Title Page
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Site conducted
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Store Name
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Date and Time
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Evaluator Name
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Manager In Charge
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Location
CRITICAL OPERATIONS ELEMENTS
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Four (4) or more sizes/types of expired ingredients (non-dough) (-10)
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Lack of available cleaning supplies, potable water, and/or no functioning hand sink in the production area
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Refrigerated product(s), or refrigeration unit(s), over 50°F/10°C (including Alfredo sauce) (-10)
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Mold found on food products and/or on food contact surfaces (-10)
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Pest control standards past critical thresholds (-10)
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Dough management procedures neglected (-10)
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Five (5) or more core apparel, appearance, and/or hygiene violations on one (1) or several store personnel (-10)
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Mature (M-rated) content, including profanity, found on store premises (-10)
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Firearms, knives, illegal drugs, marijuana (in any form), or alcohol found on store premises (to the extent permitted by applicable law) (-10)
PRODUCT
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Dough properly managed and properly proofed (5)
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Approved product procedures in use (2)
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Product prepped for expected sales volume (2)
Pizza Great/Remake Calculation (4 per pizza)
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Pizza#1
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Pizza#2
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Pizza#3
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Pizza#4
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Pizza#5
Sides: Great/Remake Calculation (3 per side)
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Side #1
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Side #2
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Side #3
FOOD SAFETY
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All products dated properly and not expired (3)
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Pest control standards are maintained (3)
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Store personnel maintain proper appearance and hygiene standards (2)
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Hand washing and hand sanitizing procedures done properly (2)
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All food contact surfaces, small-wares, and utensils clean and sanitized (2)
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Hand washing and dishwashing supplies accessible and properly stocked (1)
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No bare hand contact with post-bake food (1)
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All food products are fully protected from cross-contamination and covered in prep, dry, and cold storage, at least 6" (15.2cm) from floor (1)
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Sanitizer concentration within specified range and temperature (1)
Temperatures
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Bin
Bin
Bin
Bin
Bin
Bin
Cabinet
Cabinet
Cabinet
Cabinet
Cabinet
Cabinet
Cabinet
Walk-in
Walk-in
Cola
Cola
Cola
Other
Other
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End Bake Temperatures
Wings
Stuffed Cheesy Bread
Pan
BreadBowl
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All refrigerated products held within specified temperature ranges (3)
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All cooked product temperatures at least 165°F / 74°C (3)
IMAGE AND CLEANLINESS
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Pizza64’s logo apparel (hats, shirts, shorts/pants/skirts, and outerwear) worn properly and represents a positive brand image (3)
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Aprons must be clean and worn at full-length, tied, during food preparation and not outside the store (2)
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Hot bags clean and free of debris and mold (2)
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Production area walls, floors, and baseboards are clean and free of dirt and debris (1)
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Customer area walls, floors, baseboards, windows, and windowsills are clean and free of dirt and debris (1)
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Customer area seating, counter, and surfaces are clean, sanitized, and free of dirt and debris (1)
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Restrooms are clean, sanitary, and fully stocked (1)
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Walk-in and gaskets clean, free of debris, mold, and mildew (1)
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Makeline rail, cabinets, and gaskets are clean, free of debris, mold and mildew (1)
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Store set up properly during operational hours (1)
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Parking lot and entryway sidewalk are free of debris (1)
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Bake-wares clean and free of excessive carbon build-up (1)
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Oven catch trays, oven exterior, and heat rack are free of built-up debris (1)
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Delivery vehicles represent a positive brand image (1)
EQUIPMENT AND STORE CONDITION
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Store ceiling, T-bars, and vents are clean and not broken, chipped, or cracked (1)
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Store walls, floors, and baseboards are not broken, chipped, or cracked (1)
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Hand sinks operational and handwashing reminder signage is present (1)
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Customer area seating, counter, and tables are not faded, broken, chipped, or cracked (1)
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Restrooms and fixtures are not broken, chipped, or cracked (1)
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Parking lot, entryway sidewalk, and customer-facing building exterior are clean and not damaged (1)
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Signage is clean, properly illuminated, and not damaged (1)
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Refrigeration units operational, not broken, chipped, or cracked, and free of rust, and holding temperature (1)
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Calibrated thermometer(s) available (1)
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Small-wares and utensils are not broken, chipped, or cracked (1)
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Bake-wares are not damaged (1)
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Oven fingers and hood are clean and free from excessive grease buildup and yellowing. Oven, hood, and heat rack are operational and undamaged (1)
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Sufficient number of hot bags available and are not torn, faded, or melted (1)
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Calibrated, working scale(s) and product build job aids available (1)
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Caller ID is installed and working (1)
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Safe and drop boxes are present, operational, and secured (1)
BRAND SAFETY
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Delivery experts making drops, carrying less than $20 (or international equivalent) (1)
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Security callbacks are completed for new and suspicious orders, and for orders where Caller ID is unavailable (1)
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Safe / Cash drawer in use and deposit procedures followed (1)
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No more than $100 CAD in front till (or international equivalent) (1)
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Safety equipment in use and store personnel delivering safely to customers (1)
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No weapons, including pocket knives, mace, pepper spray, and similar items (1)
SIGN OFF
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Manager Name and Signature
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Additional Observations
