Title Page

  • Store #/Location

  • Conducted on

  • Prepared by

  • Manager In Charge

  • Previous SEE Score

  • # Criticals

  • 0.0.3 CRITICAL: Is a fully stocked biohazard kit available?

  • 1.1.1 CRITICAL: 3 or 4 compartment sink is present and used properly

  • Picklist

  • 1.2.1 BOH area and fixtures clean including all floors, walls, counters, ceilings, lights, sink(s), storage, and lockers

  • Picklist

  • 1.3.1a BOH Refrigerators/Freezers clean and in good repair

  • Picklist

  • 1.3.1c CRITICAL: BOH Refrigerator/Freezers Air Temperature Meet Temperature Standards

  • Picklist

  • 1.5.1 Water filter is changed every six months

  • Picklist

  • 2.2.2 Baked goods case clean and baked good properly labeled

  • Picklist

  • 2.3.1 Store lobby is clean and acceptable temperature

  • Picklist

  • 2.3.3 Snacks area is clean, stocked and has proper signage

  • Picklist

  • 2.4.1b Cold case clean and in good repair (For SEE purposes, also assess if properly stocked)

  • Picklist

  • 2.4.1c CRITICAL: Cold case Air Temperature meets temperature standards

  • Picklist

  • 2.7.1 Freshness cue/cube clean and merchandised properly

  • Picklist

  • 2.8.1 Doors remain closed at all times

  • Picklist

  • 2.9.1 Guest (lobby) restrooms are clean and maintained

  • Picklist

  • 2.9.2 Team member (BOH) restrooms are clean and maintained

  • Picklist

  • 3.1.1 Store exterior area and furniture clean and in good repair

  • Picklist

  • 3.4.1 FOH area floors, walls, ceilings, counters are clean

  • Picklist

  • 3.4.2 All FOH/Blending Area fixtures are clean

  • Picklist

  • 3.5.1a Dipbox clean and in good repair

  • Picklist

  • 3.5.1c CRITICAL: Dipbox at proper temperature with no significant ice buildup (No more than 1/2 inch of buildup)

  • Picklist

  • 3.5.1d Dipwell clean and in good repair, water running

  • Picklist

  • 3.5.2b Blender jars, lids, base and enclosure are in good repair

  • Picklist

  • 3.5.2c CRITICAL: Blender jars, lids, base, and enclosures are clean

  • Picklist

  • 3.5.3b Multi-fruit juicer(s) are in good repair

  • Picklist

  • 3.5.3c CRITICAL: Multi-fruit juicer(s) clean

  • Picklist

  • 3.5.5b Citrus juicer clean and in good repair

  • Picklist

  • 3.5.6b Crathcos clean and in good repair

  • Picklist

  • 3.5.7b Under counter/upright refrigerators/freezers clean and in good repair

  • Picklist

  • 3.5.7c CRITICAL: Under counter/upright refrigerators/freezers Air Temperature meets temperature standards

  • Picklist

  • 3.5.8a Toaster/TurboChef clean and in good repair

  • Picklist

  • 3.10.1 CRITICAL: When gloves are required, food handlers do not contact ready-to-eat foods (fresh produce) with bare hands

  • Picklist

  • 3.1.2 Proper drinking/eating in food service area

  • Picklist

  • 4.1.1 CRITICAL: Wiping cloths stored properly and are at the proper concentration (per manufacturer specifications); spray bottles at proper concentration

  • Picklist

  • 6.7.2 CRITICAL: Sanitizer test kits/strips available and not expired

  • Picklist

  • 4.1.2 Chemicals are approved and properly labeled

  • Picklist

  • 4.1.2b CRITICAL: Chemicals are not stored next to or above food contact items

  • Picklist

  • 4.2.2b Floor drains clean and in good repair

  • Picklist

  • 4.3.1a CRITICAL: Ice Machine clean and in good repair; scoop and bucket properly stored

  • Picklist

  • 4.3.1b CRITICAL: Ice Machine bucket and scoop clean and in good repair

  • Picklist

  • 4.3.1c Ice Machine exterior and filter screen clean

  • Picklist

  • 4.4.1 No expired product present

  • Picklist

  • 4.4.2 All perishable TCS (Time/Temperature Control for Safety) foods that are prepped, thawed, and ready to eat are properly day-dotted with the designated shelf-life

  • Picklist

  • 4.6.1 Health inspection available and all critical findings on the previous inspection have been corrected

  • Picklist

  • 4.6.2 Store consistently using Front Line Excellence Log (FLEX Log)

  • Picklist

  • 4.13.1 Manager has appropriate food safety certification

  • Picklist

  • 4.14.1 Documented Team Member Health Policy is available and/or Manager demonstrates knowledge of policy

  • Picklist

  • 4.14.1b CRITICAL: Sick team members are not working in the store

  • Picklist

  • 4.15.1 CRITICAL: Allergen list is in the Nutritional Guide Binder and manager demonstrates knowledge of policy

  • Picklist

  • 4.8.1 Utensils/equipment/contact surfaces in good repair and proper type

  • Picklist

  • 4.8.2 Food Contact Surfaces cleaned and sanitized

  • Picklist

  • 6.1.3 Food and food contact items (non-disposable) stored in appropriate locations

  • Picklist

  • 4.9.1 CRITICAL: No pest activity is observed

  • Picklist

  • 4.9.2 Pest activity prevented through proper sealing of outer openings and elimination of harborage conditions

  • Picklist

  • 4.10.1a CRITICAL: Cross contamination prevented during food storage, preparation, and handling

  • Picklist

  • 4.10.1b CRITICAL: Jamba Approved Produce Wash is used and maintained properly

  • Picklist

  • 4.11.1 Products stored first in, first out or based on manufacturer's dating

  • Picklist

  • 4.12.1 CRITICAL: Accurate food thermometers are present

  • Picklist

  • 4.16.1a Handwashing sinks are accessible/usable, properly stocked, used only for handwashing, and handwashing reminder signs are present

  • Picklist

  • 4.16.1b CRITICAL: Proper handwashing taking place at appropriate times

  • Picklist

  • 4.17.1 CRITICAL: Hot and cold water are available at facility

  • Picklist

  • 4.18.1 Back flow prevention present at all sinks (includes if dish sprayer hangs below sink's flood rim)

  • 4.19.1a CRITICAL: All perishable TCS (Time/Temperature Control for Safety) foods in cold holding are ≤ 41°F

  • 4.19.1b CRITICAL: Items in hot holding ≥ 140°F

  • Picklist

  • EXTREME CRITICAL: Cash in safe matches safe fund total. Include cash total and any variances in notes.

  • CRITICAL: Store Operating Funds pages in FLEX Log are completed properly with all count ins and count outs.

  • Additional Comments/Notes

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.