Title Page

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Section 1. Cross contamination

  • 1) No bare or gloved hands are used to touch raw hamburger (meat tongs Only)

  • 2) employee does not use meat tongs to handle cooked ready to eat products.

  • 3) no bare hands are used to touch raw fish

  • 4) Raw foods does not cross contaminate RTE food or packaging

  • 5) Chemicals do not cross contaminate food, packaging, or tray liners.

  • 6) meat tongs and sear tools are stored correctly and in separate pans. Tools are changed every 4 hours at minimum as required by the food code.

  • 7) where allowed the JIB raw egg handling procedure is correctly followed after cracking raw she'll egg.

  • 8) no raw food is stored above or behind RTE food or packing

  • 9) no chemicals are stored above any food or packing

  • 10) rings with stones, artificial fingernails, nails with nail polish or jewelry are covered by gloves.

  • 11) spatulas, cutting boards and knives are used appropriately as identified in the IPP manual

  • 12) iced tea liner at the service station secured with a zip tie and white tube trimmed

Section 2. Temperature control and food safety checklist knowledge

  • 14) auditor performs a food safety checklist review<br>1. Consistently meets standards.<br>2. MAJOR <br>Review 5 days previous previous to today's document. Items marked NIU do not require further documentation. Writing NIU or Not in use is acceptable designation if NIU is not on the form

  • 15) employee can independently and without coaching demonstrate the correct procedure to take temperature of food and equipment

  • 16) flat grill 325 degrees or Taylor grill 285 degrees (surface) and 410 degrees (top Teflon)

  • 17) storage refrigerator under 41 degrees

  • 18) POU grill refrigerator under 41 degrees

  • 19) Guest service refrigerator under 41 degrees

  • 20) POU fryer refrigerator under 41 degrees

  • 21) Fryers above 350 degrees

  • 22) regular patty above 155 degrees.

  • 23) jumbo patty over 155 degrees

  • 25) shake mix under 41 degrees

  • 26) natural cheese on condiment rail meet temperature of under 41 degrees

  • 27) rice over 135 degrees

Section 3. Final flip visual check

  • 28) final flip and visual check on all raw hamburger patties are performed correctly and consistently (no pink or red mead); juices must be clear before patty is removed from the grill.

  • 29) raw eggs are cooked thoroughly and visual checked (yolks are solid, not runny).

Section 4. Employee health and hygiene

  • 31) no employees are ill

  • 32) wounds are bandaged with blue bandage and covered with a food handlers glove.

Section 5. Quality of hand wash

  • 33) hands must be washed only at thee hand wash sink(s) using soap.

  • 34) hands are washed in running hot water. Water is available within 30 seconds.

Section 6. When to wash hands

  • 36) after using a restroom, wash hands twice (in the restroom, and again upon entering the kitchen)

  • 37) at the beginning of their shift and after returning from break

  • 38) after touching human body parts I.e., face, head or hair.

  • 39) after coughing, sneezing on hands, using a handkerchief or disposal tissue, or after using tobacco, eating, or drinking.

  • 40) after conducting a cleaning activity, handling dirty equipment, utensils or surface, touching a trash can or picking up any garbage from the floor.

  • 41) before handling food and during food preparation as often as necessary to remove soil, and to prevent cross contamination.

  • 42) before putting on or changing food handlers gloves

Section 7. Hourly hand wash management

  • The 44) all employees including management inside th restaurant involved in food handling or preparation, ingredient prep, guest service and dishwashing wash their hands within 15 minutes of the timer going off.

  • 45) the timer is always running and reset when it goes off

Section 8. General risk assessment

  • 46) the restaurant is free of any imminent health hazard while operating.

  • 47) the restaurant is free of any general health hazard while operating

Section 9. Employee knowledge check

  • 64) quat sanitizer in buckets is the correct strength (150 - 300 ppm)

  • 58) restaurant is following and completing the weekly dial thermometer calibration printed on the last page of the FSC book

  • 100) the POS system is properly and fully used to record transactions and prepare food.

  • 101) there is one management employee assigned to the restaurant with a current/ valid food safety certification from an approved licensed provider

Section 10. Re-audit/ follow up only section

  • 55) is there a completed corrective action plan in restaurant for any and all Critical standards identified as non-compliant during previous food safety audit

  • 56) have all critical standards identified as as non compliant in previous food safety audit been resolved?

  • 57) if there were any critical standards identified in the previous audit that were. It resolved please conduct the standards that were not resolved.

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