Information

  • Building Number

  • Concessionaire

  • Facility Location

  • Conducted On

  • Inspector's name

Product Ready for Sale / Temperatures.

  • 1. Check temperature of hot items (135° F or above)

  • Item #1

  • Within acceptable range?

  • Item #2

  • Within acceptable range?

  • Item #3

  • Within acceptable range?

  • Hot Temperature Comments

  • Add media

  • 2. Check temperature of cold items (40° F or below)

  • Item #1

  • Within acceptable range?

  • Item #2

  • Within acceptable range?

  • Item #3

  • Within acceptable range?

  • Cold Temperature Comments

  • Add media

Cold Product Storage

  • 3. All prepackaged products are labeled and dated?

  • Add media

  • 4. Items stored properly, raw meat on bottom, prepared foods on top?

  • Add media

  • 5. Refrigerated unit temperatures are at 40° F or below. Interior/exterior surfaces are clean, air flow not blocked, no condensation, accurate thermometers?

  • Add media

  • 6. All freezer unit temperatures are at 0° F or below. Interior/exterior surfaces are clean, air flow not blocked, no condensation/ice build up, accurate thermometers?

  • Add media

  • 7. Outdated products discarded?

  • Add media

  • Cold Product Storage Comments

Sanitation

  • 8. Blades, can opener, scissors, slicers, clean & sanitized?

  • Add media

  • 9. All handwash sinks stocked with soap and towels.

  • Add media

  • 10. Cross contamination avoided, meats and vegetables prepared separately. Separate cutting boards and knives?

  • Add media

  • 11. 3-compartment sink used properly. Pots, pans, dishes and utensils sanitized, air dried, and stored properly?

  • Add media

  • 12. Thermometers in use?

  • Add media

  • 13. Food prep contact surfaces clean, sanitized, free of clutter?

  • Add media

  • 14. Wiping cloths stored in container of sanitizer or in use?

  • Add media

  • 15. Sanitizer at proper ppm. (Use Test Strips)

  • Within acceptable range?

  • Add media

  • 16. Sink sanitizer at proper ppm. (Use Test Strips)

  • Within acceptable range?

  • Add media

  • Sanitation Comments

Facility

  • 17. Outdated products discarded?

  • Add media

  • 18. Floors clean, free of food, trash, and debris?

  • Add media

  • 19. Walls and ceilings are clean and free of spots and cobwebs?

  • Add media

  • 20. Chemical and cleaning supplies labeled, stored properly, away from food?

  • Add media

  • 21. MSDS sheets are available?

  • Add media

  • 22. Storage shelves clean, free of debris and rust?

  • Add media

  • 23. Dry goods storage is neat, clean, and orderly. Products 6 inches off floor and away from wall?

  • Add media

  • 24. Trash receptacles are clean and covered?

  • Add media

  • 25. Ceiling and ceiling vents clean and free of dust?

  • Add media

  • 26. Brooms, mops stored business end down, off the floor. Mop buckets clean?

  • Add media

  • 27. Single service items are stored and dispensed in a sanitary manner?

  • Add media

  • 28. Cups and silver/plastic ware are stored and dispensed in a sanitary manner?

  • Add media

  • 29. Exterior and interior surfaces of equipment is clean?

  • Add media

  • 30. Facility is free of pests?

  • Add media

  • Facility Comments

Personal - Grooming

  • 31. Uniforms/clothing and aprons clean?

  • Add media

  • 32. No evidence of gum chewing, drinking, or eating?

  • Add media

  • 33. Hair restraints are worn?

  • Add media

  • 34. Nails clipped, no nail polish?

  • Add media

  • 35. Cuts and/or bandages covered with gloves?

  • Add media

  • 36. Gloves worn properly and changed often?

  • Add media

  • 37. Required posters visible?

  • Add media

  • Personal - Grooming Comments

Other Issues

  • 38.

  • Is the issue or condition acceptable?

  • Add media

  • 39.

  • Is the issue or condition acceptable?

  • Add media

  • 40.

  • Is the issue or condition acceptable?

  • Add media

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.