Title Page

  • Conducted on

  • Prepared by

  • Location

PERSONNEL

  • Proper handwashing observed

  • No cross-contamination observed

  • No sick, symptomatic employee(s) present

  • No drinking, eating, smoking, gum/tobacco chewing in food service area

  • Proper hair restraint worn by all food handlers

  • Disposable gloves available/properly used

Documentation

  • Working, calibrated thermometer available

  • Food and equipment temperatures logged once per shift

SANITIZING/HANDWASHING

  • Sanitizer test strips available

  • Dish machine set up/used properly

  • Dish machine sanitizer concentration correct

  • Clean dishes/pans free of food debris/ permitted to air dry properly

  • Wiping cloths stored in sanitizer bucket

  • Wiping cloth sanitizer concentration correct

  • All handwash sinks easily accessible/clean

  • Antimicrobial soap at all handwash sinks

  • Disposable/paper towels available at all sinks

  • Hot and cold water at all sinks

FOOD PREPARATION

  • No unwrapped foods re-served

  • No packaged food stored in contact w/ water/ice

  • Pre-chilled ingredients used in salads/sandwiches

  • Pasteurized eggs used for uncooked products

  • No raw, whole shell eggs pooled

  • Proper thawing techniques used

  • No hazardous food at room temperature

MISCELLANEOUS

  • No single-use or chemical containers reused

  • Equipment maintaining proper temp with accurate thermometer (±2°F)

  • Smallwares in use properly stored

  • No sewage backed up/plumbing in poor repair

  • All restrooms have operable plumbing

  • All restroom sinks have hot and cold water

  • All restrooms fully stocked

  • No insect/Rodent activity present

  • No unauthorized chemicals in restaurant

  • Chemicals labeled and stored properly

DRY STORAGE

  • No expired product present

  • No swollen/dented/rusted cans in storage; other damaged packaging

TCS COOKING/TIME AS CONTROL

  • Product temperature taken of each batch

  • Corrective action taken if temps weren’t taken

  • Cooked product final temperature #1

  • Cooked product final temperature #2

  • Cooked product final temperature #3

  • Cooked product final temperature #4

  • Product time and date labeled

  • No expired product present

  • Written procedures available

HOT HOLDING

  • Holding times on all items

  • No holding times expired

  • Hot holding #1 product temperature <135°F

  • Hot holding #2 product temperature <135°F

  • Hot holding #3 product temperature <135°F

  • Hot holding #4 product temperature <135°F

  • Reheated product > 165°F

COLD HOLDING

  • Raw/Hazardous ingredients properly stored

  • Holding times on all items

  • No holding times expired

  • Acceptable cooling techniques used

  • Carryover time and date labeled

  • No expired product present (past Use By date)

  • Refrigerated product #1 temperature >41°F

  • Refrigerated product #2 temperature >41°F

  • Refrigerated product #3 temperature >41°F

  • Refrigerated product #4 temperature >41°F

  • Refrigerated product #5 temperature >41°F

  • Refrigerated product #6 temperature >41°F

FROZEN HOLDING

  • No expired product present

  • Walk-in freezer #1 product frozen solid

  • Reach-in freezer #1 product frozen solid

  • Reach-in freezer #2 product frozen solid

  • All freezers air temperatures 0°F+10°F

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.