FSC 2014 Assessment

• Restaurant #

• Conducted on

  Date

• ARL

• MOD

• Restaurant Visit - FSC

1.- REQUIRED DOCUMENTATION

• Most recent health department inspection report is available, and corrective actions completed on all health department critical violations.

  Yes

  No

  N/A

• At least one manager must have Food Protection Manager Certificate on file and within 3 years of issue date. Restaurant team must have appropriate food safety certification on file where required by local regulatory.

  Yes

  No

  N/A

• Current KFC Food safety checklists must be completed and retained

  Yes

  No

  N/A

• Current KFC Weekly Pest Walks must be completed and retained

  Yes

  No

  N/A

• Team Member food safety training records available and current

  Yes

  No

  N/A

• Employee Health & Illness Standard is posted visibly for employees

  Yes

  No

  N/A

2.- TEAM MEMBER HEALTH & HYGIENE PRACTICES

• Team member must not be observed working with symptoms of illness or infection. (FS-Critical)

  Yes

  No

  N/A

• Team members meet grooming and personal hygiene standards

  Yes

  No

  N/A

• Gloves and blue bandages available in the restaurant and used correctly

  Yes

  No

  N/A

• Proper hand-washing procedures followed (FS-Critical)

  Yes

  No

  N/A

• Hand washing sinks accessible, functioning, in good repair, used only for hand washing, and includes posted hand washing signs (FS-Critical)

  Yes

  No

  N/A

3.- APPROVED SOURCE

• Only approved ingredients or foods evident (FS-Critical)

  Yes

  No

  N/A

• Only approved equipment and smallwares in use

  Yes

  No

  N/A

4.- PROTECTION FROM CONTAMINATION

• Food and packaging are properly stored and in good condition; damaged or donated products are segregated; team member food/medication segregated

  Yes

  No

  N/A

• Utensils, smallwares, and food contact surfaces are properly cleaned, stored, airdried, in good repair, and held properly when in use

  Yes

  No

  N/A

• Cross contamination or potential cross contamination must not be present (FS-Critical)

  Yes

  No

  N/A

5.- CLEANING & SANITATION

• Dish Wash sink, and/or Dishwasher set up correctly and proper cleaning method followed; proper sanitizer concentration in sink and test strips available (FS-Critical)

  Yes

  No

  N/A

• Equipment is properly cleaned and free of excess debris, buildup

  Yes

  No

  N/A

• Wiping cloths used and stored properly in a sanitizer bucket with correct concentration (FS-Critical)

  Yes

  No

  N/A

• Cleaning supplies (e.g. mops, mop bucket, etc.) must be available and stored clean

  Yes

  No

  N/A

• All non-food contact surfaces are clean and in good repair

  Yes

  No

  N/A

• Floors, walls, ceiling are cleanable, clean and in good repair

  Yes

  No

  N/A

• Vents and exhaust hoods are clean and in good repair

  Yes

  No

  N/A

• All gaskets on refrigeration/freezer units, ice machines and hot holding units are clean and in good repair

  Yes

  No

  N/A

• All lighting sources are properly shielded or have shatter proof bulbs in areas where food, service utensils and equipment are stored or prepared

  Yes

  No

  N/A

• Trash receptacles in all restrooms and back of house are of sufficient availability, capacity and clean

  Yes

  No

  N/A

• Dumpster area is free of debris and odor, maintained clean and in good repair

  Yes

  No

  N/A

6.- PRODUCT PROCEDURES & TIME-TEMPERATURE CONTROL

• Thermometers in Use are Calibrated (FS-Critical)

  Yes

  No

  N/A

• Cold Time/Temperature Controlled for Safety (TCS) Foods must be held < 40°F (FS-Critical)

  Yes

  No

  N/A

• Hot Time/Temperature Controlled for Safety (TCS) Foods must be held > 140°F (FS-Critical)

  Yes

  No

  N/A

• Foods must be cooked or heated to the proper internal temperature (FS-Critical)

  Yes

  No

  N/A

• Time/Temperature Controlled for Safety (TCS) Foods (e.g. batter mixes, potato bites) using only time for food safety must have documented procedures and be within four hour hold time (FS-Critical)

  Yes

  No

  N/A

• Ingredients and products must be held correctly, within hold times or shelf life, rotated properly, and correctly labeled

  Yes

  No

  N/A

• Spoiled foods or ingredients are not in use and not for sale (FS-Critical)

  Yes

  No

  N/A

• Frozen foods are thawed correctly

  Yes

  No

  N/A

• Hot carryover procedures are followed by Team; Team only carrying over ingredients which are permitted to be carried over (FS-Critical)

  Yes

  No

  N/A

• Fresh chicken in walk-in > 33ºF and < 40ºF, and within use-by date. (Specific to KFC only)

  Yes

  No

  N/A

7.- EQUIPMENT

• Cold holding and storage equipment temperature meets standard, is functioning properly, and needs no repair

  Yes

  No

  N/A

• Hot holding and storage equipment temperature meets standard, is functioning properly, and needs no repair

  Yes

  No

  N/A

• Three-compartment sink, prep sink, dishwasher or powersoak sink is functioning properly and needs no repair

  Yes

  No

  N/A

• Other equipment in use is functioning properly and needs no repair

  Yes

  No

  N/A

• Hand wash sinks must be provided with water dispensed at > 100°F

  Yes

  No

  N/A

8.- CHEMICALS

• Chemicals are approved, and properly used, labeled and stored

  Yes

  No

  N/A

9.- PEST CONTROL AND PREVENTION

• Pest Activity Not Present (FS-Critical)

  Yes

  No

  N/A

• Pest control devices evident and installed, maintained properly; service is evident and by an approved Pest Management Professional Vendor

  Yes

  No

  N/A

• Pest activity is prevented through proper sealing of outer openings and the elimination of harborage conditions, including outside storage sheds and landscaping

  Yes

  No

  N/A

10.- SEWAGE AND PLUMBING

• Hot water > 120°F is available in the kitchen as measured at any sink providing hot water other than a handwash sink (FS-Critical)

  Yes

  No

  N/A

• Back flow prevention devices present at every sink

  Yes

  No

  N/A

• Minimum of one functioning toilet available in the facility

  Yes

  No

  N/A

• All plumbing in good repair

  Yes

  No

  N/A

• Mop sink, grease and sink traps or drains not clogged and functioning properly (FS-Critical)

  Yes

  No

  N/A

Notes

• Add signature

  Sign