Title Page

  • Restaurant

  • Conducted on

  • Prepared by

  • Location

1. HAND WASHING

  • Hand washing sink properly working

  • Hand washing sink clean no evidence of other use different to hand washing

  • Soap available

  • Sanitizer available

  • Paper towel available

  • Employees doing hand washing when required

  • II hand washing sink temperature over 55C (safely risk), no evidence of failure to hand washing procedure

  • Employees following correct procedure as per standard: nailbrush use, duration, steps sequence...

2. SANITIZING SOLUTION

  • Approved sanitizing test strips available and within expiration date

  • Sanitizer buckets approved and properly labelled

  • Sanitizer buckets/bottles according to concentration limits (Chl 100-200/0UAT 450-600 ppm) (1 fail allowed} All open required stations having designated bucket

  • Cloths totally submerged in each bucket (1 fail allowed}

3. CROSS CONTAMINATION

  • Onion/tomato/lettuce slicers clean No tongs burnt or smallware cracked

  • Soft drink machine nozzle and BIB connectors clean in part in direct contanct with food

  • Interior of ice machine is clean and ice not used as storage for other items Ice scoop is clean and properly stored in a pan

  • Correct tongs in use: frozen vs cooked

  • No tongs handler in touch with food inside freezers/coolers No evidence of new and old product mix

  • Allergen disclaimer and content poster available in front counter

  • Allergen disclaimers available in at least 1 door, DT pay window and DT menuboard

  • Allergen BOH training poster completed with: list of products, hospital route map. all employees signature

  • All allergen storage areas labelled with appropriate disclaimer Minimum of 1 POS sticker for cashier reference in case of Guest doubts Smallwares used for allergen product identified as per OPS Alert

  • No other evidence of cross contamination

4. SOFT SERVE MACHINE

5. HOT WATER

  • Hand washing sink temperature is reaching a minimum of 38 °C. If failure, wait 15 minutes before measuring temperature again.

  • 3-compartiment sink temperature is reaching a minimum of 100'f. If failure, wait 15 minutes before measuring temperature again.

6. COOKOUT

  • Reef cookout register log all temperature logs completed or no more than 3 highlighted missing

  • No registered temperatures out of range

  • Cookout performed every 3 hours, prior to open and prior to peak hour

  • MIC Knowledge' both during physical demonstration or verbalization

  • Minimum temperature 135'f

  • Maximum temperature 41'f

  • Duration of cookout 15 sec, monitored by use of digital tool (stopwatch/mobile stop watch)

8. TIME CONTROL (PHFs: proteins. dairy products, sliced vegetables)

  • All PHF's products on board marked with PTO and not expired. 10 minutes allowance for employees to realize if no one on board, not to use.

9. UNAPPROVED ITEMS

  • No unapproved food present in the restaurant

  • No unapproved chemicals present in the restaurant

  • No unapproved equipment present in the restaurant No unapproved smallware/tools present in the restaurant

10. PEST CONTROL

  • No evidence of pest infestation

11. HEALTH INSPECTION REPORT

  • No Health Deparment report failures not amended within 10 days or specific date

12. OTHER FSC

  • No evidence of water back-up in the kitchen

  • No evidence of employees working in sick condition

  • No cleaning supplies/chemicals stored close to food

  • No yellow cleaning tools for toilets (yellow brush or cloth) in touch with anything else

  • ServSafe Certificate available and in use for Manager on duty

  • Roof in good repair in all preparation and storage areas

COMPLETED BY

  • Name & Signature

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.