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Behaviors

Self Assessment
Chemicals

Chemicals are not stored on or above food preparation counters.

Chemicals are stored below or 12 inches away from food/single use items/clean dishes

Chemicals are not stored on or above dishmachine

Chemicals are not stored on/above clean drain board or sanitize basin of dish sink

Chemicals are in labeled spray bottle/container

Chemicals are covered/ sealed (excluding sanitizer bucket)

No bleach/ unapproved pesticide/ drain cleaner/ unapproved chemical present

No Scented hand lotion/unapproved hand soap/hand sanitizer present

Esteem Sani-NC (US)/ UltraSan (CAN) not observed in store with high-temp dishmachine

Sanitizer Buckets and Bar Towels

Sanitizer container is properly labeled

Proper test strips are available and free of water damage

Quat- solution between 200 and 400ppm

Chlorine- solution between 100 and 200ppm

No towels left sitting on counters/shelves/on or in sink

In container with sanitizer solution

Large red sanitizer bucket not stored on counter or in sink

Clean towels/linens not stored with chemicals or a contamination potential/stored at least 12” away from any contamination potential

Handwashing
Handwashing taking place at appropriate times

After wiping hands on apron

After wiping hands on apron

After handling trash

After coughing/sneezing into hands

After touching face/hair/skin

After eating/drinking

After breaks

After handling dirty dishes or equipment

After blowing nose

After cleaning tasks

Before starting shift

Before putting gloves on

After using restroom

Partners washing hands are using soap and proper technique (incl. 10-15 second scrub)

Documentation

Food service permit is current (note expiration date)

One partner in charge per store with valid food safety certification , or more if your jurisdiction requires it

All partners have valid food worker cards if required

Allergen certification adequate per jurisdiction (MA)

Allergen Poster present in BoH

Heimlich maneuver signage posted where required (CA, CT, GA, MI, MD, NJ, NY, TX)

Most recent Health inspection report posted or on file

Most recent pest report is within 60 days/and available for review

Temp log complete, no entries missing/when required, corrective action noted

Food Safety and Partner Habits
Food Handling & Food Safety

Partner food/beverage is not stored on shelving next to dry goods, clean smallwares, or single use items shelving and at least 12” below and away

No Drinking/Eating (or evidence of) in food storage/food prep area

Partner belongings are not stored while partner is not scheduled to work

Partner belongings are not stored with dry goods, clean smallwares and/or clean linens on metro shelving and at least 12” below and away

Partners are not touching pastries/sandwiches/beverage ingredients/mouth contact parts of items with bare hands

Hot water available in the store (100-120F/38-49C)

No sewage back up in store

Partner in charge can identify all smallwares that need to be washed, rinsed, and sanitized every 2 hours (ice scoops, in-use utensils, pitcher, spoons, lids)

Partner in charge knowledgable of proper dishwashing procedures-Wash, Rinse, Sanitize, then Air Dry

Pest Control

No evidence of mice/rats, flying insects, cockroaches, ants

Partner Uniforms

Aprons/cloths are clean and do not have more than one shift's accumulation of spills and splashes

Long hair beyond shoulder length is tied back/hair restraints are worn per jurisdictional requirement

Partner hands are cleanable, (reference partner handbook, acrylic nails, hand wrap/cast and jewelry)

Partner Health

Not working with severe chest congestion/severe runny nose

Not working with acute diarrhea/ vomiting/jaundice

Not working with fever/chills

Not working with any exposed infected lesion on hand/wrist/arm

Exposed bandages on hand/wrist are covered by single use glove

Exterior of the Store
Drive Thru Lane

Drive thru menu boards/speakers are clean

Drive thru lane does not have trash/cigarettes on ground

Drive thru window area clean

Drive thru window is closed when no cars are in queue

Drive thru trash can is not overflowing

Drive thru equipment in good repair

Entrance and patio of the Store

Doors/Windows below 12 feet clean

Operations

Operations
Exterior of the Store
Drive Thru Lane

Drive thru menu boards/speakers are clean

Drive thru lane does not have trash/cigarettes on ground

Drive thru window is closed when no cars are in queue

Drive thru trash can is not overflowing

Drive thru equipment in good repair

Entrance and patio of the Store

Doors/Windows below 12 feet clean

Exterior door is not left open without air
curtain operating

Sidewalk/patio have no recent spills/no excessive trash on the ground

Trash can(s) are not over flowing

Tables/chairs are clean and in good repair

Umbrellas clean and in good repair

Building awnings/soffit in good condition/not weathered

Exterior walls in good repair

Awnings not excessively dirty

Café: Entrance and Customer Seating Area

Walk off mat clean

Walk off mats in good repair

Door threshold is clean

Doors are in good repair and rodent proof

No Smoking signage posted at all customer entrances (leading outdoors) and patio seating (NA - CA, FL, CO)

Café ledges clean and windows below 12 feet are clean

Windows above 12 feet clean

Café Ceiling/Ducting/Lighting/Vents below 12 feet clean and lights are not out or missing

No dust build up/splatter on 12.8 ceiling/vents/lighting in FOH above 12 feet

Café chairs/tables/lamps clean and in good
repair

Café floor fixtures (baskets/newspaper stands/black apron rack) are clean

Café retail shelving clean

Retail shelving not damaged

Food

Retail packaged coffee within code date

Ambient pre-packaged RTE food within code 1.2 date (Madelines date coded)

Restrooms
Fixtures and condition

Restroom fixtures clean (Hand sink / faucets/toilet/mirror/air 11.7 fresheners/handrails/baby changing table)

Restroom faucets/drainpipes are not dripping/secure/free of damage

Approved soap/paper towel dispensers properly stocked and working

Handwashing signs are present at hand sinks

Soap is not stored in caramel bottle/syrup bottle at hand sink

Hand sink(s) have warm water 100-120 °F (38- 8.4 49 °C)

Restroom fixtures are in good repair and free
of graffiti (Handsink / faucets / toilet / mirror/ 12.2 baby changing table/doors)

Paper towel/soap/toilet paper dispensers/sconce shade/garbage cans are in good repair and free of graffiti

Toilet tissue is loaded into the dispenser

No odor present

General Cleanliness

Restroom ceiling/lighting/walls in good repair
with no graffiti present

No Smoking signage posted in restrooms where required

Food/food contact equipment not stored in restroom

Check floors, walls, ceilings (refer to page 8)

Condiment Bar
General Cleanliness and Condition

Condiment bar is free of excessive spills

No build up under napkin holders/in trash cabinet/under trash ring/under 11.1 sugar/sweetener pack container

No encrusted buildup in sugar/sweetener pack container

Condiment/stir stick containers clean

Condiment bar service plane is not excessively worn and is free of scuffs and gouges

Cabinet facings/hinges in good repair

Condiment bar is free of paint peeling

Cabinet with trash can is clean

Shelving not damaged

Check floors, walls, countertops, ceilings

Smallwares

Condiment bar shaker tops are not dented or
otherwise damaged

All condiment bar shaker(s) labeled

Condiment bar shakers/carafes labels are not peeling/worn/not readable

Exterior door is not left open without air curtain operating

Sidewalk/patio have no recent spills/no excessive trash on the ground

Trash can(s) are not over flowing

Tables/chairs are clean and in good repair

Umbrellas clean and in good repair

Building awnings/soffit in good condition/not weathered

Exterior walls in good repair

Awnings not excessively dirty

Café: Entrance and Customer Seating Area
General Cleanliness and Condition

Walk off mat clean

Walk off mats in good repair

Door threshold is clean

Doors are in good repair and rodent proof

No Smoking signage posted at all customer entrances (leading outdoors) and patio seating

Café ledges clean and windows below 12 feet are clean

Windows above 12 feet clean

Café Ceiling/Ducting/Lighting/Vents below 12 feet clean and lights are not out or missing

No dust build up/splatter on ceiling/vents/lighting in FOH above 12 feet

Café chairs/tables/lamps clean and in good repair

Café floor fixtures (baskets/newspaper stands/black apron rack) are clean

Café retail shelving clean

Retail shelving not damaged

Food

Retail packaged coffee within code date

Ambient pre-packaged RTE food within code date (Madelines date coded)

Restrooms
Fixtures and condition

Restroom fixtures clean (Hand sink / faucets/toilet/mirror/air fresheners/handrails/baby changing table)

Restroom faucets/drainpipes are not dripping/secure/free of damage

Approved soap/paper towel dispensers properly stocked and working

Soap is not stored in caramel bottle/syrup bottle at hand sink

Handwashing signs are present at hand sinks

Hand sink(s) have warm water 100-120 °F (38-49 °C)

Restroom fixtures are in good repair and free of graffiti (Handsink / faucets / toilet / mirror/ baby changing table/doors)

Paper towel/soap/toilet paper dispensers/sconce shade/garbage cans are in good repair and free of graffiti

Toilet tissue is loaded into the dispenser

No odor present

General Cleanliness

Restroom ceiling/lighting/walls in good repair with no graffiti present

No Smoking signage posted in restrooms where required

Food/food contact equipment not stored in restroom

Condiment Bar General Cleanliness and Condition

No encrusted buildup in sugar/sweetener pack container

Condiment/stir stick containers clean

Condiment bar service plane is not excessively worn and is free of scuffs and gouges

Condiment bar is free of paint peeling

Cabinet with trash can is clean

Condiment bar shaker tops are not dented or otherwise damaged

Condiment bar shakers/carafes labels are not peeling/worn/not readable

Condiment bar shakers/Carafes are not visibly dirty

Condiment bar carafes are not chipped/scratched/dented or otherwise damaged

Condiment bar carafes do not have adhesive buildup

Condiment bar bulk sugar container labeled

No build up under napkin holders/in trash cabinet/under trash ring/under sugar/sweetener pack container

Condiment bar is free of excessive spills

Food

Condiment bar packages within code date and open packages dated vanilla/chocolate/cinnamon/nutmeg

Food items stored protected , approved food covering used (indicate product improperly stored)

All Carafes are <41°F (Canada 40°F/4°C)

Pastry Case
General Food Safety

Ambient pre-packaged RTE food within code date at the POS

All products within the pastry case have signage

Allergen Signage present in pastry case

Warming display signage present 'For Display Only' (where applicable)

Non-PHF RTD within code date

Sandwiches/Boxes/Salads/Fruit Cups/Yogurt/Yogurt Parfaits within expiration date

Product is not stored over front vents in the RTD&E case

Stored multi-day pastries dated and within code date

Food items stored protected, approved food covering used (indicate product improperly stored)

Butter/Cream Cheese are not stored at room temperature in the upper portion of the pastry case

Potentially hazardous samples are actively sampled and not left at room temperature

No product above 41°F (Canada 40°F/4°C) in RTD/E case

Equipment and Smallwares

In-use tongs stored in a clean designated container

External rear grill area (vent/condenser coils) clean/free of dust

Pastry cart clean/free of dust

Thermocouple present in the store/working/in good repair/calibrated (Sandwich stores only) (Critical)

Check refrigerated case condition and cleanliness

Top portion of the pastry case clean and free of crumbs

Self-Serve RTD&E case clean

"Hand Sinks (FOH and BOH)
Accessible and used properly "

Handwashing is not taking place in FOH dump sink (and dedicated hand sink present)

Dumping or rinsing is not taking place in dedicated hand sink

Access to hand sink is not blocked by trash cans/product

Smallwares/Product/food/drinks are not stored in or on designated hand sink

Hand sink/faucet is clean

Faucets/drainpipes are not dripping/secure/free of damage

All hand sinks properly stocked soap/paper towel dispenser functioning properly

Approved soap/paper towel dispensers properly stocked and working

Approved soap/paper towel dispensers properly stocked and working

Soap is not stored in caramel bottle/syrup bottle at hand sink

No Scented hand lotion/unapproved hand soap/hand sanitizer present

Handwashing signs are present at hand sinks

Hot water available in store at hand sink 100-120°F (38-49 °C)

"Warming Station
Smallwares "

For-here cups and plates are not chipped/cracked

For-here serveware stored clean

Cutlery free of rust and not bent

Warming tongs/knives are free of multiple dried on product build up

In-use tongs stored on a clean cutting board or other clean surface

Utensil holder not rusting/in poor repair

Cutting boards are free of visible dried build up in grooves

Food contact items are from an approved source and food grade

Silverware/unwrapped plasticware stored handles up

Silverware/ unwrapped plasticware not Stored with handles in multiple directions if laid flat

Silverware/ plasticware stored in clean container

Plexi cubes not cracked/chipped

In use plexi cubes are clean

Oven

Warming oven interior/hinges/back of oven clean/under tray

Oven tray is not cracked/chipped

Warming oven exterior/vents clean

Check floors, walls, countertops, ceilings, refrigerator condition and cleanliness

Non-PHF food within code date

PHF foods within code date

Food items stored protected, approved food covering used (indicate product improperly stored)

Food contact items properly stored

Brewing Station/Backline Fixtures and condition

Faucet fixtures secure/free of damage/not dripping (including drainpipes)

Sink/faucet is clean

Sink/drain pan sealed to counter top

Equipment

Coffee Brewer maintained clean

Coffee grinder and scale maintained clean

Clover machine maintained clean

Smallwares

Spoodle/coffee scale scoop clean and free of chips/dents

Spoodle stored in a clean designated storage container

Tea tongs are stored in a clean designated storage container

8 qt. cubes/lids are free of adhesive build up/stains/scratches/chips

Coffee filters stored covered and protected

Food contact items not stored under dripping condensate or sewage lines

Food contact items are from an approved source and food grade

Stored smallwares are clean

Clean smallwares stored covered/inverted/on a clean surface

Clean smallwares stored separated from non -food related items

Unpackaged cups/lids are stored inverted and in plexi cubes

Plexi cubes not cracked/broken/no peeling tape

In use plexi cubes are clean

Single use cups/lids/reusable cups are free of splash/splatter and stored away from splash range of sinks

Exposed lids store sip side up

Sample cups stored protected

Pour Over Brewing smallwares are clean and free of damage

Pour over brewing coffee scoop stored in clean designated container.

Pour over Brew graduated pitcher stored inverted

Airpots not chipped/excessively dented

Clover whisk and scraper clean, stored properly

Food

Food items stored protected, approved food covering used (indicate product improperly stored)

Food items not stored under dripping condensate or sewage lines (specify location)

Coffee

Ground coffee and whole bean coffee stored protected

Tea and whole bean coffee (including 5 pound bullets) is dated and within code date

Drive thru

Operations
Drive Thru Area General Cleanliness and Condition

Drive thru window area clean handoff plane/window ledges/register area

Drive thru window is not left except during window interactions

Faucet fixtures secure/free of damage/not dripping (including drainpipes)

Cream dispenser clean

Check floors, walls, countertops, ceilings (refer to page 8)

Drive-thru display and equipment clean

Storage

Food items stored protected, approved food covering used (indicate product improperly stored)

Non-PHF RTD dated and within code date

Ambient pre-packaged RTE food within code date

Cream dispenser labeled with contents on exterior of unit

Thermometer located in the front of Cream Dispenser (where applicable)

Thermometer does not have any breaks or gaps in the red gauge" line "

Cream dispenser is not above 41°F (Canada 40°F/4°C)

Cream dispenser contents dated and within code date

Espresso Bar Equipment

Bar ice bins/caddies is absent of mold/slime build up

Bar ice bins/caddies covered and protected

Blender Pitcher Rinser (BPR) clean/no leaks from base or unit

Espresso Machine Clean

Top of espresso machine clean/no dust

Espresso machine food parts clean-bean hopper clean and not damabed, and espresso pour spout clean and not damaged

Espresso machine steam wand and area above steam wand is free of dried on/encrusted build-up

Dish area clean (if in FoH)

Food

Milk/soy within code date

Steaming pitchers are labeled with product type and correct pitcher used when steaming beverage

Bar vanilla/chocolate/cinnamon/ sugar/cinnamon dolce/pumpkin spice powder shaker(s) labeled

Bar caramel/mocha squeeze bottles labeled

Food items stored protected at the bar, approved food covering used (indicate product improperly stored)

Food contact items are from and approved source and food grade

Food items not stored under dripping condensate or sewage lines at the bar

Samples not left uncovered on counter at the bar/handoff plane

PHF are not left on counter above 41°F (Canada 40°F/4°C) (milk/soy/Frappuccino/ whipped cream )

PHF samples are not left on the counter at room temperature

Beverage syrups within code date and dated - list flavor

Sauces (specify product) within code date and dated

Powders/mocha with in code date and dated

Whole bean coffee within code date (including 5 lb bullets)

Milk and Soy is not below 150°F/65.5°C

Milk is never re-steamed/no new milk added to steamed milk

Tea and coffee pitcher(s) dated

Opened dry inclusion bags/pouches dated

CBS beverage syrups within code date and dated

CBS sauces/concentrates (specify product) within code date and dated

CBS powders/mocha with in code date and dated

Peeled bananas dated and within code date

CBS dry inclusions(DIDs)/protein powder/shakers labeled with contents

Caramel/mocha squeeze bottles labeled

Food items stored protected, approved food covering used (indicate product improperly stored)

In use banana tongs do not have multiple use build up and stored in a clean designated container

CBS for-here serveware cups/plates are not chipped/cracked and stored clean

In use blender pitchers and shaker lids stored properly/blender pitchers and shakers not stored stacked on top of another/pitcher or shaker lids not stored on the bottom of the overturned pitcher or shaker

Sanitizer and Wiping Cloths

No wiping cloths left sitting on counters/shelves/on or in sink

Wiping cloths are stored in container with sanitizer solution

Smallwares

Food contact items not stored under dripping condensate or sewage lines at the bar

Bar area stored smallwares put away clean

Bar area clean smallwares stored covered/inverted/on a clean surface

Bar area clean smallwares stored separated from non-food related items

Bar area smallwares have no peeling stickers/tape/adhesive residue

Single use cups/lids/reusable cups are free of splash/splatter and stored away from splash range of sinks

Exposed lids store sip side up

Sample cups stored protected

Splash sticks stored siren-side up

Ice scoops at bar are stored in clean designated storage container between use

Ice scoops at bar are free of chips/handle is not broken

Ice scoops are clean and free of splatter and adhesive build up, sanitized every 2 hours

Steaming pitchers/spoons are free of permanent milk build-up

Steaming pitchers/thermometers are rinsed after each use, sanitized every 2 hours

Dipper well does not contain any utensils/thermometers

Smallwares/sanitizer 2 hour timer is in place and running

In-use smallwares are washed, rinsed and sanitized every 2 hours.

All thermometers within calibration and are being used when required

Unpackaged cups/lids are stored inverted and in plexi cubes

Plexi cubes not cracked/broken/no peeling tape

In use plexi cubes are clean

Cold Beverage Station General Cleanliness and Condition

Sure Shot FMD is not above 41° F (Canada 40°F/4°C)

Blender(s)/housing clean

Blender shroud free of cracks or pieces missing

Blender Pitcher Rinser (BPR) clean including underside/no major leaks

Smallwares

Ice scoops at CBS are stored in clean designated container

Ice scoops at CBS are free of chips and handle is not broken

Ice scoop is clean and free of splatter and adhesive build up, santized every 2 hours

Unpackaged cups/lids are stored inverted and in plexi cubes

Plexi cubes not cracked/broken

In use plexi cubes are clean

Single use cups/lids/reusable cups are free of splash/splatter and stored away from splash range of sinks

Exposed lids store sip side up

Sample cups stored protected

CBS pitchers/8 qt. cubes/lids are free of adhesive build up/stains/scratches or chips

Blender Pitchers/shakers/lids are free of stains/scratched/chips

In use banana tongs do not have multiple use build up and stored in a clean designated container

CBS for-here serveware cups/plates are not chipped/cracked and stored clean

In use blender pitchers and shaker lids stored properly/blender pitchers and shakers not stored stacked on top of another/pitcher or shaker lids not stored on the bottom of the overturned pitcher or shaker

Equipment

CBS ice bins/caddies/FoH ice machine is absent of mold/slime build up

CBS ice bins/caddies covered and protected

Sure Shot Frappuccino Milk Dispenser (FMD) and cream dispensers labeled with contents on exterior of unit

Sure Shot Frappuccino Milk Dispenser (FMD) is clean

Thermometer located in Sure Shot - Frappuccino Milk Dispenser (FMD)

Thermometer does not have any breaks or gaps in the red gauge" line "

Equipment

CBS ice bins/caddies/FoH ice machine is absent of mold/slime build up

CBS ice bins/caddies covered and protected

Sure Shot Frappuccino Milk Dispenser (FMD) and cream dispensers labeled with contents on exterior of unit

Sure Shot Frappuccino Milk Dispenser (FMD) is clean

Thermometer located in Sure Shot - Frappuccino Milk Dispenser (FMD)

BOH Dry Storage General Cleanliness and Condition

Items are not stored on floor preventing cleaning

Dry storage shelving clean

Water filtration system clean/no dust

No Dust build up/splatter on ceiling/vents/lighting in BOH over 12 feet

Doors are in good repair and rodent-proof

No bags of trash stored on floor in back room

Lid closed on back room wheeled trash can

Smallwares

Food contact items are from an approved source and food grade

Cambros or single use Coffee Travelers stored at least 6 (15 cm) off floor and not on merchandise risers/milk crates "

Cups, lids, napkins, pastry bags stored at least 6 (15 cm) off floor and not on merchandise risers/milk crates "

Clean smallwares stored clean and inverted on a clean surface or covered, not mingled with non-food contact items

Food scoops (non-ice) stored in a clean, designated container or in the food with handle extended

Food

Stored thawed multi-day pastries dated and within code date

Packaged coffee/unopend soy/juice VIA/syrups/other within code date

RTD beverage/whole bean coffee/packaged food/pastry for donation stored at least 6 (15 cm) off floor "

Dairy/Soy in reach in within date code

Food not stored on top of turned over milk crates/brown merchandise risers /FOH retail shelving/pastry trays on the floor, approved food covering used

Partner food/beverage is not stored on shelving next to dry goods, clean smallwares, or single use items and at least 12” below and away

No Drinking/Eating (or evidence of) in food storage/food prep area

Mop Sink Area

Mop sink area clean

No strong odors from drain

Wet floor signs/brooms/dust pans/vacuums/mop bucket clean and mop not stored in dirty water

Trash can(s) not over flowing

BOH Refrigeration Equipment Food

Dairy in BoH cooler is within code date

Trash can(s) not over flowing

"BOH Refrigeration Equipment
Food "

Dairy in BoH cooler is within code date

Trash can(s) not over flowing

Dairy in BoH cooler is within code date

Sandwiches/salads/yogurts are dated and within code date

No product above 41°F (Canada 40°F/4°C) In BoH refrigerator

Non PHF RTD within code date

Check refrigerator/freezer condition and cleanliness

Ice Machine

BOH ice machine has no mold/slime build up

BOH ice machine lid is closed

No evidence of paint peeling/rust on outside of ice machine

Interior of ice machine in good repair/free of damage and chips/gasket in good condition

BOH ice scoop is stored in designated storage container between use

BOH ice scoop is not chipped or handle broken and is clean and free of adhesive build-up

BOH ice scoop storage container/bucket interior clean

BOH ice bucket labeled Ice Only" "

BOH Ice bucket is free of chips/cracks

BOH ice bucket is not used for something other than ice

Ice machine exterior dirty

Partner Habits

Partner food/beverage stored in a labeled/lidded container on the bottom shelf /ledge of refrigerator/freezer

Dishwashing Area General Cleanliness and Condition

Flex drain hose not placed in sewer pipe

No sewage back up present in facility

Dish sink/sprayer clean

No soft sponges/magic eraser-like pads in food prep area/dish area

Approved scouring pad/brushes are free of damage

Clean drain board free of anything other than clean dishes

WASH/RINSE/SANITIZE labels present/in correct order/free of damage

Dish compartment sink has hot water (120 °F in CA)

Faucets/drainpipes are not dripping/secure/free of damage

Shelving above dish sink clean

No towels left sitting on counters/shelves/on or in sink

Check floors, walls, countertops, ceilings

Dishmachine

Dishmachine and dishmachine door is clean

At least ½” of Supra is present in the auto feed container of detergent/pump for Supra available in stores without red auto-feed tube

Rinse cycle did reach 180°F on panel read-out for high temp machine (HTM)

Sani-NC (US)/UltraSan (CAN) is present in auto feed container for low temp machines

Chlorine sanitizer concentration is 50-200ppm for low temp dishmachine only

Clear auto-feed tube is not in Supra (clear is for chlorine sanitizer low temp machines only)

Rinse-Aid auto-feed (blue) tube coiled and tucked behind machine

Behind the Bar/Boh

Behind the Bar/BOH (add checkmark if No)

Floors are free of excessive crumbs/trash/debris, dark encrusted build-up cove molding/concrete in good repair (including under refrigerators and cabinetry)

Pastry Case & Warming Station

Brewing - CBS & Espresso

DT area

BOH Dry Storage & Dishwashing

Trash cans not overflowing

Pastry Case & Warming Station

Brewing - CBS & Espresso

DT area

BOH Dry Storage & Dishwashing

Drains clean/no strong odors present

Pastry Case & Warming Station

Brewing - CBS & Espresso

DT area

BOH Dry Storage & Dishwashing

Cabinets are free of water damage/rot and no bare wood exposed/no cabinet built over drain with no access, doors/drawers/hinges/facings/handles clean and in good repair

Pastry Case & Warming Station

Brewing - CBS & Espresso

DT area

BOH Dry Storage & Dishwashing

Countertops and shelving clean, no stickers or residue, sealed to wall or splash gaurd. No excessive damage pitted and facings in good repair.



Pastry Case & Warming Station

Brewing - CBS & Espresso

DT area

BOH Dry Storage & Dishwashing

Sink/ice bin/drain pan sealed to counter top

Pastry Case & Warming Station

Brewing - CBS & Espresso

DT area

BOH Dry Storage & Dishwashing

Signage clean

Pastry Case & Warming Station

Brewing - CBS & Espresso

DT area

BOH Dry Storage & Dishwashing

Walls clean and grease free (behind oven) free of bare wood/exposed dry wall/covering are secure and intact/chipped paint/holes "

Pastry Case & Warming Station

Brewing - CBS & Espresso

DT area

BOH Dry Storage & Dishwashing

Ceiling is free of water damage and chipped paint/paint repair color matches, Lighting/Vents below 12 feet maintained clean and no lights, tiles or sprinkler rings missing



Pastry Case & Warming Station

Brewing - CBS & Espresso

DT area

BOH Dry Storage & Dishwashing

Café and Customer Areas (add checkmark if No)

Pastry Case & Warming Station

Pastry Case & Warming Station

Brewing - CBS & Espresso

DT area

BOH Dry Storage & Dishwashing

Café and Customer Areas (add checkmark if No)

Floors are free of excessive crumbs/trash/debris, dark encrusted build-up cove molding/concrete in good repair (including under refrigerators and cabinetry)


Condiment Bar

Pastry Case Area

Exterior of Store

Restroom

Trash cans not overflowing

Condiment Bar

Pastry Case Area

Exterior of Store

Restroom

Drains clean/no strong odors present

Condiment Bar

Pastry Case Area

Exterior of Store

Restroom

Cabinets are free of water damage/rot and no bare wood exposed/no cabinet built over drain with no access, doors/drawers/hinges/facings/handles clean and in good repair

Pastry Case Area

Condiment Bar

Exterior of Store

Restroom

Countertops and shelving clean, no stickers or residue, sealed to wall or splash gaurd. No excessive damage pitted and facings in good repair.



Pastry Case Area

Condiment Bar

Exterior of Store

Restroom

Sink/ice bin/drain pan sealed to counter top

Pastry Case Area

Condiment Bar

Exterior of Store

Restroom

Signage clean

Pastry Case Area

Condiment Bar

Exterior of Store

Restroom

Walls clean and grease free (behind oven) free of bare wood/exposed dry wall/covering are secure and intact/chipped paint/holes "

Pastry Case Area

Condiment Bar

Exterior of Store

Restroom

Ceiling is free of water damage and chipped paint/paint repair color matches, Lighting/Vents below 12 feet maintained clean and no lights, tiles or sprinkler rings missing



Pastry Case Area

Condiment Bar

Exterior of Store

Restroom

REFRIGERATORS, FREEZERS and CHILLED CASES

Thermometer located in front of case or refrigerator/freezer and in good condition

Chilled Food Case

Warming Station

Brewing

DT Area

CBS

Espresso

BOH

Refrigerator clean and food & case is not above 41°F (Canada 40°F/4°C) with clean working fans, well lit and no torn gaskets

Chilled Food Case

Warming Station

Brewing

DT Area

CBS

Espresso

BOH

Freezer clean with below 0 temp well lit. With no torn or dirty gaskets

Chilled Food Case

Warming Station

Brewing

DT Area

CBS

Espresso

BOH

Items are not stored on top of BOH refrigerator or freezer blocking vents

Chilled Food Case

Warming Station

Brewing

DT Area

CBS

Espresso

BOH

Signatures

Feed back

Supervisor signature
Direct manager signature

Cafe Quality Assurance Standards Audit (QASA)

Created by: SafetyCulture Staff | Industry: Food & Hospitality | Downloads: 132

The Quality Assurance Standards Audit (QASA) is used to measure and drive continuous improvement on the execution of food safety and cleanliness standards across retail stores. The QASA recognition program recognizes stores that demonstrate an exceptional level of adherence to quality assurance standards.

Signup for a free iAuditor account to download and edit this checklist. It will be added to your free account and you will be able to conduct inspections from your mobile device.

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Behaviors

Self Assessment
Chemicals

Chemicals are not stored on or above food preparation counters.

Chemicals are stored below or 12 inches away from food/single use items/clean dishes

Chemicals are not stored on or above dishmachine

Chemicals are not stored on/above clean drain board or sanitize basin of dish sink

Chemicals are in labeled spray bottle/container

Chemicals are covered/ sealed (excluding sanitizer bucket)

No bleach/ unapproved pesticide/ drain cleaner/ unapproved chemical present

No Scented hand lotion/unapproved hand soap/hand sanitizer present

Esteem Sani-NC (US)/ UltraSan (CAN) not observed in store with high-temp dishmachine

Sanitizer Buckets and Bar Towels

Sanitizer container is properly labeled

Proper test strips are available and free of water damage

Quat- solution between 200 and 400ppm

Chlorine- solution between 100 and 200ppm

No towels left sitting on counters/shelves/on or in sink

In container with sanitizer solution

Large red sanitizer bucket not stored on counter or in sink

Clean towels/linens not stored with chemicals or a contamination potential/stored at least 12” away from any contamination potential

Handwashing
Handwashing taking place at appropriate times

After wiping hands on apron

After wiping hands on apron

After handling trash

After coughing/sneezing into hands

After touching face/hair/skin

After eating/drinking

After breaks

After handling dirty dishes or equipment

After blowing nose

After cleaning tasks

Before starting shift

Before putting gloves on

After using restroom

Partners washing hands are using soap and proper technique (incl. 10-15 second scrub)

Documentation

Food service permit is current (note expiration date)

One partner in charge per store with valid food safety certification , or more if your jurisdiction requires it

All partners have valid food worker cards if required

Allergen certification adequate per jurisdiction (MA)

Allergen Poster present in BoH

Heimlich maneuver signage posted where required (CA, CT, GA, MI, MD, NJ, NY, TX)

Most recent Health inspection report posted or on file

Most recent pest report is within 60 days/and available for review

Temp log complete, no entries missing/when required, corrective action noted

Food Safety and Partner Habits
Food Handling & Food Safety

Partner food/beverage is not stored on shelving next to dry goods, clean smallwares, or single use items shelving and at least 12” below and away

No Drinking/Eating (or evidence of) in food storage/food prep area

Partner belongings are not stored while partner is not scheduled to work

Partner belongings are not stored with dry goods, clean smallwares and/or clean linens on metro shelving and at least 12” below and away

Partners are not touching pastries/sandwiches/beverage ingredients/mouth contact parts of items with bare hands

Hot water available in the store (100-120F/38-49C)

No sewage back up in store

Partner in charge can identify all smallwares that need to be washed, rinsed, and sanitized every 2 hours (ice scoops, in-use utensils, pitcher, spoons, lids)

Partner in charge knowledgable of proper dishwashing procedures-Wash, Rinse, Sanitize, then Air Dry

Pest Control

No evidence of mice/rats, flying insects, cockroaches, ants

Partner Uniforms

Aprons/cloths are clean and do not have more than one shift's accumulation of spills and splashes

Long hair beyond shoulder length is tied back/hair restraints are worn per jurisdictional requirement

Partner hands are cleanable, (reference partner handbook, acrylic nails, hand wrap/cast and jewelry)

Partner Health

Not working with severe chest congestion/severe runny nose

Not working with acute diarrhea/ vomiting/jaundice

Not working with fever/chills

Not working with any exposed infected lesion on hand/wrist/arm

Exposed bandages on hand/wrist are covered by single use glove

Exterior of the Store
Drive Thru Lane

Drive thru menu boards/speakers are clean

Drive thru lane does not have trash/cigarettes on ground

Drive thru window area clean

Drive thru window is closed when no cars are in queue

Drive thru trash can is not overflowing

Drive thru equipment in good repair

Entrance and patio of the Store

Doors/Windows below 12 feet clean

Operations

Operations
Exterior of the Store
Drive Thru Lane

Drive thru menu boards/speakers are clean

Drive thru lane does not have trash/cigarettes on ground

Drive thru window is closed when no cars are in queue

Drive thru trash can is not overflowing

Drive thru equipment in good repair

Entrance and patio of the Store

Doors/Windows below 12 feet clean

Exterior door is not left open without air
curtain operating

Sidewalk/patio have no recent spills/no excessive trash on the ground

Trash can(s) are not over flowing

Tables/chairs are clean and in good repair

Umbrellas clean and in good repair

Building awnings/soffit in good condition/not weathered

Exterior walls in good repair

Awnings not excessively dirty

Café: Entrance and Customer Seating Area

Walk off mat clean

Walk off mats in good repair

Door threshold is clean

Doors are in good repair and rodent proof

No Smoking signage posted at all customer entrances (leading outdoors) and patio seating (NA - CA, FL, CO)

Café ledges clean and windows below 12 feet are clean

Windows above 12 feet clean

Café Ceiling/Ducting/Lighting/Vents below 12 feet clean and lights are not out or missing

No dust build up/splatter on 12.8 ceiling/vents/lighting in FOH above 12 feet

Café chairs/tables/lamps clean and in good
repair

Café floor fixtures (baskets/newspaper stands/black apron rack) are clean

Café retail shelving clean

Retail shelving not damaged

Food

Retail packaged coffee within code date

Ambient pre-packaged RTE food within code 1.2 date (Madelines date coded)

Restrooms
Fixtures and condition

Restroom fixtures clean (Hand sink / faucets/toilet/mirror/air 11.7 fresheners/handrails/baby changing table)

Restroom faucets/drainpipes are not dripping/secure/free of damage

Approved soap/paper towel dispensers properly stocked and working

Handwashing signs are present at hand sinks

Soap is not stored in caramel bottle/syrup bottle at hand sink

Hand sink(s) have warm water 100-120 °F (38- 8.4 49 °C)

Restroom fixtures are in good repair and free
of graffiti (Handsink / faucets / toilet / mirror/ 12.2 baby changing table/doors)

Paper towel/soap/toilet paper dispensers/sconce shade/garbage cans are in good repair and free of graffiti

Toilet tissue is loaded into the dispenser

No odor present

General Cleanliness

Restroom ceiling/lighting/walls in good repair
with no graffiti present

No Smoking signage posted in restrooms where required

Food/food contact equipment not stored in restroom

Check floors, walls, ceilings (refer to page 8)

Condiment Bar
General Cleanliness and Condition

Condiment bar is free of excessive spills

No build up under napkin holders/in trash cabinet/under trash ring/under 11.1 sugar/sweetener pack container

No encrusted buildup in sugar/sweetener pack container

Condiment/stir stick containers clean

Condiment bar service plane is not excessively worn and is free of scuffs and gouges

Cabinet facings/hinges in good repair

Condiment bar is free of paint peeling

Cabinet with trash can is clean

Shelving not damaged

Check floors, walls, countertops, ceilings

Smallwares

Condiment bar shaker tops are not dented or
otherwise damaged

All condiment bar shaker(s) labeled

Condiment bar shakers/carafes labels are not peeling/worn/not readable

Exterior door is not left open without air curtain operating

Sidewalk/patio have no recent spills/no excessive trash on the ground

Trash can(s) are not over flowing

Tables/chairs are clean and in good repair

Umbrellas clean and in good repair

Building awnings/soffit in good condition/not weathered

Exterior walls in good repair

Awnings not excessively dirty

Café: Entrance and Customer Seating Area
General Cleanliness and Condition

Walk off mat clean

Walk off mats in good repair

Door threshold is clean

Doors are in good repair and rodent proof

No Smoking signage posted at all customer entrances (leading outdoors) and patio seating

Café ledges clean and windows below 12 feet are clean

Windows above 12 feet clean

Café Ceiling/Ducting/Lighting/Vents below 12 feet clean and lights are not out or missing

No dust build up/splatter on ceiling/vents/lighting in FOH above 12 feet

Café chairs/tables/lamps clean and in good repair

Café floor fixtures (baskets/newspaper stands/black apron rack) are clean

Café retail shelving clean

Retail shelving not damaged

Food

Retail packaged coffee within code date

Ambient pre-packaged RTE food within code date (Madelines date coded)

Restrooms
Fixtures and condition

Restroom fixtures clean (Hand sink / faucets/toilet/mirror/air fresheners/handrails/baby changing table)

Restroom faucets/drainpipes are not dripping/secure/free of damage

Approved soap/paper towel dispensers properly stocked and working

Soap is not stored in caramel bottle/syrup bottle at hand sink

Handwashing signs are present at hand sinks

Hand sink(s) have warm water 100-120 °F (38-49 °C)

Restroom fixtures are in good repair and free of graffiti (Handsink / faucets / toilet / mirror/ baby changing table/doors)

Paper towel/soap/toilet paper dispensers/sconce shade/garbage cans are in good repair and free of graffiti

Toilet tissue is loaded into the dispenser

No odor present

General Cleanliness

Restroom ceiling/lighting/walls in good repair with no graffiti present

No Smoking signage posted in restrooms where required

Food/food contact equipment not stored in restroom

Condiment Bar General Cleanliness and Condition

No encrusted buildup in sugar/sweetener pack container

Condiment/stir stick containers clean

Condiment bar service plane is not excessively worn and is free of scuffs and gouges

Condiment bar is free of paint peeling

Cabinet with trash can is clean

Condiment bar shaker tops are not dented or otherwise damaged

Condiment bar shakers/carafes labels are not peeling/worn/not readable

Condiment bar shakers/Carafes are not visibly dirty

Condiment bar carafes are not chipped/scratched/dented or otherwise damaged

Condiment bar carafes do not have adhesive buildup

Condiment bar bulk sugar container labeled

No build up under napkin holders/in trash cabinet/under trash ring/under sugar/sweetener pack container

Condiment bar is free of excessive spills

Food

Condiment bar packages within code date and open packages dated vanilla/chocolate/cinnamon/nutmeg

Food items stored protected , approved food covering used (indicate product improperly stored)

All Carafes are <41°F (Canada 40°F/4°C)

Pastry Case
General Food Safety

Ambient pre-packaged RTE food within code date at the POS

All products within the pastry case have signage

Allergen Signage present in pastry case

Warming display signage present 'For Display Only' (where applicable)

Non-PHF RTD within code date

Sandwiches/Boxes/Salads/Fruit Cups/Yogurt/Yogurt Parfaits within expiration date

Product is not stored over front vents in the RTD&E case

Stored multi-day pastries dated and within code date

Food items stored protected, approved food covering used (indicate product improperly stored)

Butter/Cream Cheese are not stored at room temperature in the upper portion of the pastry case

Potentially hazardous samples are actively sampled and not left at room temperature

No product above 41°F (Canada 40°F/4°C) in RTD/E case

Equipment and Smallwares

In-use tongs stored in a clean designated container

External rear grill area (vent/condenser coils) clean/free of dust

Pastry cart clean/free of dust

Thermocouple present in the store/working/in good repair/calibrated (Sandwich stores only) (Critical)

Check refrigerated case condition and cleanliness

Top portion of the pastry case clean and free of crumbs

Self-Serve RTD&E case clean

"Hand Sinks (FOH and BOH)
Accessible and used properly "

Handwashing is not taking place in FOH dump sink (and dedicated hand sink present)

Dumping or rinsing is not taking place in dedicated hand sink

Access to hand sink is not blocked by trash cans/product

Smallwares/Product/food/drinks are not stored in or on designated hand sink

Hand sink/faucet is clean

Faucets/drainpipes are not dripping/secure/free of damage

All hand sinks properly stocked soap/paper towel dispenser functioning properly

Approved soap/paper towel dispensers properly stocked and working

Approved soap/paper towel dispensers properly stocked and working

Soap is not stored in caramel bottle/syrup bottle at hand sink

No Scented hand lotion/unapproved hand soap/hand sanitizer present

Handwashing signs are present at hand sinks

Hot water available in store at hand sink 100-120°F (38-49 °C)

"Warming Station
Smallwares "

For-here cups and plates are not chipped/cracked

For-here serveware stored clean

Cutlery free of rust and not bent

Warming tongs/knives are free of multiple dried on product build up

In-use tongs stored on a clean cutting board or other clean surface

Utensil holder not rusting/in poor repair

Cutting boards are free of visible dried build up in grooves

Food contact items are from an approved source and food grade

Silverware/unwrapped plasticware stored handles up

Silverware/ unwrapped plasticware not Stored with handles in multiple directions if laid flat

Silverware/ plasticware stored in clean container

Plexi cubes not cracked/chipped

In use plexi cubes are clean

Oven

Warming oven interior/hinges/back of oven clean/under tray

Oven tray is not cracked/chipped

Warming oven exterior/vents clean

Check floors, walls, countertops, ceilings, refrigerator condition and cleanliness

Non-PHF food within code date

PHF foods within code date

Food items stored protected, approved food covering used (indicate product improperly stored)

Food contact items properly stored

Brewing Station/Backline Fixtures and condition

Faucet fixtures secure/free of damage/not dripping (including drainpipes)

Sink/faucet is clean

Sink/drain pan sealed to counter top

Equipment

Coffee Brewer maintained clean

Coffee grinder and scale maintained clean

Clover machine maintained clean

Smallwares

Spoodle/coffee scale scoop clean and free of chips/dents

Spoodle stored in a clean designated storage container

Tea tongs are stored in a clean designated storage container

8 qt. cubes/lids are free of adhesive build up/stains/scratches/chips

Coffee filters stored covered and protected

Food contact items not stored under dripping condensate or sewage lines

Food contact items are from an approved source and food grade

Stored smallwares are clean

Clean smallwares stored covered/inverted/on a clean surface

Clean smallwares stored separated from non -food related items

Unpackaged cups/lids are stored inverted and in plexi cubes

Plexi cubes not cracked/broken/no peeling tape

In use plexi cubes are clean

Single use cups/lids/reusable cups are free of splash/splatter and stored away from splash range of sinks

Exposed lids store sip side up

Sample cups stored protected

Pour Over Brewing smallwares are clean and free of damage

Pour over brewing coffee scoop stored in clean designated container.

Pour over Brew graduated pitcher stored inverted

Airpots not chipped/excessively dented

Clover whisk and scraper clean, stored properly

Food

Food items stored protected, approved food covering used (indicate product improperly stored)

Food items not stored under dripping condensate or sewage lines (specify location)

Coffee

Ground coffee and whole bean coffee stored protected

Tea and whole bean coffee (including 5 pound bullets) is dated and within code date

Drive thru

Operations
Drive Thru Area General Cleanliness and Condition

Drive thru window area clean handoff plane/window ledges/register area

Drive thru window is not left except during window interactions

Faucet fixtures secure/free of damage/not dripping (including drainpipes)

Cream dispenser clean

Check floors, walls, countertops, ceilings (refer to page 8)

Drive-thru display and equipment clean

Storage

Food items stored protected, approved food covering used (indicate product improperly stored)

Non-PHF RTD dated and within code date

Ambient pre-packaged RTE food within code date

Cream dispenser labeled with contents on exterior of unit

Thermometer located in the front of Cream Dispenser (where applicable)

Thermometer does not have any breaks or gaps in the red gauge" line "

Cream dispenser is not above 41°F (Canada 40°F/4°C)

Cream dispenser contents dated and within code date

Espresso Bar Equipment

Bar ice bins/caddies is absent of mold/slime build up

Bar ice bins/caddies covered and protected

Blender Pitcher Rinser (BPR) clean/no leaks from base or unit

Espresso Machine Clean

Top of espresso machine clean/no dust

Espresso machine food parts clean-bean hopper clean and not damabed, and espresso pour spout clean and not damaged

Espresso machine steam wand and area above steam wand is free of dried on/encrusted build-up

Dish area clean (if in FoH)

Food

Milk/soy within code date

Steaming pitchers are labeled with product type and correct pitcher used when steaming beverage

Bar vanilla/chocolate/cinnamon/ sugar/cinnamon dolce/pumpkin spice powder shaker(s) labeled

Bar caramel/mocha squeeze bottles labeled

Food items stored protected at the bar, approved food covering used (indicate product improperly stored)

Food contact items are from and approved source and food grade

Food items not stored under dripping condensate or sewage lines at the bar

Samples not left uncovered on counter at the bar/handoff plane

PHF are not left on counter above 41°F (Canada 40°F/4°C) (milk/soy/Frappuccino/ whipped cream )

PHF samples are not left on the counter at room temperature

Beverage syrups within code date and dated - list flavor