Title Page

  • Date:

  • Profit Center Number/Name:

  • Location Number/Name:

  • Site

  • Prepared By

  • Frequency

CLEAN

  • Dining | Concessions | Refreshments With Bulk Dispensing

  • Q1. Are employees correctly washing their hands when necessary?

  • Criteria Not Met

  • Dining | Concessions | Refreshments With Bulk Dispensing

  • Q2. Are handwash sinks accessible, stocked appropriately, in good repair, and equipped to provide water at a minimum of 100°F (38°C), with a handwashing sign posted

  • Criteria Not Met

  • Dining | Concessions | Refreshments With Bulk Dispensing

  • Q3. Are disposable gloves used to reduce the risk of cross contamination of ready-to-eat foods?

  • Criteria Not Met

  • Dining | Concessions | Refreshments With Bulk Dispensing

  • Q4. Are food-contact surfaces; equipment, utensils and cutting boards properly cleaned: washed, rinsed, sanitized, air-dried and stored to prevent cross contamination?

  • Criteria Not Met

  • Dining | Concessions | Refreshments With Bulk Dispensing | Refreshments Without Bulk Dispensing

  • Q5. Are non-food-contact surfaces; floors, walls, ceilings, including equipment (e.g. gaskets, vents, HVAC, and exhaust hoods) clean?

  • Criteria Not Met

  • Dining | Concessions | Refreshments With Bulk Dispensing | Refreshments Without Bulk Dispensing

  • Q6. Are all areas and equipment listed on the Master Cleaning Schedule? Is the Master Cleaning Schedule available and complete?

  • Criteria Not Met

  • Dining | Concessions | Refreshments With Bulk Dispensing

  • Q7. Are the red sanitizer buckets/spray bottles available where all food is prepared/served, at the correct quaternary ammonium concentration of 200-400 ppm with wiping cloths stored inside the red bucket?<br>Check a minimum of two red sanitizer buckets/spray bottles.

  • Criteria Not Met

  • Dining

  • Q8. Is the high-temperature dish machine sanitizing at the required minimum surface temperature of 160°F (71°C) or is the low temperature dish machine at the required sanitizer concentration? Is the Dish machine log available and completed?

  • Criteria Not Met

  • Dining | Concessions | Refreshments With Bulk Dispensing

  • Q9. Is the three-compartment sink stocked appropriately, in good repair, and equipped to provide wash water at a minimum of 113°F (45°C) and sanitizer at the correct quaternary ammonium concentration of<br>200-400 ppm?

  • Criteria Not Met

  • Dining | Concessions | Refreshments With Bulk Dispensing

  • Q10. Are all sanitizer dispensers equipped to provide quaternary ammonium concentration at 200-400 ppm? Is the Sanitizer Dispenser log available and completed?

  • Criteria Not Met

  • Dining

  • Q11. Is raw, unwashed produce washed prior to use in a clean and sanitized food preparation sink?

  • Criteria Not Met

SAFE TEMPERATURES

  • Dining | Concessions

  • Q12. Are hot Ready-to-Eat PHF foods at ≥140°F (60°C)? Check at least 2 hot Ready-to-Eat PHF for each hot holding equipment/service area. Are the logs available and in use?

  • Criteria Not Met

  • Record food name and temperature:

  • Dining | Concessions

  • Q13. Are cold Ready-to-Eat PHF foods at ≤40°F (4°C)? Check at least 2 cold Ready-to-Eat PHF in each refrigerator/service station/air screen/Grab-n-Go unit. Are the logs available and in use?

  • Criteria Not Met

  • Record food name and temperature:

  • Dining

  • Q14. Are foods being cooled to 68°F (20°C) within 2 hours and finally cooled to ≤40°F (4°C) within 4 hours in the storage refrigerator? Check Cooling log to identify cooling/cooled foods from current/previous day.

  • Criteria Not Met

  • Record food name and temperature:

  • Dining | Refreshments With Bulk Dispensing | Refreshments without Bulk Dispensing

  • Q15. Are receiving temperatures documented with corrective actions?

  • Criteria Not Met

  • Dining

  • Q16. Are foods being thawed/slacked according to the standard?

  • Criteria Not Met

  • Dining | Concessions | Refreshments With Bulk Dispensing | Refreshments Without Bulk Dispensing

  • Q17. Do the refrigerators/freezers/air screen and Grab-n-Go equipment have working internal hanging thermometers with logs available and completed for either a manual or automated process?

  • Criteria Not Met

SEPARATE

  • Dining | Concessions

  • Q18. Are all foods stored in refrigerators arranged to keep raw (PHF) food and unwashed produce separated from Ready-to-Eat food?

  • Criteria Not Met

  • Dining | Concessions | Refreshments With Bulk Dispensing | Refreshments Without Bulk Dispensing

  • Q19. Are all foods and single-use articles stored to prevent cross contamination in refrigerators/freezers, dry storage, preparation and service areas?

  • Criteria Not Met

COOK

  • Dining | Concessions

  • Q20. Are (PHF) foods cooked/reheated to the minimum internal temperatures/times? Are the logs available and in use?

  • Criteria Not Met

  • Record food name and temperature:

MANAGEMENT

  • Dining | Concessions | Refreshments With Bulk Dispensing | Refreshments Without Bulk Dispensing

  • Q21. Is there at least a manager or employee present at the time of the inspection with a current (not expired) TrainCan ADVANCED.fst Certification or other approved certifications?

  • Criteria Not Met

  • Dining | Concessions | Refreshments With Bulk Dispensing | Refreshments Without Bulk Dispensing

  • Q22. Have all of the food safety violations been addressed from the previous Regulatory and/or third party inspection? (e.g., Health Department, Third Party food safety audit, any line of business regulatory<br>requirement)

  • Criteria Not Met

  • Dining | Concessions | Refreshments With Bulk Dispensing | Refreshments Without Bulk Dispensing

  • Q23. Are managers and employees aware of what action to take if they have a foodborne illness and/or vomiting and diarrhea?

  • Criteria Not Met

  • Dining | Concessions | Refreshments With Bulk Dispensing | Refreshments Without Bulk Dispensing

  • Q24. Is smoking, eating, drinking, tobacco use or chewing gum observed only in designated area?

  • Criteria Not Met

  • Dining | Concessions | Refreshments With Bulk Dispensing | Refreshments Without Bulk Dispensing

  • Q25. Is the location free from any physical evidence of pests (e.g., rats, mice, cockroaches, flies, droppings)?

  • Criteria Not Met

  • Dining | Concessions | Refreshments With Bulk Dispensing | Refreshments Without Bulk Dispensing

  • Q26. Are foods stored in refrigerators/freezers accurately labeled and not expired?

  • Criteria Not Met

  • Dining | Concessions | Refreshments With Bulk Dispensing | Refreshments Without Bulk Dispensing

  • Q27. Are digital thermometers available, accurate and sanitized prior to testing internal food temperatures?

  • Criteria Not Met

  • Dining | Concessions | Refreshments With Bulk Dispensing

  • Q28. Is the Food Allergy policy and visual aid displayed?

  • Criteria Not Met

  • Dining | Concessions | Refreshments With Bulk Dispensing

  • Q29. Are food-contact surfaces; equipment, utensils and cutting boards in good condition?

  • Criteria Not Met

  • Dining | Concessions | Refreshments With Bulk Dispensing

  • Q30. Are all employees and visitors wearing approved hair restraints (e.g., hat or visor & hairnet or hairnet) and clean uniforms?

  • Criteria Not Met

  • Dining | Concessions | Refreshments With Bulk Dispensing

  • Q31. Are all employees and visitors following the jewelry standards?

  • Criteria Not Met

  • Dining | Concessions | Refreshments With Bulk Dispensing | Refreshments Without Bulk Dispensing

  • Q32. Are personal belongings stored in designated area(s) (Employee locker/break room or labeled bin) according to the standard?

  • Criteria Not Met

  • Dining | Concessions

  • Q33. Is the Consumer Advisory for raw or undercooked foods available in the menu, on a menu board, or on table tents where raw or undercooked foods are being served?

  • Criteria Not Met

  • Dining | Concessions | Refreshments With Bulk Dispensing | Refreshments Without Bulk Dispensing

  • Q34. Are nonfood-contact surfaces; equipment, floors, walls and ceilings in good repair?

  • Criteria Not Met

  • Dining | Concessions | Refreshments With Bulk Dispensing | Refreshments Without Bulk Dispensing

  • Q35. Are all lighting sources properly shielded in areas where food, service utensils and equipment are stored or prepared?

  • Criteria Not Met

  • Dining | Concessions | Refreshments With Bulk Dispensing | Refreshments Without Bulk Dispensing

  • Q36. Are foods stored in dry storage not expired?

  • Criteria Not Met

Sign-off

  • QA Completed By:

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.