Title Page

  • Conducted on

  • Prepared by

  • Location

Imminent Health Risk Item

  • Running hot and cold water is available

  • Manager and Restaurant team member is free of illnesses and symptoms

  • Free of adulterated/contaminated products

  • Free of sewer backups

  • Free of pest infestation leading to food/contact surface contamination

  • Restaurant has sanitizer

  • Free of flood

  • Hand washing sinks are provided

  • Time and Temperature Controlled for safety (TCS) food are held at the proper temperature and documentation proves that the product has been held at the proper temperature for the last 4 hours or more

  • IMMINENT HEALTH RISK: PASS: All FSR point/rating available. FAIL (not cured in the moment):0% score is applied to the review

Food Safety Sanitation Item:

  • Hot water Reaches a minimum of 100 F at all sinks, 110 F at ware washing sink

  • Sanitizer is at a proper concentration at all sinks, buckets and cups

  • Chemicals are all approved, properly labeled and stored correctly

  • Premises in the back of the house are clean and maintained

  • All components of the ware washing sink are set up correctly and used properly

  • All equipment and prep tables are clean and sanitized at proper frequency

  • All utensils and small wares are clean and sanitized at proper frequency

Employee Health Item

  • Person in charge understands Dunkin' Brands standards for employee health

  • Hand washing sinks are fully stocked and used properly

  • No bare hand contact with ready to eat (RTE) foods

  • Franchisee's employees are washing hands at proper frequency and hygienic practices are followed

Temperature Item

  • Refrigerated food are held at 41 F or below and hot food at 140 F or above

  • Foods are cooked to the correct temperature

Good Retail Practices Item

  • Food is within date code and labeled properly

  • Food and packaging are protected from contamination and allergen cross contact

  • Packaging is used in an approved manner

  • Restaurant meet Dunkin' Brand Pest Management standards

Documentation Item

  • Monthly Food Safety self-Assessment are complete, accurate and with corrective actions

  • Cold and hot holding temperature are complete, accurate and with corrective actions

  • Cooking temperature documents are comlete, accurate and with corrective actions

  • Receiving documents are comlete, accurate, and with corrective actions

  • Additional required Food Safety documentation and resources are present and accessible as required

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.