Chemical Contaminant Food Safety In-Service Checklist

• Vendor Name:

• Site (if multiple locations, specify):

• Address:
  Address

• Conducted On (Date/Time):

  Date

• Inspected By:

CHEMICALS AND STORAGE:

• Chemicals are supplied from approved, reputable suppliers.

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• There are no protruding or leaking chemical containers.

  Yes

  No

  N/A

FOOD AND FOOD PREPARATION:

• Food is protected from contamination.

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• All packaged food are stored at appropriate temperatures.

  Yes

  No

  N/A

• All produce is properly washed according to food standards.

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• All utensils are stored handles up.

  Yes

  No

  N/A

CLEANING AND PROTOCOLS:

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

  Yes

  No

  N/A

• All trash is disposed in designated area.

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

COMPLETION

• Recommendations for Site:

• Full Name and Signature of the Inspector:

  Sign