Title Page

  • Site conducted

  • Premise Name

  • Location
  • Conducted on

  • Inspected by

Hygiene

  • Employees wash their hands with soap and warm water before starting work, immediately after using washroom, any time needed to prevent cross-contamination

  • Employees wearing clean outer garments

  • Hair of employees is properly confined

  • Employees in good health with no open cuts or sores

  • Clothing and personal effects stored away from products in a proper manner

Sanitary Facilities

  • Toilet facilities, both public and staff are clean, well maintained and in proper working order

  • Self closing doors for toilet and dressing room working properly

  • Toilet tissue dispensers full. Sanitary napkin disposal unit available.

  • Single service soap and towel dispensers operable and full

  • Ventilation provided and in proper working order

  • Separate hand washing basin in each area with required supplies

Water and Sewage

  • All sinks are fully operable with hot and cold water at each faucet

  • All sinks drain properly. Floor drains and sink in good order

  • Plumbing in good repair

Floors, Wall, Ceilings, Lighting and Ventilation

  • Floors clean, well maintained and in good repair

  • Walls, ceilings and windows clean. Well maintained and in good repair

  • Adequate lighting and ventilation provided throughout the facility

  • Light fixtures have approved safety covers

  • Exhaust ventilation filters are clean and well maintained

Equipment and Utensils

  • Food contact surfaces washed, rinsed and sanitised before using, at least every 4 hours when not in use

  • Non-Food contact surfaces visibly clean and in good repair

  • All equipment (i.e.) stoves, grilld, refrigerators, tables, sinks, ect. cleaned and well maintained

  • Inoperable equipment has been repaired, replaced, or removed from facility

  • Multi- service utensils are being washed and sanitised by one of the following methods:

  • Single service utensils are properly stored and dispensed

  • All multi-service utensils are clean, properly stored, maintained and dispensed

  • Damaged or unapproved utensils have been repaired or replaced

Ware Washing

  • High-temp dish machines minimum washing temp of 151°F/66°C rinse temp 179°F/82°C for 10 seconds

  • Low-temp dish machine minimum wash and rinse temp of 130°F to 150°F/50°C to - 66°C. with chlorine sanitizer solution at a Minimum 100ppm.

  • Manual sink ware washing minimum wash, rinse, sanitizing sink water temp 11 3°F/45°C.<br>Sanitizing solution minimum chlorine 1 00mg/L; Quat. 200mg/L; or Iodine 12.5 – 25mg/L (ppm) Soak for 2 minutes

  • Pocket thermometers and sanitizer test kit readily available to verify temperatures and concentrations.

  • Wiping clothes clean, sanitized, stored and maintained properly

Garbage and Waste

  • Trash containers are lined with insect and vermin-proof disposable plastic bag at all times.

  • Plastic bags are tied before being placed in outside trash bin. Bin lids are kept closed.

  • Outside premises and refuse areas are clean, sanitized, illuminated by light and well maintained.

  • Frequency of garbage removal adequate to maintain premises in a sanitary condition.

Pest Control

  • Adequate protection against the entrance of insects, vermin, rodents, dust and fumes.

  • Outside doors and screen doors are self-closing and closures are in acceptable working order.

  • Keep all areas free of debris, moisture, and visable soil and well lit.

  • Working with a licensed pest control company.

Items Critical to Food Safety

  • Food is purchased ONLY from approved sources

  • Food is inspected when received and found to be free from contamination, adulteration, and spoilage.

  • Frozen food is received and stored at -18°C/0°F or colder

  • Refrigerated food is received and stored at 4°C/40°F or colder

  • All food is stored a minimum 6” off the floor and 2”away from the walls

  • All food is labeled, dated and stored in leak proof packaging or food grade containers

  • All food is protected from dirt, unnecessary handling, over-head leakage and other forms of contamination

  • Prepared and ready to eat food are stored above and away from raw foods

  • A thermometer, accurate to 1 °C/2°F, is provided either as an integral part of the refrigerator / freezer (outside dial) or is located inside each unit at its warmest spot (usually at the point of access)

  • An accurate thermometer, approved for measuring food temperatures, is readily available and is being used to verify internal food temperature on a daily basis

  • Restrooms are not used for storage of food, equipment or non-washroom supplies

  • All paper products are stored in a manner so as to protect them from contamination

  • Thawing of food using one or more of the following acceptable methods:

  • Thawed food items must not be refrozen. Cooked or processed foods may be refrozen

  • Separate raw foods from ready-to-eat foods during storage and handling

  • Maintain separation of ready-to-eat foods from raw foods during preparation and from surfaces and utensils

  • Food handlers use proper utensils to minimize direct hand contact with raw, cooked or prepared foods

  • Hands are properly washed before and after handling food

  • Foods are cooked to minimum internal temperatures:

  • Holding hot foods at a minimum 140°F/60°C and cold foods at a maximum 5°C/40°F

  • Cool from 60°C to 20°C or less in 2 hours and from 20°C to 4°C or less in 4 hours for a total of 6 hours

  • Reheat food to a minimum 74°C/165°F within 2 hours. Hold at minimum 60°C/140°F

  • Unpackaged food, which have been served or returned are discarded

  • All food is protected from potential contamination

  • Foods are dispensed and/or disposed in an approved manner

  • High acid food are prepared and stored in corrosion resistant containers and equipment

  • Signed off by

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.