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  • Site conducted

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  • Inspected By

  • Accompanied By

  • Location
  • Inspection Code: <br>Yes - Meets Standard<br>No - Does Not Meet Standard<br>Not Reviewed

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Environmental Safety

  • Are daily cleaning and sanitation procedures being followed and documented? <br>29 CFR 1910.141; 29 CFR 1926.51; 29 CFR 1928.110; OSHA guidance on Mitigating & prevention of COVID-19 updated 06-10-21

  • Is the area free from clutter with materials properly stored safely to prevent tripping, fire or pest hazards? <br>29 CFR 1910.22; 29CFR 1926.25; FSH 6709.11 38.33

  • Are garbage cans intended for disposing of food emptied daily and outfitted with solid tight-fitting covers?

  • Are wiping cloths clean, stored properly?

  • Are floors free from damage, holes or cracks? <br>CFR 29 1910.22

  • Are ceilings free from holes or missing tiles? <br>1910

  • Are overhead lights working and protected from breakage? <br>CFR 29 1910.269

  • Are utensils and equipment clean, in good working order and stored properly?

  • Are spills cleaned up promptly?

  • Are all food areas free of evidence of insects or rodents? <br>CFR 21 Food Code FDA Codebook 2017 Controlling Pests 6-501.11

  • Do staff and student practice proper hygiene? (Clothes clean, no jewelry, hair restrained etc.) <br>CFR 21 Food Code Employee Health and Personal Hygiene Handbook

  • Is the area free from damaged, worn or unsafe messaging?

Restroom Facilities

  • Are toilets and washing facilities clean and stocked with supplies (soap, towels, toilet paper)? FDA Codebook 2017 Handwashing signage 6-301.14; CFR 21

  • Are fixtures in toilets and washing facilities working and in good repair?

  • Are tiles clean and free from damage?

  • Are showers, sinks and toilets free from leaks?

  • Is there evidence of mold or mildew?

Storage

  • Are storage racks tightly assembled and free of sagging from overload or damage?

  • Are storage areas kept free of tripping and fire hazards?

  • Are materials stored to ensure liquids are kept away from/below paper products?

  • Are dry storage rooms/areas organized and clean with no food stored on the floor?

  • Do employees have a safe way to stock and unstock the shelves?

  • Are grease containers appropriate and grease collection is at an acceptable level? <br>CFR 21 Food Code FDA 2017 5-402.12 Grease Trap.

  • Are cleaning supplies properly labeled?

  • Are mopping supplies properly cleaned and stored?

Hazardous Chemicals

  • Are eyewash stations serviceable, inspected, not blocked, signposted, tested weekly, and signed off? <br>NFPA 101; ANSI Z358.1 Sec 5.5.2; CFR 29 1910.132

  • Are all containers of hazardous materials clearly labeled with their contents? <br>CFR 21 Food Code FDA 2017 Annex 4, Table 2b. Added Chemical Hazards at Retail, Along with Their Associated Foods and Control Measures

  • Are all chemicals stored according to the manufacturer’s recommendations and local or national fire codes.

  • Are all employees & students required to use personal protective clothing and equipment (gloves, eye protection, etc.) when handling chemicals?

  • Are employees prohibited from eating in areas where hazardous chemicals are present?

  • Is personal protective equipment provided, used and maintained whenever necessary?

  • Are there procedures in place and being followed for obtaining and returning hazardous chemicals?

  • Are Safety Data Sheets (SDS) available, up-to-date and students can demonstrate their use?

Electrical Safety

  • Are extension cords used only for temporary use with correct voltage and rated for usage? <br>CFR 1910.269

  • Are power cords free of splices, taps, and damaged insulation?

  • Is daisy chaining present?

  • Are live electrical parts on tools, equipment, building wiring, and electrical panels enclosed to prevent contact?

  • Do circuits become overloaded? If so why?

  • Are breaker boxes clear and can they be accessed?

  • Are electrical GFCI outlets used in wet locations? <br>29 CFR 1910.334; 1910.304; 1926.404

  • Do electrical cords and equipment used at wet locations have waterproof covers or seals to keep moisture out?

  • Are lockouts/tagouts used as needed to control hazard energy? <br>29 CFR 1910.147

  • Are all outlets and covers in good repair?

First Aid

  • Are first aid and blood borne pathogen kits available, accessible and stocked using a list of required items posted? CFR 1910.151(b), 1926.50( c ), ANSI/ISEA Z3-8.1, 1910.151 , 1926.50(d)(1), PRH Exhibit 5-4

  • Are the AED machines inspected to ensure good working order with current batteries and pads (not expired)?

Fire Safety

  • Are all fire extinguishers present in their correct location?  PRH-5.9-R5.a-f ; CFR 1910.157(c)(4) NFPA 10

  • Are all extinguishers hung or stand mounted, unobscured, unobstructed and freely visible?  CFR 1910.157 (c)(1) NFPA 10

  • Do all fire extinguishers with pressure gauges show correct pressure?  <br>PRH 5.9-R5.a-f; CFR 1910.157.(c) (4) NFPA 10

  • Are all extinguishers free from signs of corrosion (incl. tap-test)?  <br>PRH-5.9R5.a-f; CFR 1910.157(f)(2)(iii) NFPA 10

  • Are alarm pull stations and smoke detectors in good working order? <br>CFR 29 1910.164

  • Are fire extinguishers tagged, serviced and inspected by the building manager or designee? CFR 29 1910.157( c )(1), NFPA 10

  • Is the fire alarm panel in good working order? <br>NFPA 72 NFPA 70 29 CFR. 164-165; 1926.150

Escape Routes/Exits

  • Are occupancy loads posted with adequate exit discharge routes that lead outside? 1910.36 (c)

  • Are exits clearly marked and well lit?

  • Are escape routes clear and free from debris and obstruction?   CFR 1910.37(a)(3) ;NFPA 101B

  • Are all internal fire doors closed (not wedged open)?  <br>NFPA LSC 19.3.6.3.10

  • Are exterior exit doors clear and unobstructed on both sides?  <br>CFR 1910.37 (a) (3)

  • Do exterior exit doors open easily from the inside without a key?  CFR 1910.36 (d)(1)

  • Are external pathways from the exits away from the building clear?  CFR 1910.37 (b) (4) 1910.37 (d) (1)

  • Has the area documented a safety drill in the past 30 days?

Food Safety

  • Do potentially hazardous food meet temperature requirements during storage, preparation, display, service, and transport? <br>CFR 21 Food Code FDA 2017 3-202.11; Applicable Sections of Parts 3-4 & 3-5

  • Thawing meats stored6” off ground?

  • Is food properly dated and documented for rotation control?

  • Are thermometers provided and conspicuous? <br>CFR 21 Food Code FDA 2017 4-204.112

  • Are food and ice dispensing utensils properly stored? <br>CFR 21 Food Code FDA 2017 3-304.12 In-Use Utensils, Between-Use Storage.

  • Are ServSafe Certificates posted in visible location?

Food Service Sanitation

  • Are food contact surfaces adequately designed, maintained, and located? <br>CFR 21 Food Code FDA 2017 4-202.11 Food-Contact Surfaces.

  • Are sneeze guards clean?

  • Are non-food contact surfaces adequately maintained and located? <br>CFR 21 Food Code FDA 2017 4-202.16 Nonfood-Contact Surfaces

Dishwashing

  • Are dishwashing chemical ratios and temperatures checked and documented - temps at 165 for wash and 185 for rinse?

  • Are three compartments sink properly installed and used with an adequate supply of pH paper and sanitization test strips? <br>CFR 21 Food Code .4-301.12 Manual Warewashing, Sink Compartment

  • Are dishwashing test strips and heat-sensitive tapes being used and not expired?

  • Do water sources provide hot and cold water with adequate pressure and temperatures?

Hoods

  • Are hood filters washed weekly?

  • Are hoods cleaned according to HAACP stickers?

  • Are cooking devices properly placed under suppression system?

Temperature Controls

  • Is food stored and labeled properly in walk-in freezer?

  • Condensing units are free from ice buildup?

  • Is food stored and labeled properly in walk-in cooler?

  • Are temperature logs up-to-date and displayed properly?

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.