Food Safety Self-Inspection (Food Manufacturers/Distributors)

• Premise Name

• Client / Site

  Select
• Location
  Address

• Conducted on

  Date

• Inspected by

Hygiene

• Do employees wash their hands with soap and warm water before starting work, immediately after using the washroom, and any time needed to prevent cross-contamination?

  Yes

  No

  N/A

• Are employees wearing clean outer garments?

  Yes

  No

  N/A

• Is the hair of employees properly confined?

  Yes

  No

  N/A

• Are employees in good health with no open cuts or sores?

  Yes

  No

  N/A

• Are clothing and personal effects stored away from products in a proper manner?

  Yes

  No

  N/A

Sanitary Facilities

• Are toilet facilities, both public and staff, clean, well maintained and in proper working order?

  Yes

  No

  N/A

• Are self-closing doors for the toilet and dressing room working properly?

  Yes

  No

  N/A

• Are toilet tissue dispensers full, and is a sanitary napkin disposal unit available?

  Yes

  No

  N/A

• Are single-service soap and towel dispensers operable and full?

  Yes

  No

  N/A

• Is ventilation provided and in proper working order?

  Yes

  No

  N/A

• Is there a separate hand washing basin in each area with the required supplies?

  Yes

  No

  N/A

Water and Sewage

• Are all sinks fully operable with hot and cold water available at each faucet?

  Yes

  No

  N/A

• Do all sinks drain properly, and are floor drains and sinks in good order?

  Yes

  No

  N/A

• Is the plumbing in good repair?

  Yes

  No

  N/A

Floors, Wall, Ceilings, Lighting and Ventilation

• Are the floors clean, well maintained, and in good repair?

  Yes

  No

  N/A

• Are the walls, ceilings, and windows clean, well maintained, and in good repair?

  Yes

  No

  N/A

• Is adequate lighting and ventilation provided throughout the facility?

  Yes

  No

  N/A

• Do light fixtures have approved safety covers?

  Yes

  No

  N/A

• Are exhaust ventilation filters clean and well maintained?

  Yes

  No

  N/A

Equipment and Utensils

• Are food contact surfaces washed, rinsed, and sanitized before use and at least every 4 hours when not in use?

  Yes

  No

  N/A

• Are non-food contact surfaces visibly clean and in good repair?

  Yes

  No

  N/A

• Is all equipment cleaned, maintained and calibrated (if necessary)?

  Yes

  No

  N/A

• Has inoperable equipment been repaired, replaced, or removed from the facility?

  Yes

  No

  N/A

• Are multi-service utensils being washed and sanitized by one of the approved methods?

  Select hand washed in a two or three compartment sink (wash-rinse-sanitise) dish washing machine warewashing (low temp rinse water) with chemical sanitiser in solution dish washing machine warewashing (high temp rinse water) reaches at least 179F/82 degrees for 10 seconds

  • hand washed in a two or three compartment sink (wash-rinse-sanitise)
  • dish washing machine warewashing (low temp rinse water) with chemical sanitiser in solution
  • dish washing machine warewashing (high temp rinse water) reaches at least 179F/82 degrees for 10 seconds

• Are single-service utensils properly stored and dispensed?

  Yes

  No

  N/A

• Are all multi-service utensils clean, properly stored, maintained, and dispensed?

  Yes

  No

  N/A

• Have damaged or unapproved utensils been repaired or replaced?

  Yes

  No

  N/A

Ware Washing

• Does the high-temperature dish machine have a minimum washing temperature of 151°F/66°C and a rinse temperature of 179°F/82°C for 10 seconds?

  Yes

  No

  N/A

• Does the low-temperature dish machine have a minimum wash and rinse temperature of 130°F to 150°F/50°C to 66°C, with a chlorine sanitizer solution at a minimum of 100 ppm?

  Yes

  No

  N/A

• Is the manual sink ware washing conducted with a minimum wash, rinse, and sanitizing sink water temperature of 113°F/45°C?

  Yes

  No

  N/A

• Is the sanitizing solution used with a minimum chlorine concentration of 100 mg/L, Quat. 200 mg/L, or Iodine 12.5–25 mg/L (ppm), and is it soaked for 2 minutes?

  Yes

  No

  N/A

• Are pocket thermometers and sanitizer test kits readily available to verify temperatures and concentrations?

  Yes

  No

  N/A

• Are wiping cloths clean, sanitized, and properly stored and maintained?

  Yes

  No

  N/A

Garbage and Waste

• Are trash containers lined with insect and vermin-proof disposable plastic bags at all times?

  Yes

  No

  N/A

• Are plastic bags tied before being placed in outside trash bins, and are bin lids kept closed?

  Yes

  No

  N/A

• Are the outside premises and refuse areas clean, sanitized, well-illuminated, and well maintained?

  Yes

  No

  N/A

• Is the frequency of garbage removal adequate to maintain the premises in a sanitary condition?

  Yes

  No

  N/A

Pest Control

• Is there adequate protection against the entrance of insects, vermin, rodents, dust and fumes?

  Yes

  No

  N/A

• Are outside doors and screen doors self-closing, and are their closures in acceptable working order?

  Yes

  No

  N/A

• Are all areas kept free of debris, moisture, visible soil, and properly lit?

  Yes

  No

  N/A

• Do you have a scheduled Pest Service by a licensed pest controller?

  Yes

  No

  N/A

Items Critical to Food Safety

• Is food purchased ONLY from approved sources?

  Yes

  No

  N/A

• Is food inspected, when received, found to be free from contamination, adulteration, and spoilage?

  Yes

  No

  N/A

• Is frozen food received and stored at -18°C/0°F or colder?

  Yes

  No

  N/A

• Is refrigerated food received and stored at 4°C/40°F or colder?

  Yes

  No

  N/A

• Is all food stored a minimum of 6 inches off the floor and 2 inches away from the walls?

  Yes

  No

  N/A

• Is all food labeled, dated and stored in leak-proof packaging or food-grade containers?

  Yes

  No

  N/A

• Is all food protected from dirt, unnecessary handling, overhead leakage and other forms of contamination?

  Yes

  No

  N/A

• Are prepared and ready-to-eat foods stored above and away from raw foods?

  Yes

  No

  N/A

• Is a thermometer, accurate to 1°C/2°F, provided either as an integral part of the refrigerator/freezer (outside dial) or located inside each unit at its warmest spot (usually at the point of access)?

  Yes

  No

  N/A

• Is an accurate thermometer, approved for measuring food temperatures, readily available and used to verify internal food temperatures on a daily basis?

  Yes

  No

  N/A

• Are restrooms not used for storing food, equipment, or non-washroom supplies?

  Yes

  No

  N/A

• Are all paper products stored in a manner that protects them from contamination?

  Yes

  No

  N/A

• Is food thawed using one or more of the acceptable methods?

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Are thawed food items not refrozen, while cooked or processed foods may be refrozen?

  Yes

  No

  N/A

• Are raw foods separated from ready-to-eat foods during storage and handling?

  Yes

  No

  N/A

• Is there maintained separation of ready-to-eat foods from raw foods during preparation and from surfaces and utensils?

  Yes

  No

  N/A

• Do food handlers use proper utensils to minimize direct hand contact with raw, cooked, or prepared foods?

  Yes

  No

  N/A

• Are hands properly washed before and after handling food?

  Yes

  No

  N/A

• Are foods cooked to minimum internal temperatures?

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Are hot foods held at a minimum of 140°F/60°C and cold foods at a maximum of 40°F/5°C?

  Yes

  No

  N/A

• Is food cooled from 60°C to 20°C or less in 2 hours and from 20°C to 4°C or less in 4 hours for a total of 6 hours?

  Yes

  No

  N/A

• Is food reheated to a minimum of 74°C/165°F within 2 hours and held at a minimum of 60°C/140°F?

  Yes

  No

  N/A

• Is/are unpackaged(s) food that has been served or returned discarded?

  Yes

  No

  N/A

• Is all food protected from potential contamination?

  Yes

  No

  N/A

• Are foods dispensed and/or disposed of in an approved manner?

  Yes

  No

  N/A

• Are high-acid foods prepared and stored in corrosion-resistant containers and equipment?

  Yes

  No

  N/A

• Signed off by

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