FOOD SAFETY VERIFICATION

• Conducted on

  Date

• Prepared by

• Location
  Address

Points

CRITICAL FOOD SAFETY

• Is the restaurant free of a pest infestation and/or signs of an active pest infestation in the restaurant building, adjoining corral and any area within 10 feet of the building?

  Yes

  No

  N/A

• ⃝ Inside the restaurant has visible infestation

  Yes

  No

  N/A

• ⃝ Inside the restaurant shows signs of infestation

  Yes

  No

  N/A

• ⃝ Outside the restaurant has visible infestation

  Yes

  No

  N/A

• ⃝ Outside the restaurant shows signs of infestation

  Yes

  No

  N/A

• ⃝ Un-trapped live rodent(s)

  Yes

  No

  N/A

• ⃝ Live cockroach(es)

  Yes

  No

  N/A

• ⃝ Rodent droppings

  Yes

  No

  N/A

• ⃝ Other

  Yes

  No

  N/A

• Are the internal temperatures of beef patties after cooking at or above 155°F?

  Yes

  No

  N/A

• Product name:

• ⃝ Temperature settings and cooking timers are not set correctly

  Yes

  No

  N/A

• ⃝ Maximum run size exceeded

  Yes

  No

  N/A

• ⃝ Patties not laid and removed in the proper sequence

  Yes

  No

  N/A

• ⃝ Release sheets are not in good condition or not tightly placed on platen

  Yes

  No

  N/A

• ⃝ Release sheets are not squeegeed between every run and wiped off with a grill cloth at least four times

  Yes

  No

  N/A

• every hour

  Yes

  No

  N/A

• ⃝ Patties not solidly frozen or shows signs of thawing

  Yes

  No

  N/A

• ⃝ Grill is not in good repair

  Yes

  No

  N/A

• ⃝ Other

  Yes

  No

  N/A

• Are the internal temperatures of chicken products after cooking at or above 165°F?

  Yes

  No

  N/A

• Product name:

• ⃝ Temperature settings and cooking timers are not set correctly

  Yes

  No

  N/A

• ⃝ Maximum run size exceeded

  Yes

  No

  N/A

• ⃝ Proper fryer baskets not being used or are overfilled

  Yes

  No

  N/A

• ⃝ Oil levels in fryers are not correct

  Yes

  No

  N/A

• ⃝ Portions not solidly frozen or shows signs of thawing

  Yes

  No

  N/A

• ⃝ Fryer is not in good repair

  Yes

  No

  N/A

• ⃝ Other

  Yes

  No

  N/A

• FS1-US

  Yes

  No

  N/A

• FS2-US

  Yes

  No

  N/A

• FS3-US

  Yes

  No

  N/A

• Are the internal temperatures of Filet-O-Fish portions after cooking are at or above 155°F?

  Yes

  No

  N/A

• ⃝ Temperature settings and cooking timers are not set correctly

  Yes

  No

  N/A

• ⃝ Maximum run size exceeded

  Yes

  No

  N/A

• FS4-US

  Yes

  No

  N/A

• ⃝ Proper fryer baskets not being used or are overfilled

  Yes

  No

  N/A

• ⃝ Oil levels in fryers are not correct

  Yes

  No

  N/A

• ⃝ Portions not solidly frozen or shows signs of thawing

  Yes

  No

  N/A

• ⃝ Fryer is not in good repair

  Yes

  No

  N/A

• ⃝ Other

  Yes

  No

  N/A

• Product name:

• Are the internal temperatures of breakfast steak and breakfast sausage after cooking at or above 155°F?

  Yes

  No

  N/A

• FS5-US

  Yes

  No

  N/A

• ⃝ Temperature settings and cooking timers are not set correctly

  Yes

  No

  N/A

• ⃝ Maximum run size exceeded

  Yes

  No

  N/A

• ⃝ Patties not laid and removed in the proper sequence

  Yes

  No

  N/A

• ⃝ Release sheets are not in good condition or not tightly placed on platen

  Yes

  No

  N/A

• ⃝ Release sheets are not squeegeed between every run and wiped off with a grill cloth at least four times

  Yes

  No

  N/A

• every hour

  Yes

  No

  N/A

• ⃝ Patties not solidly frozen or shows signs of thawing

  Yes

  No

  N/A

• ⃝ Grill is not in good repair

  Yes

  No

  N/A

• ⃝ Other

  Yes

  No

  N/A

• Critical:

  Yes

  No

  N/A

• Critical:

  Yes

  No

  N/A

• Critical:

  Yes

  No

  N/A

• Critical:

  Yes

  No

  N/A

• Critical:

  Yes

  No

  N/A

• Are the internal temperatures of round eggs after cooking at or above 155°F?

  Yes

  No

  N/A

• FS6-US

  Yes

  No

  N/A

• ⃝ Temperature settings and cooking timers are not set correctly

  Yes

  No

  N/A

• ⃝ Eggs not laid and removed in the proper sequence

  Yes

  No

  N/A

• ⃝ Egg ring not positioned properly on the grill surface or egg cooker not level on the floor

  Yes

  No

  N/A

• ⃝ Improper amount of water is poured into the center of the egg ring or timer is not started immediately after

  Yes

  No

  N/A

• pouring the water

  Yes

  No

  N/A

• ⃝ Egg ring or egg cooker is not in good repair

  Yes

  No

  N/A

• ⃝ Grill is not in good repair

  Yes

  No

  N/A

• ⃝ Other

  Yes

  No

  N/A

• FS7-US

  Yes

  No

  N/A

• ⃝ Pyrometer is not being properly placed in the center of the patties

  Yes

  No

  N/A

• ⃝ Not all the 4:1 patties cooked are checked

  Yes

  No

  N/A

• ⃝ The manager does not know the correct minimum cooking temperature requirement

  Yes

  No

  N/A

• ⃝ The manager does not take proper corrective action when a product is undercooked

  Yes

  No

  N/A

• ⃝ Other

  Yes

  No

  N/A

• Critical:

  Yes

  No

  N/A

• Critical:

  Yes

  No

  N/A

Scored Food Safety

• ⃝ Fresh beef

  Yes

  No

  N/A

⃝ Produce

• ⃝ Cheese / Eggs / Dairy

  Yes

  No

  N/A

• ⃝ Canadian bacon

  Yes

  No

  N/A

• ⃝ Apple Slices

  Yes

  No

  N/A

• ⃝ Milk

  Yes

  No

  N/A

• ⃝ Shake / Sundae mix

  Yes

  No

  N/A

• ⃝ Other

  Yes

  No

  N/A

• Handwashing sinks:

  Yes

  No

  N/A

• ⃝ Hand washing sink knobs/automatic tap not working well

  Yes

  No

  N/A

• ⃝ Soap dispenser empty / not working

  Yes

  No

  N/A

• ⃝ No warm running water of at least 100˚F

  Yes

  No

  N/A

• ⃝ No paper towel/working hand dryer

  Yes

  No

  N/A

• ⃝ Hand washing sink/tap obstructed and not accessible

  Yes

  No

  N/A

• ⃝ Hand washing sink used for other purposes

  Yes

  No

  N/A

• ⃝ Other

  Yes

  No

  N/A

• FS8-US

  Yes

  No

  N/A

• FS9-US

  Yes

  No

  N/A

• Handwashing procedure:

  Yes

  No

  N/A

• FS10-US

  Yes

  No

  N/A

• ⃝ Hands not washed on hourly basis

  Yes

  No

  N/A

• ⃝ Hand washing clock / timer not working / not in use / system not in place

  Yes

  No

  N/A

• ⃝ Hand washing activity not monitored

  Yes

  No

  N/A

• ⃝ Hands not washed after using restroom / taking a break

  Yes

  No

  N/A

• ⃝ Hands not washed after handling raw products and working on other station, e.g., prep table

  Yes

  No

  N/A

• ⃝ Hands not washed after tasks (i.e. handling waste, cell phone usage, touching face, hair, picking items off floor, etc)

  Yes

  No

  N/A

• ⃝ Proper hand washing procedure not followed

  Yes

  No

  N/A

• ⃝ Other

  Yes

  No

  N/A

• Sanitized towel/cloth buckets:

  Yes

  No

  N/A

• FS11-US

  Yes

  No

  N/A

• ⃝ Fresh bucket with sanitized towels not prepared

  Yes

  No

  N/A

• ⃝ Buckets not labeled correctly

  Yes

  No

  N/A

• ⃝ No towels in fresh bucket

  Yes

  No

  N/A

• ⃝ Bucket is soiled

  Yes

  No

  N/A

• ⃝ Sanitizer level is less than 50 ppm

  Yes

  No

  N/A

• ⃝ Test strips not available / damaged / expired / not in usable condition

  Yes

  No

  N/A

• ⃝ Other

  Yes

  No

  N/A

• Sanitizer-soaked towels/cloths:

  Yes

  No

  N/A

• FS12-US

  Yes

  No

  N/A

• ⃝ Grill towels left out on kitchen surfaces

  Yes

  No

  N/A

• ⃝ Cloth towels left out on kitchen surfaces

  Yes

  No

  N/A

• ⃝ Cloth towels left out on beverage/service areas

  Yes

  No

  N/A

• ⃝ Soiled towels mixed with fresh towels in the clean towel bucket

  Yes

  No

  N/A

• ⃝ Other

  Yes

  No

  N/A

• Utensils sanitizing:

  Yes

  No

  N/A

• FS13-US

  Yes

  No

  N/A

• ⃝ UHC trays, utensils, and utensil holders have excessive grease or build-up

  Yes

  No

  N/A

• ⃝ Items are not being cleaned and sanitized every 4 hours

  Yes

  No

  N/A

• ⃝ Back sink dispenser/ware washer not operating properly

  Yes

  No

  N/A

• ⃝ Sanitizer solution not at the correct concentration

  Yes

  No

  N/A

• ⃝ Water at back sink is not 110˚F or hotter

  Yes

  No

  N/A

• ⃝ Test strips not available or damaged / expired / not in usable condition

  Yes

  No

  N/A

• ⃝ Other

  Yes

  No

  N/A

• All soiled raw wares that came into contact with fresh beef are washed and sanitized last (unless a warewasher is used). Soiled blue raw beef trays and lids are kept in blue bus box until cleaned. Back sink is properly sanitized after washing wares that came into contact with raw proteins

  Yes

  No

  N/A

• ⃝ Raw ware equipment not cleaned last

  Yes

  No

  N/A

• ⃝ Raw ware equipment not washed separately

  Yes

  No

  N/A

• ⃝ Soiled raw beef tray(s) / lid(s) are not stored in blue bus box

  Yes

  No

  N/A

• ⃝ Back sink / Powersoak sink not cleaned after washing raw ware equipment

  Yes

  No

  N/A

• ⃝ Raw ware equipment is soaking in Powersoak sink

  Yes

  No

  N/A

• ⃝ Other

  Yes

  No

  N/A

• State of cleanliness:

  Yes

  No

  N/A

• FS13-US-01

  Yes

  No

  N/A

• FS14-US

  Yes

  No

  N/A

• ⃝ Excessive build up of dirt/grease/mold on floors/walls/ceiling

  Yes

  No

  N/A

• ⃝ Excessive build up of dirt/grease/mold on equipment

  Yes

  No

  N/A

• ⃝ Standing/puddling water on the floor

  Yes

  No

  N/A

• ⃝ Other

  Yes

  No

  N/A

• State of repair:

• Is the restaurant (all areas), the floors/walls/ceilings, and equipment functioning properly and in a good state of repair

  Yes

  No

  N/A

• (not cracked or damaged)? The freezers should not have excessive buildup of ice

  Yes

  No

  N/A

• FS15-US

  Yes

  No

  N/A

• ⃝ Floors/drains/walls/ceiling not in good repair (e.g. broken/missing tiles)

  Yes

  No

  N/A

• ⃝ In-use food contact equipment/utensils/trays cracked or damaged

  Yes

  No

  N/A

• ⃝ Grease traps in use not functioning properly

  Yes

  No

  N/A

• ⃝ Ice build up in freezer

  Yes

  No

  N/A

• ⃝ Other

  Yes

  No

  N/A

• Water and ice:

  Yes

  No

  N/A

• ⃝ Water filter(s) not dated (if not serviced by Coke)

  Yes

  No

  N/A

• FS16-US

  Yes

  No

  N/A

• ⃝ Water filter(s) bypassed

  Yes

  No

  N/A

• ⃝ Ice transfer bucket or ice scoop not clean

  Yes

  No

  N/A

• ⃝ Ice scoop not stored in holder

  Yes

  No

  N/A

• ⃝ Water / ice not protected from possible contamination

  Yes

  No

  N/A

• ⃝ Ice machine, bin, or ice chute has visible mold or build up

  Yes

  No

  N/A

• ⃝ Other

  Yes

  No

  N/A

• FS17-US

  Yes

  No

  N/A

• FS18-US

  Yes

  No

  N/A

• Food product opened:

  Yes

  No

  N/A

• ⃝ Frozen beef

  Yes

  No

  N/A

• ⃝ Fresh beef

  Yes

  No

  N/A

• ⃝ Frozen chicken

  Yes

  No

  N/A

• ⃝ Fish

  Yes

  No

  N/A

• ⃝ Breakfast meats

  Yes

  No

  N/A

• ⃝ Potato products

  Yes

  No

  N/A

• ⃝ Produce / Salad ingredients

  Yes

  No

  N/A

• ⃝ Cheese / Eggs / Dairy

  Yes

  No

  N/A

• ⃝ Raw products are not stored separately from ready-to-eat foods

  Yes

  No

  N/A

• ⃝ Packages of food stored touching the wall/floor

  Yes

  No

  N/A

• ⃝ Packages of food are not covered/wrapped

  Yes

  No

  N/A

• ⃝ Other

  Yes

  No

  N/A

• Raw food product handling:

  Yes

  No

  N/A

• ⃝ Gloves not discarded when removed/are being reused

  Yes

  No

  N/A

• ⃝ Double set of gloves being worn

  Yes

  No

  N/A

• ⃝ Proper blue glove procedures for use/removal are not being followed

  Yes

  No

  N/A

• ⃝ Yellow yolk breaking tool not available

  Yes

  No

  N/A

• ⃝ Yellow yolk breaking tool used for items other than raw eggs

  Yes

  No

  N/A

• ⃝ Yellow yolk breaking tool is improperly stored in contact with food or utensils used for cooking food

  Yes

  No

  N/A

• ⃝ Utensils other than yellow yolk breaking tool used to break raw egg yolks

  Yes

  No

  N/A

• ⃝ Dedicated tongs are used for anything other than handling raw protein products

  Yes

  No

  N/A

• ⃝ Bare hands used with raw product at grill / fryer

  Yes

  No

  N/A

• ⃝ Other

  Yes

  No

  N/A

• Ready-to-eat food product handling:

  Yes

  No

  N/A

• ⃝ Gloves not worn when preparing sandwiches, salads, or burritos

  Yes

  No

  N/A

• FS19-US

  Yes

  No

  N/A

• ⃝ Gloves not replaced when damaged / contaminated

  Yes

  No

  N/A

• ⃝ Gloves not discarded when removed or being reused

  Yes

  No

  N/A

• ⃝ Gloves not changed if they become contaminated

  Yes

  No

  N/A

• ⃝ Clear gloves are used for handling raw products

  Yes

  No

  N/A

• ⃝ Double set of gloves being worn

  Yes

  No

  N/A

• ⃝ Other

  Yes

  No

  N/A

• Good hygienic practices:

  Yes

  No

  N/A

• Are proper personal hygiene procedures being followed?

  Yes

  No

  N/A

• ⃝ Crew hair/beard restraint/cover not used properly

  Yes

  No

  N/A

• ⃝ Manager hair/beard restraint/cover not used properly, where applicable

  Yes

  No

  N/A

• ⃝ Uniforms and/or apron has excessive encrusted buildup

  Yes

  No

  N/A

• FS19-US-01

  Yes

  No

  N/A

• ⃝ Excessive jewelry on hands and wrists (more than a smooth ring/wedding band)

  Yes

  No

  N/A

• ⃝ Finger nails are not trimmed, filed and maintained so the edges and surfaces are cleanable and not rough

  Yes

  No

  N/A

• ⃝ False nails, dirty fingernails or nail polish and not wearing intact disposable gloves

  Yes

  No

  N/A

• ⃝ Employees consuming food and/or beverages in food prep areas

  Yes

  No

  N/A

• ⃝ Employees consuming food and/or beverages in service areas

  Yes

  No

  N/A

• ⃝ Other

  Yes

  No

  N/A

• Chemical management:

  Yes

  No

  N/A

• Are chemicals stored away from food and packaging?

  Yes

  No

  N/A

• FS20-US

  Yes

  No

  N/A

• ⃝ Chemical spray bottles / containers stored in the kitchen

  Yes

  No

  N/A

• ⃝ Chemical spray bottles / containers stored in the service area

  Yes

  No

  N/A

• ⃝ Chemicals are stored in dry storage near to food and packaging

  Yes

  No

  N/A

• ⃝ Chemicals stored in food containers

  Yes

  No

  N/A

• ⃝ Chemicals improperly used (ex. spraying around open food or packaging)

  Yes

  No

  N/A

• ⃝ Other

  Yes

  No

  N/A

• FS21-US

  Yes

  No

  N/A

• Pest management:

  Yes

  No

  N/A

• ⃝ Pest management program is not in place

  Yes

  No

  N/A

• ⃝ Pest management program is not working effectively

  Yes

  No

  N/A

• ⃝ Restaurant is not pest proofed

  Yes

  No

  N/A

• ⃝ Drive-thru window is not closed when not in active use (and there are no cars in the Drive-thru)

  Yes

  No

  N/A

• ⃝ Report is older than 60 days or no pest service report is available for review

  Yes

  No

  N/A

• ⃝ Most recent pest control report recommendations not corrected or there is no action plan to correct

  Yes

  No

  N/A

• ⃝ Dead cockroach(es)

  Yes

  No

  N/A

• ⃝ Trapped rodent(s)

  Yes

  No

  N/A

• ⃝ Trailing ant activity in one area

  Yes

  No

  N/A

• ⃝ High large fly activity greater than 5 in one area

  Yes

  No

  N/A

• ⃝ Other

  Yes

  No

  N/A

• FS22-US

  Yes

  No

  N/A

• Are non-food spill clean-up procedures are in place?

  Yes

  No

  N/A

• ⃝ 3N1 cleaner / disinfectant not available

  Yes

  No

  N/A

• ⃝ Staff not trained in the use of the non-food spill procedures

  Yes

  No

  N/A

• ⃝ Non-food spill procedures not available

  Yes

  No

  N/A

• ⃝ Non-food spill procedures not followed

  Yes

  No

  N/A

• ⃝ Other

  Yes

  No

  N/A

• Frozen products:

  Yes

  No

  N/A

• FS23-US

  Yes

  No

  N/A

• ⃝ Walk-in freezer or other primary storage freezer is above 0°F and the unit is not in defrost

  Yes

  No

  N/A

• ⃝ Walk-in freezer or other primary storage freezer is above 10°F even if the unit is in defrost

  Yes

  No

  N/A

• ⃝ Product is not solidly frozen in two-door reach-in freezer

  Yes

  No

  N/A

• ⃝ Product is not solidly frozen in grill side reach-in freezer

  Yes

  No

  N/A

• ⃝ Product is not solidly frozen in wall-mounted freezer

  Yes

  No

  N/A

• ⃝ Product is not solidly frozen in any other unlisted secondary/reach-in freezer

  Yes

  No

  N/A

• Refrigerated products:

  Yes

  No

  N/A

• FS24-US

  Yes

  No

  N/A

• FS25-US

  Yes

  No

  N/A

• ⃝ Walk-in refrigerator

  Yes

  No

  N/A

• ⃝ Prep Table refrigerator

  Yes

  No

  N/A

• ⃝ Pass-through prep line refrigerator

  Yes

  No

  N/A

• ⃝ Two-drawer grill side refrigerator

  Yes

  No

  N/A

• ⃝ Service area refrigerator

  Yes

  No

  N/A

• ⃝ Shake / Sundae Machine

  Yes

  No

  N/A

⃝ Blended Ice Machine

• ⃝ Any other unlisted secondary/reach-in refrigerator

  Yes

  No

  N/A

• ⃝ Produce held at the prep table or chilled rail

  Yes

  No

  N/A

• ⃝ Cheese / Eggs / Dairy

  Yes

  No

  N/A

• ⃝ Canadian bacon

  Yes

  No

  N/A

• ⃝ Apple slices/butter pats at room temperature or chill pans

  Yes

  No

  N/A

• ⃝ Product held in refrigerators are not properly marked

  Yes

  No

  N/A

• ⃝ Product held in refrigerators not within proper secondary shelf life

  Yes

  No

  N/A

• ⃝ Other

  Yes

  No

  N/A

• Leftover heated foods:

  Yes

  No

  N/A

• Are leftover heated foods discarded (including any shake/sundae mix removed from heat treatment shake/sundae machines)? If no, mark what product:

  Yes

  No

  N/A

• ⃝ Shake / Sundae mix

  Yes

  No

  N/A

• FS26-US

  Yes

  No

  N/A

• ⃝ Sauces / Soups / Gravies

  Yes

  No

  N/A

• ⃝ Food donation products not stored in freezer

  Yes

  No

  N/A

• ⃝ Other

  Yes

  No

  N/A

• Hot holding units:

  Yes

  No

  N/A

• FS26-US-01

  Yes

  No

  N/A

• ⃝ Products held without a timing mechanism

  Yes

  No

  N/A

• ⃝ Breakfast meats

  Yes

  No

  N/A

• ⃝ Egg products

  Yes

  No

  N/A

• ⃝ Beef patties

  Yes

  No

  N/A

• ⃝ Fried chicken products

  Yes

  No

  N/A

• ⃝ Fried fish products

  Yes

  No

  N/A

• ⃝ Hot cakes

  Yes

  No

  N/A

• ⃝ Marinator

  Yes

  No

  N/A

• ⃝ Extended Hot Holding Cabinet

  Yes

  No

  N/A

• ⃝ Other (e.g., sausage gravy, limited time offer (LTO) protein products and/or sauces)

  Yes

  No

  N/A

• Pyrometer:

  Yes

  No

  N/A

• Is the Pyrometer calibrated, working correctly, and is the probe clean?

  Yes

  No

  N/A

• ⃝ Probe not complete/missing

  Yes

  No

  N/A

• FS27-US

  Yes

  No

  N/A

• ⃝ Pyrometer not in calibration

  Yes

  No

  N/A

• FS28-US

  Yes

  No

  N/A

• FS29-US

  Yes

  No

  N/A

• Sourcing:

  Yes

  No

  N/A

• Are all food, food packaging, equipment (including utensils), and cleaning chemicals from approved sources?

  Yes

  No

  N/A

• ⃝ Pyrometer / probes damaged

  Yes

  No

  N/A

• ⃝ Probe has excessive, encrusted food residue

  Yes

  No

  N/A

• ⃝ Other

  Yes

  No

  N/A

• ⃝ Food not from approved sources

  Yes

  No

  N/A

• ⃝ Packaging not from approved sources

  Yes

  No

  N/A

• ⃝ Equipment not from approved sources

  Yes

  No

  N/A

• ⃝ Cleaning chemicals not from approved sources

  Yes

  No

  N/A

• ⃝ Other

  Yes

  No

  N/A

• Employee health:

  Yes

  No

  N/A

• ⃝ Manager does not know what symptoms (at a minimum, vomiting, diarrhea and jaundice) would result in

  Yes

  No

  N/A

• employees not being allowed to work

  Yes

  No

  N/A

• ⃝ Manager does not know the procedures to follow when presented with an ill employee

  Yes

  No

  N/A

• ⃝ Manager does not know when an ill employee would be allowed to return to work

  Yes

  No

  N/A

• ⃝ Manager does not know the reportable illness causes

  Yes

  No

  N/A

• ⃝ Employee(s) are observed exhibiting any of the reportable illness symptoms

  Yes

  No

  N/A

• ⃝ Other

  Yes

  No

  N/A

• Staff training:

  Yes

  No

  N/A

• ⃝ Certification date is not current

  Yes

  No

  N/A

• FS30-US

  Yes

  No

  N/A

• ⃝ Certification for managers not issued by ServSafe or equivalent/accredited organization

  Yes

  No

  N/A

• ⃝ Certification records for all managers not available for review during the visit

  Yes

  No

  N/A

• ⃝ Employee training tracking document not available for review during the visit

  Yes

  No

  N/A

• ⃝ Not all employees have been trained and verified

  Yes

  No

  N/A

• ⃝ Other

  Yes

  No

  N/A

Food Safety Checklists:

• FS31-US

  Yes

  No

  N/A

• ⃝ 3 or more missing required sections or days within the 14 days record review

  Yes

  No

  N/A

• ⃝ 12 or more missing required sections or days within the 60 days record spot check

  Yes

  No

  N/A

• ⃝ Daily Food Safety Book (records) not available

  Yes

  No

  N/A

• ⃝ Last two completed Monthly Food Safety Procedure Verifications are not available

  Yes

  No

  N/A

• ⃝ Digital Food Safety less than 80% completion for the last 60 days of Food Safety Daily Checklists

  Yes

  No

  N/A

• ⃝ Other

  Yes

  No

  N/A

Health Department Inspections:

• FS32-US

  Yes

  No

  N/A

• ⃝ Health department inspection report not available

  Yes

  No

  N/A

• ⃝ Critical violations noted by Health Department have not been corrected

  Yes

  No

  N/A

• ⃝ Plan not in place to correct issues

  Yes

  No

  N/A

• ⃝ Other

  Yes

  No

  N/A

Allergen management:

• Are nut containing McFlurry mix-ins kept in the orange container with lid and a dedicated scoop?

  Yes

  No

  N/A

• FS33-US

  Yes

  No

  N/A

• ⃝ Orange container not utilized for nut containing mix-ins

  Yes

  No

  N/A

• ⃝ Dedicated scoop not utilized or available

  Yes

  No

  N/A

• ⃝ Nut-free mix-ins kept in the orange container

  Yes

  No

  N/A

• ⃝ Other

  Yes

  No

  N/A

TOTAL FOOD SAFETY POINTS ACHIEVED

• If the overall score is below 80%, the visit results in not meeting standards and a follow-up is required between 30 - 90 days. Food

  Yes

  No

  N/A

• Safety Review Guide is available for this section

  Yes

  No

  N/A