Title Page
-
Conducted on
-
Completed by
-
Location
-
Purpose of visit
Records
-
Food Handlers Permit
-
Number up to date
-
Number expired
-
Food establishment certificate
-
Certificate up to date
-
Pest control certificate
-
Pest control logs
-
Supplier certificates
-
Temperature logs
-
Cleaning schedule and processes
-
Inhouse trainings
-
Delivery logs for high risk foods
Section A
Food
-
Source
-
Condition
-
Original container
-
Food spoilage/ expiration
-
labels present
Food Protection
-
High risk food meets temperature requirements
-
Cold food storage units
-
Hot food storage units
-
Thermometers provided and conspicuous
-
Thawing methods (high risk foods)
-
High risk food reserved
-
Food protection during storage and display
-
Food protection during preparation and service
-
Food protection during transportation
-
Handling of food (ice) minimized
-
Inuse food dispensing utensils stored properly
Food Equipment and Utensils
-
Food contact surfaces designed, constructed, maintained, installed & located appropriately
-
Non-food contact surfaces designed, constructed, maintained, installed & located appropriately
-
Dishwashing facilities designed, constructed, maintained, installed & located appropriately
-
Thermometers, test kits etc used & stored properly
-
Single service articles stored, used and dispensed appropriately
-
No re-use of single serve articles
-
Dishwashing process
-
Sanitizing process
-
Sanitizing solution prepared properly
-
Wiping cloths clean, used and restricted
-
Food equipment and utensils clean, free of abrasives and rust free
-
Non-food equipment clean and rust free
-
Utensils and equipment stored and handled in sanitary condition
Section B
Personnel
-
Personnel with infections restricted
-
Handwashing procedure followed and done properly
-
Personnel donned in clean garments and PPE as necessary
-
Dressing rooms clean, lockers provided
Water
-
Source
-
Hot water available
-
Potability
Liquid Waste Management
-
Condition of sewer system
-
Plumbing fixtures installed and maintained
-
No cross connections, backflow or blockages
-
Water closets adequate in number, convenient and accessible
-
Water closets in good repair
-
Toilet rooms enclosed
-
Handwashing facilities adequately stocked with soap, paper towel and waste bin
Solid Waste Management
-
Receptacles clean
-
Receptacles lined, covered and not overfilled
-
Waste segregation suitable
-
Receptacles free from pests
Section C
-
Evidence of pest/ rodent infestation
-
Floors clean and in good repair
-
Walls and windows clean and in good repair
-
Ceilings clean and in good repair
-
Lighting provided as required, shielded and in good repair
-
Ventilation system in good repair, clean and installed as needed
-
Dressing rooms clean, provided and maintained
-
Chemicals properly stored, labelled and used as directed
-
Cleaning and maintenance equipment properly stored and separated from food items, electrical components or hazardous situations
-
premises free from litter and unnecessary items
Conclusion
-
Comments
-
Auditor seal
