  Yes

  No

  N/A

• Disposable Gloves - Disposable gloves changed when contaminated

  Yes

  No

  N/A

Food Prep/Storage

• Prep Sinks/Table - Prepping food on table/sink properly cleaned/sanitized

  Yes

  No

  N/A

• Prep Sinks/Table - Prep sink used only for food prep

  Yes

  No

  N/A

• Utensils/Pans - Utensils, pans, knives, cutting boards clean and in good repair

  Yes

  No

  N/A

• Utensils/Pans - Approved scoop, ice buckets (not stacked), used for ice only, clean and in good repair. No cracks/chips

  Yes

  No

  N/A

• Produce Slicer/Dicer - Equipment stored clean. No food debris or buildup

  Yes

  No

  N/A

• Produce Slicer/Dicer - Dicer block in good repair. No pieces missing

  Yes

  No

  N/A

• Produce Slicer/Dicer - Slicer cutting blade in good repair. No chips in the cutting edge

  Yes

  No

  N/A

• Ice Machine/Bins - Ice machine interior is clean and free of rust/mold

  Yes

  No

  N/A

• Ice Machine/Bins - Lid on beverage bar ice bin

  Yes

  No

  N/A

• Ice Machine/Bins - Interior of ice bin clean at drive thru

  Yes

  No

  N/A

Cold Storage

• Walk in Cooler, Reach ins. Breakfast Products on Ice Baths - Product temperature < 41 degrees F (PHF)

  Yes

  No

  N/A

• Walk in Cooler, Reach ins. Breakfast Products on Ice Baths - PHF product not out of date/stored protected from contamination

  Yes

  No

  N/A

• Walk in Cooler, Reach ins. Breakfast Products on Ice Baths - Proper cooling procedures (<2" shallow pans/product depth)

  Yes

  No

  N/A

Frozen Storage

• Walk in Freezer/Reach ins - Product hard frozen. PHF product not out of date

  Yes

  No

  N/A

Safe Cooking

• Raw Product Temps - Raw beef (160 degrees F) and raw chicken products (165 degrees F)

  Yes

  No

  N/A

• Charbroiler Condition - Reverberator screen not burned through/no loose wires

  Yes

  No

  N/A

General Sanitation

• Pests - No roaches/flies/rodents/pests evident

  Yes

  No

  N/A

• Chemicals - Chemicals not stored with food, single service items, or at or above prep sink/clean side of 3 compartment sink

  Yes

  No

  N/A

• Sanitizer availability and Usage - Quat sanitizer concentration between 200-400 ppm while in use at 3 compartment sink, backline, and chicken station

  Yes

  No

  N/A

• Employee Food/Drinks - No employee food/drinks improperly stored or in work area

  Yes

  No

  N/A

• QA Temperature Forms - Properly completed with corrective action, working thermometer

  Yes

  No

  N/A

Restrooms

• Restroom Supplies - Soap, paper towels/operating hand dryer present

  Yes

  No

  N/A

• Toilets/Fictures Functional - Functional toilet in each restroom

  Yes

  No

  N/A

• Toilet paper available

  Yes

  No

  N/A

Comments/Corrective Action For Any Item Checked No

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