Cafe Inspection

• Document No.

• Conducted on

  Date

Food Temperature/Time Requirements

• 1.Proper Cooling for Cooked /prepared Food

  Yes

  No

  N/A

• 2. Cold Hold (41/45 degrees window)

  Yes

  No

  N/A

• 3.Hot Hold (135 degrees)

  Yes

  No

  N/A

• 4. Proper Cooking Temperatures

  Yes

  No

  N/A

• 4.1. Beef, Veal, Lamb, Steaks & Roasts 165F

  Yes

  No

  N/A

• 4.2. Fish 145F

  Yes

  No

  N/A

• 4.3. Pork 160F

  Yes

  No

  N/A

• 4.4. Ground Beef, Veal, Lamb 160F

  Yes

  No

  N/A

• 4.5. Egg Dishes 160F

  Yes

  No

  N/A

• 4.6. Turkey, Chicken, Duck, Whole or Ground 165F

  Yes

  No

  N/A

• 5.Rapid Reheating (165 degrees)

  Yes

  No

  N/A

• Additional Notes

Personnel/Handling/Source Requirements

• 6.Personnel with Infections Restricted/Excluded

  Yes

  No

  N/A

• 7.Proper/Adequate Hand Washing

  Yes

  No

  N/A

• 8.Good Hygienic Practices (No Eating/Drinking/Smoking)

  Yes

  No

  N/A

• 9.Proper Handling of Ready-To-Eat-Foods

  Yes

  No

  N/A

• 10.Cross-contamination of Raw/Cooked Foods/Other

  Yes

  No

  N/A

• 11.Approved Systems (HACCP Plans/Time)

  Yes

  No

  N/A

• 12.Water Supply (Sufficient Hot and Cold Under Pressure)

  Yes

  No

  N/A

• Additional Notes

Facility and Equipment Requirements

• 13.Equipment Adequate to Maintain Product Temp

  Yes

  No

  N/A

• 14.Hand Wash Facilities Adequate and Accessible

  Yes

  No

  N/A

• 15.Hand Wash Facilities with Soap and Towels

  Yes

  No

  N/A

• 16.Evidence of Insect Contamination

  Yes

  No

  N/A

• 17.Evidence of Rodent/Other Animals

  Yes

  No

  N/A

• 18.Toxic Items Properly Labeled/Stored/Used

  Yes

  No

  N/A

• 19.Manual/Mechanical Ware Washing and Sanitizing

  Yes

  No

  N/A

• 20.Manager Demonstration of Knowledge/Certified Food Manger

  Yes

  No

  N/A

• 21.Approved Sewage/Wastewater Disposal System, Proper Disposal

  Yes

  No

  N/A

• 22.Thermometers Provided/Accurate/Properly Calibrated (+or-2 degrees)

  Yes

  No

  N/A

• 23.Food Contact Surfaces of Equipment and Utensils Cleaned/Sanitized/Good Repair

  Yes

  No

  N/A

• 24.Posting of Consumer Advisories (Heimlich/Disclosure/Reminder)

  Yes

  No

  N/A

• 25.Inspection Reports/Food Establishment Permit are Posted and Current

  Yes

  No

  N/A

• Additional Notes

Inspection Summary

• Based on this inspection the contracted food vendor meets the health and safety standards set forth by the local metropolitan health district.

  Yes

  No

  N/A

• This inspection was performed on the following date and time:

  Date

• This inspection was performed by:

  Sign