Title Page

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

DELI

  • All hand washing sinks are fully stocked, have hot water and are not blocked?

  • Proper handwashing and glove use practices in place?

  • Hairnets are available at entry of department?

  • All employees engaged in food preparation are wearing hat and hairnets?

  • Hot water (120'f), Pot & Pan detergent and Sanitizer available at all 3-Compartment sinks?

  • Correct Sanitizer test strips available (not expired), in-use and sanitizer testing between 150-400ppm?

  • Food contact surfaces are being washed, rinsed, sanitized and air-dried at required frequency (every 4hrs non-refrigerated or 10hrs refrigerated)?<br>

  • Food contact surfaces are maintained clean and in good repair ( check slicer, sandwich bar, knives, cutting boards and prep tables)?

  • Food protected from contamination?

  • Prepared foods are chilled to below 40'f before placed out for display/sale?

  • Cold foods are holding below 40'f (check cheese table corners, grab & go, soup, cold bar, sushi)?

  • Hot foods are holding above 140'f (check fried chicken, rotisserie, soup and hot bar)?

  • Foods are date marked and not past sell by date (retail case, back storage area, walk-in cooler, and service case)?

  • Raw chicken is stored and handled properly to avoid cross contamination (check walk-in, prep tables, sinks and reading area)?

  • Floors and drains are visibly clean?

  • Any there evidence of pest?

  • Storage Equipment in good repair?

  • Chemicals properly stored?

BAKERY

  • All hand washing sinks are fully stocked, have hot water and are not blocked?

  • Proper handwashing and glove use practices in place?

  • Hairnets are available at entry of departments?

  • All employees engaged in food preparation are wearing hat and hairnets?

  • Hot water (120'f), Pot & Pan detergent and Sanitizer available at all 3-Compartment sinks?

  • Correct Sanitizer test strips available (not expired), in-use and sanitizer testing between 150-400ppm?

  • Food contact surfaces are being washed, rinsed, sanitized and air-dried at required frequency (every 4hrs non-refrigerated or 10hrs refrigerated)?<br>

  • Food contact surfaces are maintained clean and in good repair (check icing tips, utensils, bread slicer)?

  • Dish machine reaches 180'f at the manifold during rinse cycle?

  • Does the department have Thermostrips to test internal temp of dish machine?

  • Food protected from contamination?

  • Nuts are properly stored and separated?

  • Floors and drains are visibly clean?

  • Any evidence of pests?

  • Storage Equipment in good repair?

  • Chemicals properly stored?

MEAT/SEAFOOD

  • All hand washing sinks are fully stocked, have hot water and are not blocked?

  • Proper handwashing and glove use practices in place?

  • Hairnets are available at entry of department?

  • All employees engaged in food preparation are wearing hat and hairnets?

  • Hot water (120'f), Pot & Pan detergent and Sanitizer available at all 3-Compartment sinks?

  • Correct Sanitizer test strips available (not expired), in-use and sanitizer testing between 150-400ppm?

  • Food contact surfaces are being washed, rinsed, sanitized and air-dried at required frequency (every 4hrs non-refrigerated or 10hrs refrigerated)?<br>

  • Food contact surfaces are maintained clean and in good repair (check grinder, band saw, cuber)?

  • Floors are properly cleaned and sanitized (chlorinated cleaner and sanitizer hooked up to former)?

  • Meat grind and trim logs are being accurately filled out?

  • Nothing stored above grinder, no physical hazards present that could fall in grinder?

  • Shellfish tags available, kept on chronological order for last 90 days?

  • Food protected from contamination?

  • Raw species are properly separated, proper food hierarchy followed?

  • Foods are date marked and not held past sell by date?

  • Prepared foods are chilled to below 40'f before placed out for display/sale?

  • Floors and drains are visibly clean?

  • Any evidence of pests?

  • Storage Equipment in good repair?

  • Chemicals properly stored?

PRODUCE

  • All hand washing sinks are fully stocked, have hot water and are not blocked?

  • Proper handwashing and glove use practices in place?

  • Hairnets are available at entry of department?

  • All employees engaged in food preparation are wearing hat and hairnets?

  • Hot water (120'f), Pot & Pan detergent and Sanitizer available at all 3-Compartment sinks?

  • Correct Sanitizer test strips available (not expired), in-use and sanitizer testing between 150-400ppm?

  • Food contact surfaces are being washed, rinsed, sanitized and air-dried at required frequency (every 4hrs non-refrigerated or 10hrs refrigerated)?<br>

  • Food contact surfaces are maintained clean and in good repair (check food processor, knives, cutting boards, bowls, trays, storage bins)?

  • Fresh cut posters are in place, employees following proper procedures?

  • Sterilox available, sterilox test strips available (not expired) and solution between 25-50ppm?

  • Food protected from contamination?

  • Melons and vegetables pre-chilled to 40'f or below prior to prep

  • Prepared foods are chilled to below 40'f before placed out for display/sale?

  • Floors and drains are visibly clean?

  • Any evidence of pests?

  • Storage Equipment in good repair?

  • Chemicals properly stored?

GROCERY

  • Is their any expired baby formula on sales floor?

  • All items are stored 6" off the floor and away from walls?

  • Compactor area (interior & exterior) are clean and free of excess clutter?

  • Receiving doors properly seal with no notable gaps?

  • Doors kept closed unless receiving delivery?

  • Backroom is clean, organized and free of clutter that could harbor pest?

  • Dairy cooler and milk racks are clean and free from mold and debris?

  • Any evidence of pest?

  • Storage Equipment is in good repair?

  • Chemicals properly stored?

GENERAL

  • Fire exits are maintained clear and not blocked?

  • Safety board is up to date?

  • Hazardous waste center in use?

  • Restrooms clean and properly stocked

  • Cleaning center well maintained and organized?

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.