Title Page

  • Store #

  • PIC

  • Conducted on

  • Prepared by

  • Location

Food Safety Travel Path

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  • Imminent Health Hazards(AF)

  • Crossing the Blue Door Wash Your HandsMake sure Food Safety Timers are on. (Handwash, Tools, and Sanitizer)(5pt)

  • Check Serve Safe Not Expired EE works at store. (5pt) Illness

  • Policy Visably Posted and no sick EE working (5pt)

  • Show and Know book present (3pt) /Bodily Fluid Clean up Kit (1pt)

  • FSC Book % completion (3pt)

  • Receiving Log (3pt)

  • Ecolab book - has come to store 3 months

  • Check Sanitizer strength is 150-400ppm, test strips not expired, towel in bucket. Buckets labeled. (1,1pt)

  • Check 5 items at sink. Clean sink, hot and cold water, job aid, trash can, soap and towels. But nothing stocked in sink. (5pt)

  • Check all TPH timers are running (5pt)

  • Check all hot-holding PHU, UHC, Taco Warmer, Fry Bin timers are on (5pt)

  • Food contact surfaces, Dishes, Equipment, Prep Tools, and Backup Tools are clean. (3pt)<br>If not in standard, what was not clean? Check all that apply

  • Microwaves

  • Backup Tools

  • Food Contact Surfaces (ie. assembly table, taco assembly)

  • Dishes

  • Prep Tools and Equipment

  • Food contact surfaces, Dishes, Equipment, Prep Tools, and Backup Tools are in good condition. (3pt)

  • Microwaves

  • Backup Tools

  • Food Contact Surfaces (ie. assembly table, taco assembly)

  • Dishes

  • Prep Tools and Equipment

  • 3 Compartment Sink and Dishwashing. (5pt)

  • Dishwashing Job AId Posted

  • Sink has wash, rinse, and sanitize stickers

  • Spray head Clean

  • Sink drain covers/screens are on

  • Soap and Sanitizer Dispensers Working

  • Water reaches 120F

  • If store has a Dishwasher check Sanitizer Strenght

  • Drains have 1-inch air gap, no standing water. Back flow devices installed (5pt)-

  • Drains free of debris(3pt)

  • POU or Walk-in check: Are the gaskets and unit dirty? (3pt)

  • POU or Walk-in check: Are the gaskets torn? (1pt)

  • POU or Walk-in check: Is there a working dial thermometer in the warmest part of the unit? Is unit at correct temp? (3pt)

  • Product Temperatures(5pt): Is the food inside of the unit meeting the correct temperature? No Product outside longer than 40min. Proper thawing procedures followed.

  • Ice Machines (3pts) - Ice bin and lid clean clean, Ice bucket stored upside down, DT ice bin and lid clean

  • Beverage dispensers

  • Contamination: Food or Packaging(5pt)

  • Storage: Food and Packaging (no raw products above ready to eat, no products exposed to air)(3pt)

  • Make sure no expired products. (3pt)

Procedures By Station

Grill/Assembly

  • Team Member Name

  • When starting observations take a picture of workstation planner

  • Did TM Place, Time Sear when cooking patties on the grill?

  • How did you coach the EE?

  • Did TM perform a final flip and check?

  • How did you coach the EE?

  • Did TM have a hold time on products held at their station and the product was discarded product once the hold time sounded?

  • How did you coach the EE?

  • Did TM use TPH timers correctly?

  • How did you coach the EE?

  • Was the TM was using cook times for all products (including bacon, eggs and onions)? Does not remove food before the timer sounds?

  • How did you coach the EE?

  • When ending observations take a picture of the Build to Charts

Fryer

  • Team Member Name

  • When starting observations take a picture of workstation planner

  • Did the TM wait until the cook time sounded to remove the food?

  • How did you coach the EE?

  • Did TM have a hold time on products held at their station and the product was discarded product once the hold time sounded? Including taco stager.

  • How did you coach the EE?

  • Does TM have their TPH timers turned on?

  • How did you coach the EE?

  • Does TM shake baskets when shake time sounds?

  • How did you coach the EE?

  • Are raw products stored and handled properly?

  • How did you coach the EE?

  • When ending observations take a picture of the Build to Charts

Handwashing and Glove Use

  • Was an hourly handwash performed correctly?

  • How did you coach the EE?

  • Were Employees washing their hands correctly (ie. with warm water, 20 seconds)?

  • How did you coach the EE?

  • Where EE washing their hands when crossing the blue door?

  • How did you coach the EE?

  • Did EE wash their hands after touching their body or uniform?

  • How did you coach the EE?

  • Did EE wash their hands after conducting a cleaning activity?

  • How did you coach the EE?

  • Did EE wash their hands when picking up something off the floor?

  • Gloves are used when handling read to eat foods

  • How did you coach the EE?

  • If wearing nail polish or artificial nails were TM wearing gloves?

  • How did you coach the EE?

PIC

  • Can PIC calibrate thermometers correctly?

  • Did PIC take the temperature of the grill and patty correctly?

  • Did the PIC take the temperature of microwaved rice properly?

  • Did the PIC take the temperature of the shake machine correctly?

  • Did the PIC take temperature of the fryers correctly?

Speed Academy Tools

Speed Academy

  • Workstation Planners Posted and In Use

  • PIC Planner Posted and in Use (# 1263)

  • WSP Chart Posted and Up to date

  • Quick Excellence Poster Posted / Updated with Goals (#4143)

  • Build to Charts Posted, Current, And replenished at 50%

Find the Fives Board

  • Take a picture of Find the Fives Board

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.