Title Page
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Client / Site
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Location
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Conducted on
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Prepared by
Transportation & Distribution - 3.2.2 -10
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All foods are protected from contamination?
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Potentially hazardous food (PHF) transported under time/ temp control?
STORAGE AREAS - 3.2.2 -6 & receival of goods - 3.2.2 - 5
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Are floors clean, dry and in good condition?
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Are aisles free of boxes or clutter?
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Are all the ingredients / Packing material off the floor on the pallets?
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Are receival goods protected from contamination?
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Are potentially Hazardous PHF stored under temp control?
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Are doors and latches working properly?
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Are products or supplies properly stored? cooked product on top & raw products on bottom.
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Are allergen stored separately?
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Is shelving in good condition?
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Are receival goods traceable & accurately identified?
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Are potentially Hazardous food (PHF) received under control temperature?
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Are day dot sticker available on display cabinet stock?
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Are open date sticker available on open ingredients ?(chilled/ dry)
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Are combustibles kept away from heat sources? (Heating unit, hot water tank, electrical boxes, etc.)
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Are outlets, switches and electrical components working properly?
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Are ladders in good condition and properly stored?
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Are chemicals separated from foodstuffs?
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Is first aid kit adequately stocked and accessible?
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Are lights working properly?
FOOD PREPARATION AND COOKING AREA - Standard 3.2.2 -7, 8
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Are floors clean, dry and in good condition?
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Are aisles free of clutter?
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Are practical measures in place to process safe & suitable food?
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Foods protected from contamination
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All foods processed adequately - in particular high risk foods?
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Minimum amount of time PHF are out of temperature control zone?
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PHF are cooled correctly (2/4 hour rules followed)?
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Are drain screens being cleaned regularly?
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PHF rapidly reheated to hold it hot
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Are display foods protected from contamination? RTE self service food supervised and separate utensils provided?
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PHF displayed under temp control or time limit not exceeded
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Is food preparation and storage equipment in good repair?
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Is grill and fryer exhaust system clean and in good repair?
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Has fire extinguishing system been inspected and serviced within last 6 months? (Check tags)
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Have portable fire extinguishers been inspected and serviced within last year? (Check tag and gauge.)
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Are combustibles kept away from heat sources? (Ovens, grill, fryer, toaster,etc.)
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Are outlets, switches and electrical components working properly?
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Are lights working properly?
Premises and Equipment - 3.2.2 - 4 to 24
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Accessible handwashing facilities used only for washing hands, face and Arms
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Suitability & Maintenance of premises, are equipment & premise fit for purpose?
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Are all fixtures, fittings and equipment fit for purpose
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Adequate ventilation and lighting
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Adequate toilet facilities
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facilities provided for storage of personal / non food items
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Adequate water supply
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Adequate disposable for sewage & waste water
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Adequate storage of garbage & recyclables
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practicable pest exclusion & eradication measures used
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No sign of pest activity
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Accurate temp measuring device available
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Single used item protected & disposed
Adequate cleaning of 3.2.2 - 17 to19
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Premises
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Fixtures, fittings & equipment
Adequate cleaning & sanitation of (3.2.2 -10 to 12), (3.2.3 - 17)
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Food contact surfaces - including equipment (e.g. - benches / boards)
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Eating & drinking utensils
Food handler must
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Not handle food in a way that could make the food unsafe or unsuitable
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Not handle food if suffering from foodborne illness
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Wear appropriate clean clothing/ bandages and minimise personal contamination of food/ food contact surfaces
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Not eat, sneeze, spit, cough, use tobacco or similar over food/ food preparation surfaces
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Not eat sneeze, spit, cough, use tobacco or similar over food or food preparation surfaces
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Wash & dry hands as directed
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wash hand using soap, warm running water and dry hands appropriately
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Demonstrate appropriate food handling skill & knowledge
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sanitize temperature probe before and after usage
DINING AND RESTROOM AREAS
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Are floors clean, dry and in good condition?
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Are highchairs, tables and seating in good condition?
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Are floor mats in good condition? (Lay flat, smooth edges)
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Is product display equipment in good repair? (½ gallon cases, shelving, cooler doors, etc.)
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Are exit signs illuminated?
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Are outlets, switches and electrical components working properly?
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Are fixtures in restrooms in good condition?
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Are lights working properly?
OUTSIDE SEATING AREAS/ PLAYGROUND
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Are walking surfaces clean, dry and in good condition?
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Are tables and seating in good condition?
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Are gates and access passage locked?
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Is playground equipment in good condition? (No missing parts, holes or tears, sharp objects, clean, etc.)
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Is playground equipment inspected on a daily basis?
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Is playground area clean and free of debris or clutter? (Balls returned to pit area)
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Are proper signs in place?
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Are lights working properly?
EXTERIOR (WALKWAYS AND PARKING LOT)
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Are sidewalks and curbs in good repair?
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Is landscaping trimmed away from walks and to eliminate possible hiding places?
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Is the parking lot free of pot holes or tripping hazards?
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Is the dumpster area in good condition?
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Is the garden hose properly stored?
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Are outside lights working properly?
SAFE WORKING PRACTICES
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Do employees demonstrate a team approach in preventing accidents?
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Are spills or dropped items cleaned up promptly?
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Are “Wet Floor” warning signs displayed when needed?
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Are employees wearing proper footwear?
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Are employees instructed in proper lifting techniques?
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Is cooking oil at room temperature before changing or straining?
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Are knives cleaned safely? (Not left in soapy water)
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Are slicers cleaned and stored properly?
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Are employees instructed in the proper use of slicers?
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Are all cleaning supplies properly labeled?
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Do employees know where Material Safety Data Sheets are kept?
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Do employees practice safe ladder usage?
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Do employees use mechanical hand when changing marquee?
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Have all maintenance issues been reported as required?
FOLLOW-UP
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Have the issues or hazards that were identified last month been corrected? (If “NO”, specify which hazards below.)
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Have maintenance-related items been reported, called in or informed concern person
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Have unsafe practices been addressed with all employees?
Completion
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Recommendations
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Full Name and Signature of Inspector