Title Page

  • Vendor Name:

  • Site (if multiple locations, specify):

  • Address:
  • Conducted On (Date/Time):

  • Inspected By:

AUDIT:

CHEMICALS AND STORAGE:

  • Chemicals are supplied from approved, reputable suppliers.

  • Chemicals are clearly labeled and stored away from food.<br>

  • No chemicals are stored in or near food prep surfaces and/or equipment.<br>

  • There are no protruding or leaking chemical containers.

FOOD AND FOOD PREPARATION:

  • Food is protected from contamination.

  • Food is stored in the original container or a food grade container.

  • All food is stored at least 6 inches off the floor and away from the walls.

  • All packaged food are stored at appropriate temperatures.

  • All produce is properly washed according to food standards.

  • All glasses are stored upside down on a clean, sterile surface.

  • All utensils are stored handles up.

  • Hands are washed properly after chemical contact

CLEANING AND PROTOCOLS:

  • No chemical residues are on food prep surfaces and equipment. <br>

  • All trash is disposed in designated area.

  • Towels for cleaning food spills are stored in a designated container with regularly replaced sanitizer solution.

  • Clean reusable towels are used only for sanitizing equipment and surfaces and not for drying hands, utensils, or the floor. <br>

  • The facility has a spill fix kit and/or materials to minimize a chemical contamination if it were to occur.<br>

  • Emergency plan is printed and accessible to all employees in case chemical contamination occurs.

COMPLETION

  • Recommendations for Site:

  • Full Name and Signature of the Inspector:

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.