Title Page

  • Conducted on

  • Prepared by

  • Location
  • If the item you are evaluating is unavailable, leave the answer blank and enter an explanation in the notes.

    If there are multiple items to evaluate, record the worst reading (lower temp for hot items, higher temp for cold items)

Primary/Secondary

  • No Chix towels were found laying around (if any towel not actively in use is found please throw it away)

  • Cook Line Cheese Cook Line Tomatoes

Hot holding pans

  • Holding pans timers set (for every pan in use)

  • Cook Line Filets Cook Line Nuggets Cook Line Spicy fliets Cook Line Strips

Grilled holding pans

  • Grilled timers set (for every pan in use)

  • Cook Line Grilled Nuggets Cook Line Grilled Filets
  • Who was working Primary at the time?

  • Who was working Secondary at the time?

Prep Table

  • No Chix towels were found laying around (if any towel not actively in use is found please throw it away)

  • Lid closed or in use

  • Ice under pans and covered with lids

  • Prep Table Sliced Chicken Prep Table Spicy Chicken Prep Table Lettuce Prep Table Cheese
  • Who was working Prep at the time?

Front counter cold holding

    Front counter low boy cooler temperature Front Counter Wraps Front Counter Market Salads Front Counter Southwest Salads Front Counter Parfaits

Breading table

  • Lid closed or in use

  • Ice under pans

  • Breading table- Milk wash Temp Breading table- Raw chicken temp
  • Who was working in the Breading Area at the time?

Cleaning/Sanitizing

  • All paper towel dispensers stocked and functional (Front of house, Back of house, Restrooms etc.)

  • All Soap and Sanitizer dispensers stocked and functional (Front of house, Back of house, Restrooms etc.)

Sanitizer bucket, Kicks bucket or sanitizer package available in:

  • Front counter

  • Primary

  • Secondary

  • Breading area

  • Food prep area

  • Sanitizer buckets, kicks bucket and dish sinks all prepared to appropriate sanitizer levels (check box if no buckets are in use)

  • Produce wash (select only one answer)

Report details

  • Date/time report completed

  • Who completed this audit?

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.