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)

  • Working thermometers present in all coolers under centerline

  • No employee food or drinks were found outside of designated areas. (Drink racks, sealed employee food bucket in walk in cooler)

  • Cook Line Cheese 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)

  • Working thermometer present in cooler under prep table

  • Cooler temperature under prep table
  • 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

  • Working thermometer present in all front counter low boy coolers

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

Breading table

  • Working thermometer present in cooler under breading table

  • Under breading table temperature
  • 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?

Thaw Cabinets

  • Working thermometer present in each Thaw Cabinet door

  • Thaw Cabinet temperatures (Record the highest temperature found)
  • Chicken case labels available for each case in the thawing cabinet

  • Thaw Cabinets have been properly cleaned

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)

Walk In Cooler

  • All items properly labeled (Label present on container, not only lid)

  • All employee food is located inside of employee food container. (And food container is labeled and has a lid on it)

Dishes

  • Labels properly cleaned off clean dishes (For dishes already put away or on drying rack)

  • Dishes properly dried (For dishes that have already been put away)

Food Prep Dishes

  • Chicken Chopper

  • Lettuce Chopper

  • Lettuce Spinner

  • Tomato Slicer

Dumpster pad

  • Dumpster lid/ side doors & dumpster area doors closed

  • Free of debris

Ice Machine

  • Please wipe down all areas being evaluated every time audit is performed

  • Door Mold Free

  • Door Rails Mold Free

  • Under Bin Lid Mold Free

  • Inside Mold Free

Manager on duty knowledge

  • Manager on duty knows where to find the MSDS data sheets

  • Manager on duty knows the symptoms that will require an employee to stay home from work. (Vomiting, Diarrhea, Jaundice, Sore throat, Fever)

  • Manager on duty knows how long produce should be left in produce wash. (90 seconds)

  • What manager was asked to confirm their knowledge for this audit? (Please insure all managers are asked at least once every 2 weeks)

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.