Food Safety Audit

• Establishment

• Address
  Address

• Conducted on

  Date

• Prepared by

• Person in Charge

• Food Safety Manager

• Food Safety Manager Certification Expiration Date

  Date

Foodborne Illness Risk Factors and Public Health Interventions

• 1- Person in charge, demonstrates knowledge, and performs duties

  IN

  OUT

  N/A

  N/O

• Corrected On-site

• Repeat

• 2- Management awareness policy present

  IN

  OUT

  N/A

  N/O

• Corrected On-site

• Repeat

• 3- Proper use of reporting, restriction and exclusion

  IN

  OUT

  N/A

  N/O

• Corrected On-site

• Repeat

• 4- Proper eating, tasting, drinking, or tobacco use

  IN

  OUT

  N/A

  N/O

• Corrected On-site

• Repeat

• 5- No discharge from eyes, nose, and mouth

  IN

  OUT

  N/A

  N/O

• Corrected On-site

• Repeat

• 6- Hands clean and properly washed

  IN

  OUT

  N/A

  N/O

• Corrected On-site

• Repeat

• 7- No bare hand contact with ready-to-eat foods or approved alternate method properly followed

  IN

  OUT

  N/A

  N/O

• Corrected On-site

• Repeat

• 8- Adequate handwashing facilities supplied and accessible

  IN

  OUT

  N/A

  N/O

• Corrected On-site

• Repeat

• 9- Food obtained from approved source

  IN

  OUT

  N/A

  N/O

• Corrected On-site

• Repeat

• 10- Food received at proper temperature

  IN

  OUT

  N/A

  N/O

• Corrected On-site

• Repeat

• 11- Food in good condition, safe and unadulterated

  IN

  OUT

  N/A

  N/O

• Corrected On-site

• Repeat

• 12- Required records available: shellstock tags, parasite destruction

  IN

  OUT

  N/A

  N/O

• Corrected On-site

• Repeat

• 13- Food separated and protected

  IN

  OUT

  N/A

  N/O

• Corrected On-site

• Repeat

• 14- Food contact surfaces: cleaned and sanitized

  IN

  OUT

  N/A

  N/O

• Corrected On-site

• Repeat

• 15- Proper disposition of returned, previously served, reconditioned, and unsafe food

  IN

  OUT

  N/A

  N/O

• Corrected On-site

• Repeat

• 16- Proper cooking time and temperatures

  IN

  OUT

  N/A

  N/O

• Corrected On-site

• Repeat

• 17- Proper reheating procedures for hot holding

  IN

  OUT

  N/A

  N/O

• Corrected On-site

• Repeat

• 18- Proper cooling time and temperatures

  IN

  OUT

  N/A

  N/O

• Corrected On-site

• Repeat

• 19- Proper hot holding temperatures

  IN

  OUT

  N/A

  N/O

• Corrected On-site

• Repeat

• 20- Proper cold holding temperatures

  IN

  OUT

  N/A

  N/O

• Corrected On-site

• Repeat

• 21- Proper date marking and disposition

  IN

  OUT

  N/A

  N/O

• Corrected On-site

• Repeat

• 22- Time as a public health control: procedures and records

  IN

  OUT

  N/A

  N/O

• Corrected On-site

• Repeat

• 23- Consumer advisory provided for raw or undercooked foods

  IN

  OUT

  N/A

  N/O

• Corrected On-site

• Repeat

• 24- Pasteurized foods used: prohibited foods not offered

  IN

  OUT

  N/A

  N/O

• Corrected On-site

• Repeat

• 25- Food additives: approved and properly used

  IN

  OUT

  N/A

  N/O

• Corrected On-site

• Repeat

• 26- Toxic substances properly identified, stored, used

  IN

  OUT

  N/A

  N/O

• Corrected On-site

• Repeat

• 27- Compliance with variance,specialized process, and HACCP plan

  IN

  OUT

  N/A

  N/O

• Corrected On-site

• Repeat

Good Retail Practices

• 28- Pasteurized eggs used where required

  OUT

• Corrected On-site

• Repeat

• 29- Water and ice from an approved source

  OUT

• Corrected On-site

• Repeat

• 30- Variance obtained for specialized processing methods

  OUT

• Corrected On-site

• Repeat

• 31- Proper cooling methods used: adequate equipment for temperature control

  OUT

• Corrected On-site

• Repeat

• 32- Plant food properly cooled for hot holding

  OUT

• Corrected On-site

• Repeat

• 33- Approved thawing methods

  OUT

• Corrected On-site

• Repeat

• 34- Thermometers provided and accurate

  OUT

• Corrected On-site

• Repeat

• 35- Food properly labeled: original container

  OUT

• Corrected On-site

• Repeat

• 36- insects, rodents, and animals not present

  OUT

• Corrected On-site

• Repeat

• 37- Contamination prevented during food preparation, storage, and display

  OUT

• Corrected On-site

• Repeat

• 38- Personal cleanliness

  OUT

• Corrected On-site

• Repeat

• 39- Wiping cloths: properly used and stored

  OUT

• Corrected On-site

• Repeat

• 40- Washing fruit and vegetables

  OUT

• Corrected On-site

• Repeat

• 41- In-use utensils: properly stored

  OUT

• Corrected On-site

• Repeat

• 42- Utensils, equipment, and linens: properly stored, dried, handled

  OUT

• Corrected On-site

• Repeat

• 43- Single-use/single-service articles: properly stored, used

  OUT

• Corrected On-site

• Repeat

• 44- Gloves used properly

  OUT

• Corrected On-site

• Repeat

• 45- Food and non-food contact surfaces cleanable, properly designed, constructed

  OUT

• Corrected On-site

• Repeat

• 46- Warewashing facilities; installed, maintained, used; test strips

  OUT

• Corrected On-site

• Repeat

• 47- Non-food contact surfaces clean

  OUT

• Corrected On-site

• Repeat

• 48- Hot and cold water available; adequate pressure

  OUT

• Corrected On-site

• Repeat

• 49- Plumbing installed; proper backflow devices

  OUT

• Corrected On-site

• Repeat

• 50- Sewage and wastewater properly disposed

  OUT

• Corrected On-site

• Repeat

• 51- Toilet facilities: properly constructed, supplied, cleaned

  OUT

• Corrected On-site

• Repeat

• 52- Garbage/refuse properly disposed; facilities maintained

  OUT

• Corrected On-site

• Repeat

• 53- Physical facilities installed, maintained, and clean

  OUT

• Corrected On-site

• Repeat

• 54- Adequate ventilation and lighting; designated areas use

  OUT

• Corrected On-site

• Repeat

Comments and Signatures

• Comments

• Person in Charge

  Sign

• Inspector

  Sign