Infection Prevention Dietary Rounds

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

I. General

• ServSafe Certified Manager/Associate on site during hours of operation. Date of Certification complies with LOB recertification standard.

  Yes

  No

  N/A

• Licensed pest prevention contractor providing at a minimum monthly inspections. Reports available in file, and corrective actions completed.

  Yes

  No

  N/A

• Ecolab Service reports available (Monthly visit with dish machine / quarterly visit no dish machine). Corrective actions completed.

  Yes

  No

  N/A

• A documented Allergen Policy is available, knowledge of the major food allergens and their symptoms with supporting documents

  Yes

  No

  N/A

• Up to date permit available and posted as required by Health Department

  Yes

  No

  N/A

• Most recent Health Department inspection report available. Corrective actions assigned and completed within agreed due dates

  Yes

  No

  N/A

• Annual planned preventative maintenance program (ARAMARK or client program) in place for temperature controlled equipment i.e. refrigerators, freezers, hot / cold holding equipment, ice machines etc.

  Yes

  No

  N/A

II. Personnel Standards

• Employees wearing approved hats or hairnet, beard restraints worn, if beard longer than 1/4'', clean shirt/jackets/apron, clean pants, slip resistant shoes

  Yes

  No

  N/A

• Hands and wrists free from jewelry and watches (except 1 plain ring, no stones). Earrings are only 1/4'' diameter studs. Finger nails are free from polish and false nails

  Yes

  No

  N/A

• No eating, smoking, chewing gum, in food prep, storage or dish wash areas. Use approved area

  Yes

  No

  N/A

• Hands being washed at start of shift, before using gloves/changing gloves, after toilet, smoking

  Yes

  No

  N/A

• Use of utensils or food service single use gloves when handling ready to eat food or ice

  Yes

  No

  N/A

• Food service single use gloves changed in between tasks (hands must also be washed)

  Yes

  No

  N/A

• Employee drinks in lidded cup with straw. Stored below food prep and service areas

  Yes

  No

  N/A

• Cut glove worn when using & cleaning knifes. Food service single use glove worn over the top

  Yes

  No

  N/A

• All employee belongings stored away from food prep, storage, dish room areas i.e. designated lockers or in designated labeled storage bins

  Yes

  No

  N/A

• Aprons removed and hung in designated area when visiting bathroom or while on break

  Yes

  No

  N/A

• Cuts / wounds / burns covered with clean bandage and food service single use glove

  Yes

  No

  N/A

• Employees reporting illness i.e. vomiting, diarrhea, jaundice, sore throat with fever, & open sores excluded from handling food, ice, utensils, equipment & linens.

  Yes

  No

  N/A

• Dirty uniforms, aprons and wiping cloths (changed daily) stored in designated area

  Yes

  No

  N/A

• First aid supplies / employee medication properly labeled and stored to prevent cross contamination

  Yes

  No

  N/A

III. Kitchen / Station Standards

• Hand wash sinks convenient, accessible, hot & cold water (mixed water 100F), pressure, stocked with soap & paper towels. Hand wash poster (bilingual posted if needed). Not used for food production.

  Yes

  No

  N/A

• Trash bins conveniently located near hand wash sinks and stations. Emptied as required. Check for evidence of hand washing (i.e. paper towels).

  Yes

  No

  N/A

• Dish machine maintaining proper rinse temperature (180F). Verify by using digital thermometer or 160F surface test strip

  Yes

  No

  N/A

• 3 compartment sink set up correctly (wash, rinse, sanitize). Verify water levels, wash water temp >110F and sanitizer concentration (Oasis 144 200ppm / Oasis 146 150-400ppm) with quat sanitizer test strips.

  Yes

  No

  N/A

• Sanitizer dispensers set up and dispensing sanitizer/water at correct conc. Oasis 144 - 200ppm / Oasis 146 150-400ppm

  Yes

  No

  N/A

• Automatic faucets provide water for a minimum of 15 seconds.

  Yes

  No

  N/A

• Clean pots, pans and small wares stored properly after washing and sanitizing i.e. air dry, and stored upside down. NSF approved containers used, and original food containers not reused for storage.

  Yes

  No

  N/A

• Clean utensils stored properly after washing and sanitizing i.e. air dry and store in dry container with handles all pointing in same direction

  Yes

  No

  N/A

• Plumbing properly installed and maintained i.e. no leaking sinks. Backflow preventor / back siphonage devices installed

  Yes

  No

  N/A

• Chemicals stored in designated area away or below food and drink items. MSDS sheets up to date and accessible

  Yes

  No

  N/A

• Walls, floors and drains maintained (no holes/missing tiles), clean, free of water/spills. Wet floors signs readily available

  Yes

  No

  N/A

• Walls, floors and drains maintained (no holes/missing tiles), clean, free of water/spills. Wet floors signs readily available

  Yes

  No

  N/A

• Overhead lights shatterproof or protected by light shields. No pins / tacks on notice boards above food / equipment areas

  Yes

  No

  N/A

• Damaged / broken equipment reported to management/client for repair with due date

  Yes

  No

  N/A

• Location free from pest activity i.e. mice droppings, flies, fruit flies, gnats, cockroaches, etc.

  Yes

  No

  N/A

• All food and packaging protected and stored off the floor on clean (non-rusty) shelves (6'' above floor)

  Yes

  No

  N/A

• Ice machine scoop(s) stored in dedicated container outside of machine. Dedicated ice carriers stored off the floor and upside down/covered

  Yes

  No

  N/A

• All rooms and areas vented as required. Ventilation/extraction systems above cooking/frying areas clean and maintained

  Yes

  No

  N/A

• Food in serving areas displayed behind sneeze guards or wrapped to prevent contamination

  Yes

  No

  N/A

• Plastic eating utensils in customer area displayed with handles all pointing in the same way. No re-use of plastic eating utensils (forks, knifes, and spoons)

  Yes

  No

  N/A

IV. Process and Product Standards

• Digital food thermometers available & verified as working correctly on a daily basis using the ice/water method 32F

  Yes

  No

  N/A

• Green detergent, Red sanitizer buckets or spray bottles (stored below) are available at all stations and prep areas. Wiping cloths are stored inside buckets and sanitizer concentration verified and documented using quat sanitizer test strip

  Yes

  No

  N/A

• Receiving: Refrigerated products delivered at 41F or below. Frozen products delivered frozen. (check product temperatures and record). Products within shelf life. Products labeled with received date to facilitate FIFO

  Yes

  No

  N/A

• Storage: Refrigerators between 34-40F. Food at 41F or below. Temperature taken from internal thermometer. (Test product temperatures stored in refrigerator)

  Yes

  No

  N/A

• Storage: Walk-in freezers at 0F or below, Reach-in at 10F or below. Temperature taken from internal thermometer

  Yes

  No

  N/A

• Storage: All products stored in refrigerator / freezer / dry storage rotated, labeled with name, prep date and use by date / best before date

  Yes

  No

  N/A

• Storage: Dry ingredients (tuna, mayonnaise etc), and fruit (melon and tomatoes) used for chilled products (i.e. tuna salad), chilled to 41F prior to use or chill to 41F within 4hrs prior to display or service

  Yes

  No

  N/A

• Storage: Refrigerator / freezer - Raw foods (including shelled eggs) stored below ready to eat foods. Produce segregated

  Yes

  No

  N/A

• Storage: Canned foods free from dents, leaks, rust or swelling

  Yes

  No

  N/A

• Thawing: Products thawed using approved standard. Products not thawed at room temperature

  Yes

  No

  N/A

• Prep: Color cutting board used correctly (sign displayed). Not damaged or deeply grooved <br>RED for raw<br>GREEN for vegetables<br>WHITE for Ready to Eat foods

  Yes

  No

  N/A

• Prep: Supplied previously unwashed Vegetables, Fruit (including melons), herbs washed prior to use.

  Yes

  No

  N/A

• Cooking: Raw animal foods cooked to proper internal cooking temperature. (Test food and check records)

  Yes

  No

  N/A

• Hot holding: potentially hazardous foods (TCS)*: Product temperatures are 140F or above. (Test food and check records)

  Yes

  No

  N/A

• Reheating: Products reheated to 165F. (Test food and check records)

  Yes

  No

  N/A

• Reheating: Microwave Foods are heated ≥ 165° and allowed to stand covered for 2 minutes after cooking

  Yes

  No

  N/A

• Cooling: potentially hazardous foods (TCS)*. Cooled from 140F to 70F within 2 hours. 70F to 41F within 4 hours. Test food and check records. (Check cooled foods in refrigerators)

  Yes

  No

  N/A

• Cold holding: potentially hazardous foods (TCS)*: Product temperatures at 41F or below. (Test food on salad bars / grab and go displays)

  Yes

  No

  N/A

V. External Areas

• External garbage container covered/lidded and maintained

  Yes

  No

  N/A

• Clean and stocked restroom facilities. Self closing door. Hand wash poster

  Yes

  No

  N/A

• Location free from pest activity i.e. mice droppings, flies, fruit flies, gnats, cockroaches, etc.

  Yes

  No

  N/A

VI. General Observations

• Location has acceptable standards of cleanliness

  Yes

  No

  N/A

• Location is well organized

  Yes

  No

  N/A

• Additional comments or findings

• Surveyor Signature

  Sign

• Select date

  Date