Information

  • Store/Location

  • OT rating

  • Food TvA

  • LBW TvA

  • Conducted on

  • Prepared by

  • Personnel

Facilities - exterior

  • Outside entrance is clean, well kept and welcoming

  • No cigarettes or trash in parking lot or gum on sidewalks

  • Parking lot Striping

  • Parking lot Curbs

  • Parking lot Handicap signs

  • Parking lot cracks or potholes

  • Awnings

  • Building

  • Exterior lighting working and turned on/off at appropriate times

  • Building Signs are working and turned on and off at appropriate times

  • Windows and ledges are clean

  • Roof and gutters are free of debris

  • Landscaping

Terrace

  • Music on, set to an appropriate level

  • All lights and fans are on and working properly

  • Floors, walls and ceiling are clean, free of dirt, dust and residue

  • Awnings/Umbrellas

  • Chairs

  • Tables

  • Planters/plants

  • POS system

  • Sidestands

Facilities Interior- Host stand/Waiting Area

  • All lights are on and working properly

  • Music on, set to an appropriate level

  • Pagers

  • Menus/dessert

  • Feature cards

  • I-pads

  • Crayons/Kid Menus together

  • Pizza Dough Automatic

  • High chairs clean

  • Hammocks clean

  • Booster seats clean

  • Floors, walls and ceiling are clean, free of dirt, dust and residue

  • Fixtures and furniture are clean, free of dirt, residue and gum

  • All posters and ad material is up to date, and displayed professionally

  • Host stand is set up and organized properly

Facilities-Restrooms

  • All lights are on and working properly

  • Mirrors are clean and streak free

  • Door/Frame clean

  • Employee hand wash signs in place

  • Feminine boxes

  • Drains

  • Commodes

  • Toilet seats tightened

  • Urinals

  • Toilet paper spindles

  • Soap dispenser with soap

  • Trash cans

  • Air misters

  • Ceiling

  • Floors

  • Paper towel dispensers and soap dispensers are in good working order and are properly stocked

  • Vents and ducts clean

  • Counter is clean and free of water

  • Walls and partitions are clean, free of dirt, dust, or residue

  • All lights are working properly

  • No foul odors are present

Facilities Dining Room

  • Ceiling

  • Flooring

  • Exit/emergency signs

  • Menu boxes

  • Wine boxes

  • Silver baskets

  • Lights

  • Music

  • Plants

  • Columns

  • Vents/Ducts

  • Soda fountains and below

  • Hand sinks with soap and towels

  • Side stands

  • Server cooler clean. Dairy dots in use

  • Coffee machine

  • Coffee pots

  • Coffee urns/spigots

  • Iced tea machine

  • Iced tea urns/spigots

  • Iced tea and water pitchers

  • Bread station

  • Booth seats are clean and in good condition

  • All posters and ad material is up to date, and displayed professionally

  • Tables and bases are clean and in good condition

  • Sugar caddies are clean, full and functional

  • Salt and Pepper are clean, full and functional

  • All tables are set properly and display proper table tents

  • Chairs are in good condition-not wobbly

  • Drapes curtains are in clean and in good repair

  • Mirrors are clean and streak free

  • Railings

  • Walls

  • 1/2 Walls

  • Blinds

  • Windows are clean and streak free

Facilities-Bar

  • All lights are on and working properly

  • Televisions on, set to an appropriate station, volume at an appropriate level

  • Floors, walls, and ceiling are clean, free of dirt, dust, or residue

  • Fixtures and furniture are clean, free of dirt, residue and gum

  • Liquor wine and beer are properly displayed and open wine dated

  • Mug chiller clean and working

  • Coolers are clean and have thermometers

  • Bar top is clean and free if dirty dishes, water and clutter

  • Menus are available to the guest

  • Equipment is in good condition and working correctly

  • Sodas are calibrated correctly - Guns are clean

  • Ice bins are clean and scoops are in use.

  • Glassware is clean, spotless, dry and frozen where applicable

  • Blenders are clean and working

  • Test strips available

  • Cutting boards are clean and sanitary (not overly grooved)

  • Hand sink with soap and towels

  • All products labeled

  • Floor under equipment

  • Walls behind equipment

  • Floors

  • Drains

  • Supply levels (glassware, buckets, ect) are adequate for business

  • Bar terminal works and is in good condition

  • No foul odors are present

Facilities-Expo

  • All lights are on, covered and working properly

  • Tray maintenance

  • Tray jacks

  • Floors, mats, walls, and ceiling are clean, free of dirt, dust, or residue

  • Sani bucket in place

  • Tables are clean, in good condition, and are free of food debris

  • Mis em place in place and on ice

  • Heat lamps are clean and working

  • Ticket times within standard

  • Proper temps

  • Red lining program in place

  • Hand sinks are clean, stocked, and in good working condition

Facilities-Kitchen Hot line Sanitation

  • All lights are on, covered, and working properly

  • Floors, mats, walls, and ceiling are clean, free of dirt, dust, or residue

  • Sani buckets in place

  • Hotel Broiler

  • Saute Ovens

  • Pasta burners

  • Oven

  • Fryer filter

  • Fryer clean and at temp

  • Steam table

  • Alto sham

  • Hood lights

  • Back walls

  • Floors

  • Line plumbing

  • Dip well

  • Ice cream freezer/Gaskets/clean

  • Plate cooler/Gaskets/thermometer

  • Pantry cooler/Gaskets/thermometer

  • Pizza cooler/Gaskets/thermometer

  • Pasta cooler/Gaskets/thermometer

  • Grill cooler/Gaskets/thermometer

  • Pantry cooler/Gaskets/thermometer

  • Filters coils and fans

  • Glove use

  • Labels accurate and in date

Facility- BOH Equipment

  • Stand up mixer

  • Bur mixer

  • Convection oven

  • Hot box

  • Tilt skillet

  • Food processor

  • Slicer

  • Scales

Facilities- Prep area

  • Table legs

  • Flour bins

  • Three sink working and clean

  • Tables

  • Hands sinks are clean and in good working order

  • Shelves are clean, organized, and are free of food debris

  • Floors and drains clean

  • Lighting

  • Walls

  • Ceiling/vents

  • All Builds and Recipes are current and in use

  • No foul odors are present

Mechanical Room

  • Roof inspection HVAC units closed and roof debris free

  • Hot water heater

  • Pepsi tree

  • Marlin panel free of dust

  • Roof inspection HVAC units closed and roof debris free

  • Holding tank

  • Water softener functional and filled with salt

  • RTI system

  • Bulk CO2

  • Floor drains clear of trash or debris

Facilities-Dish/Dry Storage Cleanliness

  • All lights are on, covered, and working properly

  • Floors, mats, walls, and ceiling are clean, free of dirt, dust, or residue

  • Sanitizing & Cleaning materials are available and labeled properly

  • Tables are clean, in good condition, and are free of food debris

  • Shelves and racks are clean, In good condition, and are free of food debris

  • Clean dishes are stored in a sanitary way

  • Dirty dishes are stacked and organized

  • Dish machine is clean outside, gauges working, and water is changed out every 2 hours

  • Dish machine is free of lime

  • Proper chemical test strips are available and used

  • Hoods are clean and functioning

  • Dish machine reaches proper temperature

  • Dish machine gauges functional and accurate

Facilities-Walk-In/Freezer Cleanliness

  • Door curtain and gaskets are clean and undamaged

  • Floors, mats, walls, and ceiling are clean, free of dirt, dust, or residue

  • All lights are on and working properly

  • Swim, walk fly storage is followed

  • Speed racks and shelving are clean, in good condition, and are free of food debris

  • Cooler and Freezer are holding proper temperatures and are in good working order, thermometer present and working

  • Items are labeled with the date they were received

  • Fish is properly iced in drip tray

  • Product has the correct rotation FIFO/not out of date

  • Fans and covers are clean

  • No foul odors are present

Safety

  • Ansul inspection up to date

  • Health Inspection violations corrected

  • Fire extinguishers present and in date

  • Ecolab book-MSDS complete

  • Wash and walk in use

  • First aid kit present, stocked and includes blood borne hazard kit

  • All managers serve safe certified

Kitchen Food safety in action

  • Wash hands with glove change and throughout shift

  • Sani buckets with clean towel and checked with test strips during line check

  • Proper cooling with chart

  • Produce washed properly with victory wash

  • Pull thaw method in place

  • Ready to eat above raw

  • Colored tongs for proteins system in use

  • Allergy tongs in use

  • Cutting boards in good repair

  • Receiving temps noted on invoices

Security

  • Back door locked

  • Office door locked

  • I Pads locked

Systems in place

  • All line checks are performed by manager or certified shift leader and completed thoroughly

  • Supplies used: digital thermometer, Ph test strips, follow-up sheets, scale, Sani Bucket, spoons

  • 30 days of line checks available and complete

  • Bar banks & Petty cash correct. No IOUs

  • 30 days of sanitation checks available and complete

  • Flight plan complete

  • Daily sanitation checklist completed for today

  • Completed Linecheck is filed and held on-hand as a record for 7 days

  • Closing checklist com[plete

  • SOP manual in place

  • 5 in 1 Poster: (FMLA, Polygraph, OSHA, FLSA Minimum Wage Retirement, Equal Employment Opportunity)

  • Choke Poster

  • Work Related Injury Plan 6 Notification Posters - (English & Spanish)

Manager Operations-Operations & Licenses

  • Staff follows hygiene standards-Hair up, clean and trimmed nails

  • Staff food handlers complete and current

  • First Aid kit available, readily accessible for guest/staff members, and stocked with adequate/ample supplies

  • Entire office is clean, organized, and clutter free at all times- including file cabinets/shelving. Till/chairs are in good working condition

  • SOP Manual in office

  • I9 Binder is 100% complete and current, staff members are 100% ABC/TABC/Food Handler complaint where applicable

  • Most recent health inspection is kept for records and is above a 90%

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.