Critical’s

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Required Hand-Washing Procedures are Followed (10 Points)

• Hand washing sink is not obstructed<br>Hands are washed when required<br>Hand washing procedure executed properly<br>Paper towel dispensers and gloves are stocked and easily dispensed<br>Approved antibacterial soap and hand sanitizer dispensers are stocked and functioning

  Yes

  No

  N/A

Health Department Inspections are available and Violations have been corrected (10 Points)

• Most current health inspection report available<br>Items noted on inspection are corrected within 10 days, or within timeline specified

  Yes

  No

  N/A

Hot Water is Available (10 Points)

• The hand washing sink meets a minimum of 100 degrees F<br>Non-Hand washing sinks meets a minimum of 110 degrees F

  Yes

  No

  N/A

Potentially Hazardous Foods meet temperature Standards (10 Points)

• Hot PHF's (Potentially Hazardous Foods) meet minimum of 140 degrees F.<br>Cold PHF's (Potentially Hazardous Foods) meet minimum of 40 degrees F.<br>Soft Serve and shake machine in hopper meets temperature standard<br>Daily Planner observed complete for last 30 days<br>Approved calibrated thermometer available

  Yes

  No

  N/A

Sanitizing Solutions are properly stored/labeled/used (10 Points)

• Sanitizing solution strength is according to standard<br>Properly labeled and approved containers<br>Sanitizing buckets/bottles available for all stations and/or not close to open food containers (12 inches)<br>Approved and clean cloths submerged in sanitizing solution<br>Sanitizer test strips available and not expired

  Yes

  No

  N/A

Shake/Soft Serve Machine Sanitized Properly (10 Points)

• No evidence of build up or cross contamination in the soft serve vat<br>All required brushes are present, clean and in good condition, and stored correctly<br>Soft serve machine sanitizer and approved lube available<br>Brushes are stored in a clean and approved storage unit, or shake cabinet

  Yes

  No

  N/A

Restaurant is only using approved items (10 Points)

• All food present is approved<br>all packaging and paper supplies present are approved<br>All small wares and tools present are approved<br>All chemicals present are found in the ABL and approved<br>All equipment present is approved

  Yes

  No

  N/A

Prepped Items are marked with hold time and are not expired (PHF's) (10 Points)

• No expired items present<br>No items marked with incorrect hold time that is longer than permitted<br>No items missing hold times

  Yes

  No

  N/A

Cross-Contamination is not observed (10 Points)

• Proper use of tongs<br>Cooked and raw products are kept separate<br>Old and new PHF's are not mixed<br>Ice machine free of dirt or mold <br>Physical Contamination<br>W/R/S procedure is properly followed<br>Hands immediately washed, rinsed, and sanitized, after coming into contact with raw product<br>Employee food is properly stored<br>Small wares properly maintained and not burnt, no evidence of cracks<br>PHU pans are properly maintained, no evidence of cracks<br>Vegetable slicers properly cleaned with no build up observed<br>Allergen guidelines and procedures properly followed<br>No build up observed on the soda nozzles

  Yes

  No

  N/A

Effective Pest Elimination is in Place (10 Points)

• No live or dead rodent observed<br>No rodent droppings observed<br>No live or dead cock roach observed<br>No birds nesting inside of restaurant<br>No ant trail observed in back of house<br>No flies landing on food<br>No excessive fly activity<br>Pest control report is on file and in the restaurant

  Yes

  No

  N/A

Product Cook-Out procedures/temperatures meet standards (10 Points)

• Beef cookout register log fully completed<br>Registered temperatures in the log within proper range<br>Manager able to perform proper cook-out procedures

  Yes

  No

  N/A

No other Food Safety Violations are Present (10 Points)

• No drainage back-up<br>No evidence of Team Members working while ill (cold, flu, diarrhea, vomiting, jaundice, and stomach disorders that can potentially contaminate food and others)<br>Food prep area is free from roof leaks<br>Chemicals are labeled and stored properly<br>Servsafe Certificate available for Manager<br>All washing sinks are functional<br>Other

  Yes

  No

  N/A

Other Observed Criticals (not listed above)

• List other critical violations observed that are NOT listed above

Visit Summary

• Overall visit comments:

• Total number of food safety opportunities identified:

  Select None 1 2 3 4 5 6 8 9 10 11 12 13 14 15 16 17 18 19 10

  • None
  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
  • 8
  • 9
  • 10
  • 11
  • 12
  • 13
  • 14
  • 15
  • 16
  • 17
  • 18
  • 19
  • 10

Acknowledgement

• By signing below, you acknowledge that the above findings have been discussed with you and corrective actions are being taken to immediately resolve any findings. You are also acknowledging that critical violations are a violation of company policy and that you may be subject to disciplinary action up to and including termination for any negative findings contained in this report.

  I Agree

  I Disagree

• Manager in Charge Signature

  Sign

• Manager conducting REV RAGE Signature

  Sign