Title Page
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Conducted on
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Prepared by
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Location:
Guest Areas
Double Door Foyer
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Is the Foyer clean?
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Is the Fly Light Working and is Glue board in good condition?
- Yes
- Glue board full/ not present
- Light not working
Side Dining Room
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Is trash can Clean
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Is the Drain Clean
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Are Floors Clean
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Is the Fly Light Working and is Glue board in good condition?
- Yes
- Glue board full/ not present
- Light not working
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Is Condiment Bar Clean and stocked?
- Yes
- Sticky Bins
- Stock Low
- Inside Cabinets dirty
- Wet Floor Signs dirty
Restroom Lobby
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Is the lobby clean?
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Is the cabinet clean and free of unauthorized chemicals?
- Clean
- Unorganized
- Unapproved chemicals
- Dirty
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Is the Fly Light Working and is Glue board in good condition?
- Yes
- Glue board full/ not present
- Light not working
Men’s room
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Soap
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Sanitizer
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Paper towels
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Is the bathroom clean?
- Clean
- Mold present
- Mirror dirty
- Vent Fan Dirty
- Foul Odor
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Is the Drain Clean
Hot Water Temp
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Is the water at the right temperature?
Women's Room
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Soap
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Sanitizer
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Paper towels
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Is the bathroom clean?
- Clean
- Mold present
- Mirror dirty
- Vent Fan Dirty
- Foul Odor
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Is the Drain Clean
Hot Water Temp
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Is the water at the right temperature?
Main Dining Room
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Is trash can Clean
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Is the Drain Clean
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Are Floors Clean
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Is the Fly Light Working and is Glue board in good condition?
- Yes
- Glue board full/ not present
- Light not working
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Is Condiment Bar Clean and stocked?
- Yes
- Sticky Bins
- Stock Low
- Inside Cabinets dirty
- Wet Floor Signs dirty
Men’s room
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Soap
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Sanitizer
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Paper towels
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Is the bathroom clean?
- Clean
- Mold present
- Mirror dirty
- Vent Fan Dirty
- Foul Odor
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Is the Drain Clean
Hot Water Temp
Playland
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Are Floors Clean?
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Is Play Equipment Clean?
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Hand wipes stocked
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Are handles and Door Clean?
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Does it smell Clean?
Order Queue Area
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Are Floors Clean?
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Is 'Pick Up' sign clean?
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Are Poles and Cords Clean and Sanitized?
- Yes
- Cords Dirty
- Poles Dirty
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How does the order counter look?
Single door Foyer
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Is the Foyer clean?
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Is the Fly Light Working and is Glue board in good condition?
- Yes
- Glue board full/ not present
- Light not working
Front Counter and Drive Thru
Hand Wash Sink
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Soap
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Sanitizer
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Paper Towels
Hot Water Temperature
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Is there Hot water available?
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Is the Cabinet under it Clean and no unapproved/ unlabeled Chemicals?
- Clean
- Unorganized
- Unapproved chemicals
- Dirty
Drink Fountain #1
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Are the Fountain Nozzles and area Clean?
- Yes
- Nozzles Dirty
- Diffuser Dirty
- Underside Dirty
- Mold
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Are ice Scoops Clean and Sanitized
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Is the Drain Clean
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Is the Counter top clean?
- Clean
- Sticky Residue
- Mold present
- Wet
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Are The Registers Clean and area around?
Drink Fountain #2
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Are the Fountain Nozzles and area Clean?
- Yes
- Nozzles Dirty
- Diffuser Dirty
- Underside Dirty
- Mold
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Are ice Scoops Clean and Sanitized
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Is the Drain Clean
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Is the Counter top clean?
- Clean
- Sticky Residue
- Mold present
- Wet
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Are The Registers Clean and area around?
Drink Fountain #3
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Are the Fountain Nozzles and area Clean?
- Yes
- Nozzles Dirty
- Diffuser Dirty
- Underside Dirty
- Mold
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Are ice Scoops Clean and Sanitized
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Is the Drain Clean
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Is the Counter top clean?
- Clean
- Sticky Residue
- Mold present
- Wet
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Are The Registers Clean and area around?
Drive Thru Drink Area
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Is trash can clean and empty?
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Are the Fountain Nozzles and area Clean?
- Yes
- Nozzles Dirty
- Diffuser Dirty
- Underside Dirty
- Mold
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Are ice Scoops Clean and Sanitized
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Is the Drain Clean
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Is the Counter top clean?
- Clean
- Sticky Residue
- Mold present
- Wet
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Are The Registers and area around them clean?
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Is the Ice Dream Machine Clean?
- Clean
- Dirty
- Missing Pieces
- Leaking
- Mold
- Shake mixer dirty
Temperature of Ice Dream in Hopper
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Safe?
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Is the Drain Clean
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Is the Shake base Machine Clean?
- Clean
- Dirty
- Broken Gasket
- Ice buildup
- Handle Dirty
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Are all Labels Good?
Temperature of Shake base out of Dispenser:
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Safe?
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Are Tea Urns Clean?
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Are Lemon Dispensers Clean?
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Is reach in Low Boy Clean?
- Clean
- Dirty
- Broken Gasket
- Ice buildup
- Handle Dirty
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Are all Labels Good?
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Is there a Thermometer present?
Temp of Unit
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Is the coil Blocked?
Temp of Milk:
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Safe?
Bagging Area
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Is air Curtain on?
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Is the Counter top clean?
- Clean
- Sticky Residue
- Mold present
- Wet
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Are the sauce bins clean and free of sticky residue?
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Is Dessert Low Boy Clean?
- Clean
- Dirty
- Broken Gasket
- Ice buildup
- Handle Dirty
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Are all Labels Good?
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Is there a Thermometer present?
Temp of Dessert Fridge
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Is the coil Blocked?
Temp of Ice Dream in Reach in
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Safe?
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Is Primary Fry Chute Clean
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Is Wrap Low Boy Clean?
- Clean
- Dirty
- Broken Gasket
- Ice buildup
- Handle Dirty
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Are all Labels Good?
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Is there a Thermometer present?
Temp of Wrap Fridge
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Is the coil Blocked?
Temp of Wrap
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Safe?
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Is Nuggets Chute Clean
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Is Fruit Low Boy Clean?
- Clean
- Dirty
- Broken Gasket
- Ice buildup
- Handle Dirty
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Are all Labels Good?
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Is there a Thermometer present?
Temp of Fruit Fridge
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Is the coil Blocked?
Temp of Fruit
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Safe?
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Is Secondary Fry Chute Clean
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Are all KPS Monitors/arms/cords Clean?
- All Clean
- Desserts dirty
- Drinks Dirty
- DT Bagging Dirty
- FC Bagging Dirty
- Window KPS Dirty
Lemonade and Tea Area
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Is the Counter top clean?
- Clean
- Sticky Residue
- Mold present
- Wet
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Is reach in Low Boy Clean?
- Clean
- Dirty
- Broken Gasket
- Ice buildup
- Handle Dirty
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Are all Labels Good?
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Is there a Thermometer present?
Temp of reach in Fridge
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Is the coil Blocked?
Temp of Parfait:
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Safe?
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Are Tea Urns Clean?
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Are Coffee Urns Clean?
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Are Lemonade dispensers Clean?
Chemicals
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Are all chemicals stored properly and marked correctly behind front counter? Away from food and food prep surfaces.
Back of House
Drink Bibs and Ice Machine
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Are the BIB hoses and connections clean?
- Clean
- Sticky Residue
- Mold present
- Wet
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Is the Ice Machine Clean and Sanitized?
- Clean and Sanitized
- Mold Found
- Dirty under door
- Dirty in rail
- Wall underneath is dirty
- Broken/ not working
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Is the Drain under Ice Machine Clean?
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Is Scoop clean and sanitized?
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Are ice buckets clean and sanitized
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Is the Orange floor Fan Clean?
Prep Sink
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Safe?
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What is the Produce wash Concentration?
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Is Prep sink Clean?
- Clean
- Under lip dirty
- Mold in Caulking
- Dirty
- spray head dirty
- Wall Underneath Dirty
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Is the Drain under Prep sink Clean?
Lemon Juicer
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Is the Juicer Clean
- Clean
- Dirty
- Top section dirty
- Wall behind dirty
- floor under dirty
- Inside Cabinet dirty
- Casters Dirty
- Assembly not complete
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Is the Drain near Lemon Juicer Clean?
Hand Wash Sink near prep
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Soap
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Sanitizer
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Paper Towels
Hot Water Temperature
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Is there Hot water available?
Tea Brewers
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Are Tea Brewers Clean and in good repair?
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Is Sugar Bin and Scoop Clean?
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Is Scoop handle up and out of product?
Dish Area
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Is Area Around Dishes Clean?
- Clean
- Under lip dirty
- Mold in Caulking
- Dirty
- spray head dirty
- Wall Underneath Dirty
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Is Drying Rack Clean and in good repair?
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Are dishes stacked Wet?
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Is the Drain under Dish Sink Clean?
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Are Chopper and slicers Clean?
- All Clean/ In Use/ To be Cleaned
- Lettuce Chopper Dirty
- Nugget Chopper Dirty
- Tomato Slicer Dirty
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Is Orange Floor Fan Clean?
Compactor Area
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Is Compactor Clean and in good Repair?
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Is compressor clean and in good Repair?
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Storage Shelves Clean and in good Repair
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Is the Drain Clean?
Office
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Floors Clean
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Counters Clean
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Trash Emptied
Walk-in Cooler
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Outside Reading
Inside Reading
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Safe?
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Are coils free of ice and debris?
Whole Chicken Temp
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Safe?
Sliced Chicken Temp
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Safe?
Sliced Tomato Temp
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Safe?
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Are all Labels correct and in date?
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Are Floors Clean?
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Are Shelves Clean and in good repair
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Is Handle Clean and Sanitized?
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Is Gasket Clean and in good repair?
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Does top shelf allow for air flow?
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Is the Drain outside Clean?
Mop Sink Area
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Is the Drain Clean?
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Are Brooms, Brushes, Squeegees, and mops hung correctly and clean?
- All Clean and hung
- Mop not clean/hung
- Brushes not clean/ hung
- Brooms not clean/hung
- squeegees not clean/ hung
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Are Chemicals Clearly labeled, stored properly, and correct in content?
Walk-in Freezer
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Outside Reading
Inside Reading
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Safe?
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Are coils free of ice and debris?
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Are all Labels correct and in date?
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Are Floors Clean?
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Are Dunnage racks clean?
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Are Shelves Clean and in good repair
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Is Handle Clean and Sanitized?
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Is Gasket Clean and in good repair?
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Is the Drain outside Clean?
Thaw Area
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Is Thaw cabinet 1 clean
- Clean
- Dirty
- Dirty inside door
- Gasket torn/ dirty
- Handle dirty
- Casters dirty
- Ledge and bottom dirty
- Dirty under unit
Thaw cabinet outside reading
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Thermometer present?
Thaw cabinet inside reading
Chicken Temp of use next chicken:
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Safe?
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Thermometer present?
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Is Thaw cabinet 2 clean
- Clean
- Dirty
- Dirty inside door
- Gasket torn/ dirty
- Handle dirty
- Casters dirty
- Ledge and bottom dirty
- Dirty under unit
Thaw cabinet outside reading
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Thermometer present?
Thaw cabinet inside reading
Chicken Temp of use next chicken:
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Safe?
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Thermometer present?
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Is Thaw cabinet 3 clean
- Clean
- Dirty
- Dirty inside door
- Gasket torn/ dirty
- Handle dirty
- Casters dirty
- Ledge and bottom dirty
- Dirty under unit
Thaw cabinet outside reading
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Thermometer present?
Thaw cabinet inside reading
Chicken Temp of use next chicken:
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Safe?
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Thermometer present?
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Is Thaw cabinet 4 clean
- Clean
- Dirty
- Dirty inside door
- Gasket torn/ dirty
- Handle dirty
- Casters dirty
- Ledge and bottom dirty
- Dirty under unit
Thaw cabinet outside reading
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Thermometer present?
Thaw cabinet inside reading
Chicken Temp of use next chicken:
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Safe?
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Light cover Present?
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Is the Drain in Thaw Area Clean?