Health Inspection

• Conducted By

• Conducted on

  Date

Dumpster Area

• Are the outside doors closed?

  Yes

  No

  N/A

• Are all trash bags inside the dumpster?

  Yes

  No

  N/A

• Is the dumpster pad clean and free of debris?

  Yes

  No

  N/A

• Is the sliding door & lid closed?

  Yes

  No

  N/A

• Is the sidewalk free of trash and debris? (and cigarettes)

  Yes

  No

  N/A

Cage Area

• Are cleaning supplies (brooms, squeegees, mops, dustpans) hanging on the wall and off the ground?

  Yes

  No

  N/A

• Is there trash or trash bags on the floor?

  Yes

  No

  N/A

• Is the compactor lid closed?

  Yes

  No

  N/A

• Are all towels off the floor and inside the hamper?

  Yes

  No

  N/A

• Are both cage doors fully closed and not propped open?

  Yes

  No

  N/A

• Is the floor free of standing water?

  Yes

  No

  N/A

• Is the air curtain work properly?

  Yes

  No

  N/A

Clothes & Chemical Rack

• Have all boxes been compacted or been broken down and neatly set aside?

  Yes

  No

  N/A

• Are all employee belongings neatly organized and off the floor?

  Yes

  No

  N/A

• Is the back area free of leftover food or trash? (Employee meals need to be stored away from chemicals and food prep areas)

  Yes

  No

  N/A

• Are all chemicals on the shelf in their properly labeled bottles?

  Yes

  No

  N/A

• Are all test strips within their expiration dates?

  Yes

  No

  N/A

• Which one(s) are expired?

• Are all 3 types of test strips present? (QAC, Chlorine, and Vegetable/Fruit)

  Yes

  No

  N/A

• Which one is not present?

• Yes

  No

  N/A

Office

• Does the store have a dishwasher thermometer?

  Yes

  No

  N/A

• Does the store have all 3 types of safety cutters? (blue, green/red, and yellow)

  Yes

  No

  N/A

• Which kind is missing?

• Does the store have heat protection equipment? (heat resistant gloves, apron, and face shield)

  Yes

  No

  N/A

• Does the store have cut resistant gloves?

  Yes

  No

  N/A

• Are all cooler/freezer doors shut all the way?

  Yes

  No

  N/A

Cooler

• Are all employee meals and non-CFA products stored in a separate container?

  Yes

  No

  N/A

• Does all frozen, thawed, and prepped mac have labels?

  Yes

  No

  N/A

• What items are not labeled correctly and how many?

• Are all primary prep items labeled properly and have not passed its expiration date/time?

  Yes

  No

  N/A

• What items are not labeled correctly or have expired?

• Are all secondary prep items labeled properly and have not passed its expiration date/time?

  Yes

  No

  N/A

• What items are not labeled correctly or have expired?

• Are all other items in the cooler properly labeled and have not passed its expiration date/time?

  Yes

  No

  N/A

• What items are not labeled correctly or have expired?

• Are all items in containers properly closed/sealed?

  Yes

  No

  N/A

• What are items are not properly closed/sealed?

• Is cool down chicken properly wrapped with air pockets?

  Yes

  No

  N/A

• Do thawed/thawing corn/corn & beans have labels?

  Yes

  No

  N/A

• Are all items at least 6 inches off the floor?

  Yes

  No

  N/A

• Are all open packages labeled and resealed? (ex. opened eggs, bacon, etc.)

  Yes

  No

  N/A

• Are all shelves clean and free of build up or mold?

  Yes

  No

  N/A

• Are the floors clean and free of trash or sitting water?

  Yes

  No

  N/A

• Are there any products from unapproved distributors?

  Yes

  No

  N/A

• Are there any damaged boxes or products?

  Yes

  No

  N/A

• Are there items that have been recalled and cannot be used?

  Yes

  No

  N/A

• Has it been set aside and labeled as Do Not Use?

  Yes

  No

  N/A

• What is the temperature of the cooler?

Top of Prep Table

• Are all items in the table properly labeled and have not past their expiration date/time?

  Yes

  No

  N/A

• What items are missing labels?

• Does each container have its own scoop to avoid cross contamination?

  Yes

  No

  N/A

• What items are missing scoops?

• Does the grilled chicken pan have a portioning bowl inside the pan?

  Yes

  No

  N/A

• Are there any open bags sitting in the table?

  Yes

  No

  N/A

• What is the temperature of the lettuce?

Bottom of Prep Table

• Are all containers properly labeled and have not past its expiration date/time?

  Yes

  No

  N/A

• What items are not labeled correctly or have expired?

• Do all containers have lids and are closed?

  Yes

  No

  N/A

• What items are missing a lid or is open?

• Do the spicy and regular sliced grilled chicken have portioning bowls inside the container?

  Yes

  No

  N/A

• What is the temperature of the lowboy?

• Are the gaskets clean and free of tears?

  Yes

  No

  N/A

• Is the lowboy clean and free of sitting water?

  Yes

  No

  N/A

• Is there a sanitizer bucket present?

  Yes

  No

  N/A

• Is there a towel in use?

  Yes

  No

  N/A

• Is the towel fully submerged?

  Yes

  No

  N/A

• Is there a label showing that it has not passed it expiration time?

  Yes

  No

  N/A

• Are there any prepped items inside the lowboy?

  Yes

  No

  N/A

• Does each prepped item have a corresponding label that has not expired?

  Yes

  No

  N/A

• What items are missing labels or have expired?

  Yes

  No

  N/A

Freezer

• Are all items at least 6 inches off the floor?

  Yes

  No

  N/A

• Are there any open bags of fries/hashbrowns?

  Yes

  No

  N/A

• Are all bags folded and properly sealed?

  Yes

  No

  N/A

• Is there any outside food from unapproved distributors?

  Yes

  No

  N/A

• Are there any damaged boxes or products?

  Yes

  No

  N/A

• Are there any partial cases of chicken present?

  Yes

  No

  N/A

• Which cases of chicken only has a partial case?

Mop Sink

• Are all chemicals in their properly labeled bottles?

  Yes

  No

  N/A

• Dispose of bottles with no name/label and empty out bottles with incorrect substances.

• Are the degreaser and multi-surface hoses inside the jugs?

  Yes

  No

  N/A

• How dirty are the walls in the mop sink area?

  Good

  Fair

  Poor

  N/A

• Is the drain clean and free of trash?

  Yes

  No

  N/A

3-Compartment Sink

• Are all chemicals in their properly labeled bottles?

  Yes

  No

  N/A

• Dispose of bottles with no name/label and empty out bottles with incorrect substances.

• Is the sanitizer at the correct concentration after testing?

  Yes

  No

  N/A

• Are all dishes free of old labels?

  Yes

  No

  N/A

• Are there any cracked or broken dishes?

  Yes

  No

  N/A

• What dishes are cracked or broken? (what size and how many?)

• Are there any raw dishes in with regular dishes?

  Yes

  No

  N/A

• Are any dishes being wet-stacked?

  Yes

  No

  N/A

• What dishes were wet stacked?

• Are all knives, scoops, spatulas, and brushes in their respective areas?

  Yes

  No

  N/A

• Is the dishwasher reaching the correct temperature and pressure? (160 +/-2 degrees and 15-25 PSI)

  Yes

  No

  N/A

• Is the back splash clean and free of dirt or grime?

  Yes

  No

  N/A

Vegetable Sink

• How clean is the sink?

  Good

  Fair

  Poor

  N/A

• Are the drain clear of trash and debris?

  Yes

  No

  N/A

• Is the vegetable wash at the appropriate strength after testing?

  Yes

  No

  N/A

Handwashing Sinks

• What is the temperature of the water after letting it run for 20 seconds?

• Is there soap present?

  Yes

  No

  N/A

• Are there paper towels present?

  Yes

  No

  N/A

• Is there a trash can present?

  Yes

  No

  N/A

• Are gloves present and readily available?

  Yes

  No

  N/A

• Is the sink free of grime?

  Yes

  No

  N/A

• Is the drain clean and clear of debris?

  Yes

  No

  N/A

Ice Machine

• Is the ice scoop inside its holder?

  Yes

  No

  N/A

• Is the ice scoop free of cracks or chipping?

  Yes

  No

  N/A

• Is the inside of the ice machine (roof) clean and free of grime? (Use a sanitizer wipe to check and attach the photo)

  Yes

  No

  N/A

• Is the inside lip of the doors clean and free of grime?

  Yes

  No

  N/A

• Is the smart gate missing any metal covers in the ice poking holes?

  Yes

  No

  N/A

• Is the outside of the ice machine clean?

  Yes

  No

  N/A

• Is the ice paddle free of major chipping?

  Yes

  No

  N/A

• Are the ice buckets flipped upside down?

  Yes

  No

  N/A

• Are any ice buckets broken or cracked?

  Yes

  No

  N/A

• Is there a tray under the ice buckets?

  Yes

  No

  N/A

• Is the ice bucket trolley clean and free of mold?

  Yes

  No

  N/A

Tea Brewing Station

• Is there tea already brewed?

  Yes

  No

  N/A

• Is the tea covered?

  Yes

  No

  N/A

• Is the counter clean? (Free of excess sugar and sitting water)

  Yes

  No

  N/A

• Are all employee drinks in cups with lids and straws?

  Yes

  No

  N/A

• Is there anything sitting on top of the tea brewer?

  Yes

  No

  N/A

• Is the floor clean and free of trash/condiments?

  Yes

  No

  N/A

• Are shelves free of employee food/drinks?

  Yes

  No

  N/A

• Are the doors closed?

  Yes

  No

  N/A
Hashbrown/Fry Freezer

• Are open bags folded and sealed?

  Yes

  No

  N/A

• Is there a thermometer present?

  Yes

  No

  N/A

• What is the temperature of the freezer?

• Is there a working light bulb?

  Yes

  No

  N/A

• Is there a light bulb cover?

  Yes

  No

  N/A

• Are there hairnets, beard nets, and aprons present?

  Yes

  No

  N/A

• Are all saber king slicers and choppers free of debris?

  Yes

  No

  N/A

• Are all saber king slicers and choppers free of chips and broken blades?

  Yes

  No

  N/A

• Is the soup rethermalizer clean and free of debris on the lid/sides?

  Yes

  No

  N/A

Fry/HB Cooking Station

• Is the fry scoop in its holder and off the counter?

  Yes

  No

  N/A

• Are there any fry bags sitting out or on the fryer?

  Yes

  No

  N/A

• Fries should not sit out because it will begin to defrost and have poor quality

• Is the area free of employee drinks?

  Yes

  No

  N/A

• Is the salt shaker exterior clean and free of any build up?

  Yes

  No

  N/A

• Is the hood vent clean?

  Yes

  No

  N/A

Cookie Station

• Do cookies have labels that are not expired?

  Yes

  No

  N/A

• Do thawed brownies have labels that are not expired?

  Yes

  No

  N/A

• Do wrapped brownies have labels that are not expired?

  Yes

  No

  N/A

• Is the area clean and free of dirty dishes?

  Yes

  No

  N/A

Salad cooler/lowboy

• Does each type of salad have a label?

  Yes

  No

  N/A

• Which salad(s) is missing a label?

• Is the cooler clean and free of sitting water?

  Yes

  No

  N/A

• Are the gasket clean and free of tears?

  Yes

  No

  N/A

• Is there a thermometer present?

  Yes

  No

  N/A

• What is the temperature of the cooler?

• Are all other items in the cooler labeled and have not passed it expiration time/date? (Cheese blend, chicken for soup, etc.)

  Yes

  No

  N/A

• What items are missing labels?

Dry Stock Areas

• Are the shelves for plastic ware clean and free of excess dust or grime?

  Yes

  No

  N/A

• Are the shelves for sauces clean and free of excess dust or grime?

  Yes

  No

  N/A

• Are the shelves for dressings clean and free of excess dust or grime?

  Yes

  No

  N/A

• Are the shelves for breakfast condiments clean and free of excess dust or grime?

  Yes

  No

  N/A

• Are the shelves for salad toppings clean and free of excess dust or grime?

  Yes

  No

  N/A

• Are the shelves for catering supplies clean and free of excess dust or grime?

  Yes

  No

  N/A

• Are the shelves for bowls and lids clean and free of excess dust or grime?

  Yes

  No

  N/A

• Are the shelves for menu tabs and fry boxes clean and free of excess dust or grime?

  Yes

  No

  N/A

• Are the shelves for pickles and oil clean and free of excess dust or grime?

  Yes

  No

  N/A

• Are the shelves for coater clean and free of excess dust or grime?

  Yes

  No

  N/A

• Are the shelves for breakfast items clean and free of excess dust or grime?

  Yes

  No

  N/A

Breakfast Boards

• Are gloves and sanitizer wipes accessible?

  Yes

  No

  N/A

• Are food contact surfaces clean?

  Yes

  No

  N/A

• Are food contact surfaces being sanitized at least once every 4 hours?

  Yes

  No

  N/A

• Are all serving utensils being cleaned or replaced every 4 hours?

  Yes

  No

  N/A

• Are knives, spoons, or scoops off the counter and in an appropriate place for holding?

  Yes

  No

  N/A

• Are food prep areas free of personal items such as outside food or drinks?

  Yes

  No

  N/A

• Do the TPHC Labels have the correct time and temperature?

  Yes

  No

  N/A

• Are timers on the Merco set and in the green?

  Yes

  No

  N/A

• Are all AHA chicken timers set and have not expired?

  Yes

  No

  N/A

• Is cooked bacon in a labeled container?

  Yes

  No

  N/A

• Are open liquid eggs in a labeled container and ice bath/cooler?

  Yes

  No

  N/A

• Are salads labeled?

  Yes

  No

  N/A

• Which salads are missing labels?

• Is the cooler(s) clean?

  Yes

  No

  N/A

• Does the cooler(s) have a thermometer?

  Yes

  No

  N/A

• Which cooler(s) is missing a thermometer?

• Are the gaskets of the cooler(s) clean and free of tears?

  Yes

  No

  N/A

• Are thawed mini buns/muffins labeled?

  Yes

  No

  N/A

Primary Boards

• Are gloves and sanitizer wipes accessible?

  Yes

  No

  N/A

• Are food contact surfaces clean?

  Yes

  No

  N/A

• Are food contact surfaces being sanitized at least once every 4 hours?

  Yes

  No

  N/A

• Are all serving utensils being cleaned or replaced every 4 hours?

  Yes

  No

  N/A

• Are knives, spoons, or scoops off the counter and in an appropriate place for holding?

  Yes

  No

  N/A

• Are food prep areas free of personal items such as outside food or drinks?

  Yes

  No

  N/A

• Do the TPHC Labels have the correct time and temperature?

  Yes

  No

  N/A

• Are timers on the Merco set and in the green?

  Yes

  No

  N/A

• Are all AHA chicken timers set and have not expired?

  Yes

  No

  N/A

• Is cooked bacon in a labeled container?

  Yes

  No

  N/A

• Do multigrain buns have a label that is not expired?

  Yes

  No

  N/A

• Do gluten free buns have a label that is not expired?

  Yes

  No

  N/A

• Does the butter roller have a lid?

  Yes

  No

  N/A

• Is the soup lid(s) covered?

  Yes

  No

  N/A

Thawing/Holding Cabinets

• Does every row of chicken have a piece of cardboard that corresponds with that case?

  Yes

  No

  N/A

• What kind of chicken and how many are missing?

• Does each type of chicken have a use first clip?

  Yes

  No

  N/A

• Which chicken is missing a clip?

• Are there any unmarked partial cases of chicken?

  Yes

  No

  N/A

• Ask the kitchen leader where it should have gone.

• Do all chicken in D-pans have a rubber band holding the cardboard that corresponds with that case?

  Yes

  No

  N/A

• Does each piece of cardboard have 2 date labels on it?

  Yes

  No

  N/A

• Does each piece of cardboard have a number written on it to mark the order it should be taken?

  Yes

  No

  N/A

• Does the chicken follow the order that it is number inside the thawing cabinet?

  Yes

  No

  N/A

• Are all pans of fileted and marinated chicken wrapped and unexposed?

  Yes

  No

  N/A

• Do all pans of fileted and marinated chicken have an additional label to mark what was done?

  Yes

  No

  N/A

• Are all doors clean and free of raw residue?

  Yes

  No

  N/A

• Are the door handles clean?

  Yes

  No

  N/A

• Are all doors shut properly?

  Yes

  No

  N/A

• SHUT THEM!!

Breading Table(s)

• Are yellow gloves and aprons being worn?

  Yes

  No

  N/A

• Is anyone wearing mismatched colors? (ex. yellow apron, clear gloves)

  Yes

  No

  N/A

• Is there any chicken or milk wash past the fill lines?

  Yes

  No

  N/A

• Are there any open bags of chicken in the table?

  Yes

  No

  N/A

• What is the temperature of the milk wash?

• Are food prep areas free of personal items such as outside food or drinks?

  Yes

  No

  N/A

• Are the floors and drains clean and clear of raw chicken?

  Yes

  No

  N/A

Machines

• Is there a sanitizer bucket in use?

  Yes

  No

  N/A

• Is there a towel in use?

  Yes

  No

  N/A

• Is the towel fully submerged?

  Yes

  No

  N/A

• Is there a label showing that it has not passed it expiration time?

  Yes

  No

  N/A

• Are the hennies clean and free of sitting oil?

  Yes

  No

  N/A

• Are the grills clean and free of excess carbon build up?

  Yes

  No

  N/A

• Are the hood vents fully closed and clean?

  Yes

  No

  N/A

• Are the exterior vents clean and free of dust and debris?

  Yes

  No

  N/A

• Are all oil containers at least 6" off the floor?

  Yes

  No

  N/A