Food Premise Audit

• Conducted on

  Date

• Prepared by

Food Safety

• Check food safety?

  Yes

  No

  N/A

Good Manufacturing Practices (GMPs)

• Are ice machines clean, internally and externally?

  Yes

  No

  N/A

• Is the workspace free of dust, food debris or grease build up on equipment? (Use flashlight)

  Yes

  No

  N/A

• Food and food packaging properly protected from potential contamination: chemical, physical, biological? (raw animal products above RTE foods, chemicals, first aid supplies, when tasting food preparation, utensils are used only once)

  Safe

  At Risk

  N/A

• Meats are stored in correct order - 1. Prepared or RTE Foods 2. Fish & Seafood 3. Whole cuts of raw beef or pork 4. Ground Meat and ground fish 5. Whole & ground poultry

  Safe

  At Risk

  N/A

• In-use equipment and food contact surfaces are approved, clean and in good repair? (example, meat slicers, black carts, etc)

  Safe

  At Risk

  N/A

• Nonfood-contact surfaces of equipment/utensils are clean and in good repair? (gaskets, tables, handles)

  Yes

  No

  N/A

• Clean equipment/utensils stored properly (wet nesting, stored inverted, etc.)?

  Yes

  No

  N/A

• Uniform policies in place (hair restraints, jewelry, etc.)?

  Yes

  No

  N/A

• Personal items (bags, jackets, food, etc.) stored properly?

  Yes

  No

  N/A

• Food and food packaging are all properly stored (organized, properly labeled with date and/or common name, properly covered, 6 inches from floor, etc.)?

  Compliant

  Non-Compliant

  N/A

• All foods are not held past their expiration dates?

  Compliant

  Non-Compliant

  N/A

• Dishwasher temping at proper temperatures? If chlorine washer, is it the proper PPM?

  Yes

  No

  N/A

Fresh Fish, Raw Meats, and Bulk Produce On Site

• Source tags for shellfish are dated for when the last of the product is sold or served, and then held (in chronological order) at least 90 days from that date.

  Compliant

  Non-Compliant

  N/A

Temperatures

• TCS food is not stored at room temperature for extended amount of time (30 minutes)?

  Safe

  At Risk

  N/A

• Cold holding of TCS foods at, or lower than 41F/4C?

  Safe

  At Risk

  N/A

• What was the food?

• Where was the food located?

  Select

• Hot holding of TCS foods above 140F/60C?

  Safe

  At Risk

  N/A

• What was the food?

• Where was it located?

• Proper thawing procedures? (In the fridge, under cold running water, or microwave)

  Compliant

  Non-Compliant

  N/A

• Proper final cook temperatures of TCS foods? (Raw fish, raw ground beef and pork to 71C; raw whole poultry to 82C; Raw poultry pieces to 74C; Eggs to 63C; and microwaved foods to 74C)

  Safe

  At Risk

  N/A

Chemical Storage and Usage

• Are used towels stored in sanitizer buckets?

  Yes

  No

  N/A

• Only approved chemicals present?

  Compliant

  Non-Compliant

  N/A

• Chemicals properly labeled in working containers?

  Safe

  At Risk

  N/A

• QT-40 Test Strips Available and within best before date?

  Compliant

  Non-Compliant

  N/A

• Hydrogen Peroxide and QT-40 Sanitizer Available?

  Compliant

  Non-Compliant

  N/A

• Temperature of sanitizer is at room temperature? (65F-85F/18C-24C)?

  Yes

  No

  N/A

• Sanitizer concentration is within proper range? (150-400 ppm)

  Safe

  At Risk

  N/A

Cleanliness

• Check cleanliness?

  Yes

  No

  N/A

• Free of pests (and evidence of)?

  Safe

  At Risk

  N/A

• Non-customer area floors and drains are clean and maintained in good condition?

  Yes

  No

  N/A

• Non-customer area walls/ceilings maintained clean/lights functioning and properly shielded?

  Yes

  No

  N/A

Hand Sink

• Hand washing sink(s) are accessible and not blocked?

  Compliant

  Non-Compliant

  N/A

• Hand washing sinks properly stocked? ("Employees Must Wash Hands" sign posted, soap, paper towels, trash can available at station?

  Compliant

  Non-Compliant

  N/A

• What was missing?

  Select Signage Soap Paper towels Trash can

  • Signage
  • Soap
  • Paper towels
  • Trash can

• Hand sink water temperature is ≥ 105F / 40C?

  Compliant

  Non-Compliant

  N/A

• What temperature is the handwashing water reading at?

Facilities Check-In

Waste Management

• Does the department have all required waste bins for the station? (organics, garbage, and recycling)?

  Yes

  No

  N/A

• Is the department utilizing the waste bins in a proper sorting manner? (ie: garbage is not contaminated)

  Yes

  No

  N/A

Sign Off

• General Comments

• Additional photo attachments

  Media

• Auditor full name and signature

  Sign