2023 Food Safety Inspection

• Site conducted

  Select

• Conducted on

  Date

• Prepared by

• Location
  Address

Imminent Health Risks

• Running Hot & cold water is available

  Pass

  Fail

• Manager and team members are free of illnesses and symptoms

  Pass

  Fail

• Free of adulterated/contaminated products

  Pass

  Fail

• Free of sewer backups

  Pass

  Fail

• Free of pest infestation leading to food/contact surface contamination

  Pass

  Fail

• Restaurant has sanitizer

  Pass

  Fail

• Free of flood

  Pass

  Fail

• Hand washing sinks are provided

  Pass

  Fail

• Time and Temperature Controlled for Safety (TCS) food are held at the proper temperature and documentation proves that the product has been held at the proper temperature for the last 4 hours or more

  Pass

  Fail

Sanitation

• Hot water reaches a minimum of 100 °F at all sinks, 110 °F at 3-compartment sink, and 160 °F surface temperature in all dish washing machines

  Yes

  No

  N/A

• Sanitizer is at proper concentration at all sinks, buckets, and cups

  Yes

  No

  N/A

• Chemicals are all approved, properly labeled, and stored correctly

  Yes

  No

  N/A

• Premises of exterior & interior (back of house) are clean and maintained

  Yes

  No

  N/A

• All components of the 3-compartment sink are set up correctly and used properly

  Yes

  No

  N/A

• In-use equipment and prep tables are clean and sanitized at proper frequency

  Yes

  No

  N/A

• In-use utensils and small wares are clean and sanitized at proper frequency

  Yes

  No

  N/A

Employee Health

• Person in charge understands Dunkin'/Baskin-Robbins standards for employee health

  Yes

  No

  N/A

• Hand washing sinks are fully stocked and used properly

  Yes

  No

  N/A

• No bare hand contact with ready-to-eat (RTE) food

  Yes

  No

  N/A

• Franchisee's employees are washing hands at proper frequency and hygienic practices are followed

  Yes

  No

  N/A

Temperature

• Refrigerated food held at 41 °F or below

  Yes

  No

  N/A

• Hot food held at 140 °F or above

  Yes

  No

  N/A

• Food cooked to the correct temperature

  Yes

  No

  N/A

Good Retail Practices

• Food is approved, within date code, and labeled properly

  Yes

  No

  N/A

• Food and packaging are protected from contamination and allergen cross-contact

  Yes

  No

  N/A

• Packaging is used in an approved manner

  Yes

  No

  N/A

• Restaurant meets Dunkin'/Baskin-Robbins Pest Management standards

  Yes

  No

  N/A

Documentation

• Monthly Food Safety Self Assessments are complete, accurate, and with corrective actions

  Yes

  No

  N/A

• Cold and hot holding temperature documents are complete, accurate, and with corrective actions

  Yes

  No

  N/A

• Cooking temperature documents are complete, accurate, and with corrective actions

  Yes

  No

  N/A

• Receiving documents are complete, accurate, and with corrective actions

  Yes

  No

  N/A

• Additional required Food Safety documentation and resources are present and accessible as required

  Yes

  No

  N/A

Sign Off

• Name and Signature

  Sign