Information

  • Client / Site

  • Conducted on

  • Prepared by

Facility Structure

  • 1. Are the ceilings free of flaking paint, cracks, excessive soils, holes, unsealed openings, water damage, leaks, loose caulking, missing panels?

  • 2. Are the floors free of cracks, exposed aggregate, holes, broken areas, standing water? Are they smooth and easy to clean?

  • 3. Are overhead surfaces (pipes, condensers, ceilings), free of dust, mold, rust, peeling paint, leakage?

  • 4. Are floor/wall junctions properly sealed with no loose or missing caulking? Is there flaking paint on the coving? Is the coving clean and free of mold?

  • 5. Are there cracks/crevices in the wall which could harbor pests, water, debris? Are wall clean, free of mold, rust, condensation, flaking paint? Are there exposed rusty nails, screws, staples, bolts?

  • 6. Is pipe insulation intact, clean & free of mold?

  • 7. Are floor drains clean & functioning properly? Are drain covers easily removable?

  • 8. Do all lights have protective coverings which are clean, intact, & free of moisture?

  • 9. Are all water lines protected against backflow or siphonage?

  • 10. Are there any leaking water sources or sink drains?

  • 11. Are fans, vents, cooling units clean & in good repair?

  • 12. Are exterior doors properly sealed & in good repair?

  • 13. Are cooler/freezer doors properly closed, accessible, functioning?

  • 14. Do all areas have adequate lighting?

Temperature & Environment

  • 15. Is there a written pest control policy that is reviewed regularly?

  • 16. Are pest traps present & free of damage on both sides of exterior doors?

  • 17. Are ILTs properly placed & functioning? Are glue boards changed regularly?

  • 18. Is there evidence of rodents or other pests?

  • 19. Are signs & posters clean & in good repair?

  • 20. Are coolers/freezers clean, dry, odor free? Is standing water or ice build-up present?

  • 21. Are thermometers present, accessible, & working properly in all coolers & freezers?

  • 22. Are cooler & freezer temperatures regularly monitored & documented?

  • 23. Are cooler/freezer temperatures acceptable?

Sanitary Practices

  • 24. Are tools stored in designated areas & not on top of equipment, electrical boxes, etc?

  • 25. Are zip ties of a color that would be easily visible?

  • 27. Is there wire, tape, cardboard or string being used as a temporary fix?

  • 29. Are floors clean of excessive debris?

  • 30. Are squeegees, mops, brushes, dustpans stored on hanging fixtures & not on floor?

  • 31. Are hoses & hose nozzles stored off the floor?

  • 32. Is mop water disposed of in the service sink or mop sink?

  • 33. Are the dock areas clean, including around & under dock plates?

  • 34. Is a written sanitation schedule present and followed daily?

  • 36. Are trash cans provided, clean & well maintained?

  • 37. Are cabinets & shelving clean & organized?

  • 38. Are non-food contact surfaces of equipment kept reasonably clean?

  • 39. Are restrooms clean, functioning properly, with proper handwashing facilities?

  • 43. Is separate floor cleaning equipment used for production & non-production areas?

  • 45. Are ice machines clean inside & out, in good repair, properly plumbed with required air gap?

  • 46. Are ice scoops stored in a sanitary manner?

  • 47. Is equipment being fully & properly cleaned between products?

Production Equipment

  • 51. Is equipment designed & maintained to provide easy access, disassembly & reassembly for thorough cleaning, sanitizing & inspection?

  • 52. Are all pieces of equipment in good condition, rust free, free of flaking paint, sanitary, and made of food grade materials?

  • 53. Is any equipment generating excess dust, debris or spillage?

  • 55. Is there any wooden equipment or surfaces being used (other than those allowed)?

  • 56. Is there unused equipment &/or utensils cluttering work spaces?

Product & Process Control

  • 57. Are Food Manager Certificates available?

  • 58. Are chemical properly labeled and stored away from processing area? Are MSDS available for all chemicals?

  • 59. Are adequate precautions followed to reduce or eliminate allergen cross-contamination between ingredients?

  • 60. Is the condition/date/temperature of incoming good inspected upon receipt? Is unacceptable product rejected?

  • 61. Are all ingredients clearly marked with the date received (m/d/y)?

  • 62. Are ingredients properly covered, labeled & stored to prevent contamination? Are ingredients stored 6" above the floor at all times?

  • 63. Is proper ingredient rotation (FIFO) observed? Are there outdated ingredients present?

  • 64. are packaging materials & supplies properly stored to prevent contamination? Are such materials stored 6" off the floor at all times?

  • 65. Is product being kept from contacting non-product contact surfaces?

  • 70. Are finished products properly covered, labeled & stored to prevent contamination? Is all product stored 6" above the floor at all times?

  • 71. Is there evidence of temperature abuse on refrigerated or frozen products (excessive ice, discoloration, etc)?

  • 72. Are finished products containing nuts segregated from other products?

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.