Title Page
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Main Cafeteria, Main Men's & Women's, First Aid Room, Clean Room, Pea Receiving, Pea Bin and Picking Tables
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Conducted on
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Prepared by
Cafeteria
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All lunch boxes and food stored properly?
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Would you like to attach a picture?
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Microwaves clean and in working order?
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Would you like to attach a picture?
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All fridges are clean and in working order?
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Would you like to attach a picture?
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Are tables, chairs, floors, walls, and ceilings kept clean and properly maintained?
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Would you like to attach a picture?
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Is lighting adequate, properly maintained, and protected against breakage?
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Would you like to attach a picture?
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Are waste or recycling bins overflowing?
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Would you like to attach a picture?
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Is there any evidence of pests in the area?
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Would you like to attach a picture?
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Other issue in area?
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Location and explanation of issue
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Would you like to attach a picture?
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Other issue in area?
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Location and explanation of issue
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Would you like to attach a picture?
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Other issue in area?
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Location and explanation of issue
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Would you like to attach a picture?
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Other issue in area?
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Location and explanation of issue
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Would you like to attach a picture?
Men's Rest Room
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Locker area clean and all items stored properly?
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Would you like to attach a picture?
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Are floors, walls, and ceilings kept clean and properly maintained?
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Would you like to attach a picture?
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Is lighting adequate, properly maintained, and protected against breakage?
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Would you like to attach a picture?
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Are there temporary repairs present?
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Would you like to attach a picture?
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Are all sinks, toilets, paper towel and soap dispensers in working order?
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Would you like to attach a picture?
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Other issue in area?
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Location and explanation of issue
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Would you like to attach a picture?
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Other issue in area?
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Location and explanation of issue
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Would you like to attach a picture?
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Other issue in area?
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Location and explanation of issue
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Would you like to attach a picture?
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Other issue in area?
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Location and explanation of issue
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Would you like to attach a picture?
Women's Rest Room
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Locker area clean and all items stored properly?
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Would you like to attach a picture?
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Are floors, walls, and ceilings kept clean and properly maintained?
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Would you like to attach a picture?
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Is lighting adequate, properly maintained, and protected against breakage?
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Would you like to attach a picture?
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Are there temporary repairs present?
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Would you like to attach a picture?
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Are all sinks, toilets, paper towel and soap dispensers in working order?
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Would you like to attach a picture?
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Other issue in area?
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Location and explanation of issue
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Would you like to attach a picture?
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Other issue in area?
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Location and explanation of issue
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Would you like to attach a picture?
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Other issue in area?
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Location and explanation of issue
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Would you like to attach a picture?
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Other issue in area?
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Location and explanation of issue
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Would you like to attach a picture?
First Aid Room
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Are equipment, floors, walls, and ceilings kept clean and properly maintained?
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Would you like to attach a picture?
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Is lighting adequate, properly maintained, and protected against breakage?
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Would you like to attach a picture?
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Other issue in area?
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Location and explanation of issue
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Would you like to attach a picture?
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Other issue in area?
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Location and explanation of issue
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Would you like to attach a picture?
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Other issue in area?
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Location and explanation of issue
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Would you like to attach a picture?
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Other issue in area?
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Location and explanation of issue
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Would you like to attach a picture?
Clean Room
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Are floors, walls, and ceilings kept clean and properly maintained?
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Would you like to attach a picture?
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Is lighting adequate, properly maintained, and protected against breakage?
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Would you like to attach a picture?
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Are all sinks working in order?
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Would you like to attach a picture?
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Are all soap dispensers in working order?
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Would you like to attach a picture?
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Are all hand dryers in working order?
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Would you like to attach a picture?
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Other issue in area?
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Location and explanation of issue
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Would you like to attach a picture?
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Other issue in area?
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Location and explanation of issue
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Would you like to attach a picture?
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Other issue in area?
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Location and explanation of issue
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Would you like to attach a picture?
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Other issue in area?
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Location and explanation of issue
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Would you like to attach a picture?
Pea Receiving
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Are doors properly sealed and closer working?
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Would you like to attach a picture?
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Are all lights in area working, clean and in good repair?
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Would you like to attach a picture?
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Are equipment, floors, walls, and ceilings kept clean and properly maintained?
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Would you like to attach a picture?
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Does condensate drip into exposed product zones?
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Would you like to attach a picture?
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Are chemicals controlled with no unauthorized accesses?
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Would you like to attach a picture?
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Is there evidence of excessive grease on equipment?
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Would you like to attach a picture?
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Are unsecured tools or parts left out?
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Would you like to attach a picture?
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Are repairs being done in a safe manner?
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Would you like to attach a picture?
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Are there temporary repairs present?
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Would you like to attach a picture?
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Is there excessive product on the floor? Is this a result of some equipment failure or design error?
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Would you like to attach a picture?
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Is there any evidence of pests in the area?
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Would you like to attach a picture?
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Other issue in area?
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Location and explanation of issue
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Would you like to attach a picture?
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Other issue in area?
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Location and explanation of issue
-
Would you like to attach a picture?
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Other issue in area?
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Location and explanation of issue
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Would you like to attach a picture?
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Other issue in area?
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Location and explanation of issue
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Would you like to attach a picture?
Picking Tables & Bin Area
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Are doors properly sealed and closer working?
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Would you like to attach a picture?
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Are all lights in area working, clean and in good repair?
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Would you like to attach a picture?
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Are equipment, floors, walls, and ceilings kept clean and properly maintained?
-
Would you like to attach a picture?
-
Is lighting adequate, properly maintained, and protected against breakage?
-
Would you like to attach a picture?
-
Does condensate drip into exposed product zones?
-
Would you like to attach a picture?
-
Are chemicals controlled with no unauthorized accesses?
-
Would you like to attach a picture?
-
Is there evidence of excessive grease on equipment?
-
Would you like to attach a picture?
-
Are unsecured tools or parts left out?
-
Would you like to attach a picture?
-
Are repairs being done in a safe manner?
-
Would you like to attach a picture?
-
Are there temporary repairs present?
-
Would you like to attach a picture?
-
Is there excessive product on the floor? Is this a result of some equipment failure or design error?
-
Would you like to attach a picture?
-
Is there any evidence of pests in the area?
-
Would you like to attach a picture?
-
Other issue in area?
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Location and explanation of issue
-
Would you like to attach a picture?
-
Other issue in area?
-
Location and explanation of issue
-
Would you like to attach a picture?
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Other issue in area?
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Location and explanation of issue
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Would you like to attach a picture?
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Other issue in area?
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Location and explanation of issue
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Would you like to attach a picture?
Personnel Practices
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Are all of the employee's PPE in place and are they used correctly?
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Is there evidence of food in the production areas?
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Would you like to attach a picture?
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Is clothing appropriate for the job being performed?
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Are designated eating and smoking areas posted as such?
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Would you like to attach a picture?
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Are personal hygiene standards enforced? Are signs posted?
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Are hair restraints/beard nets worn and in accordance with company policy?
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Are all jewelry, nail polish, and watches prohibited?
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Are items found in shirt pockets?
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Any other personal practices that need to be addressed?
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Explanation of issue
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Would you like to attach a picture?
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Any other personal practices that need to be addressed?
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Explanation of issue
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Would you like to attach a picture?
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Any other personal practices that need to be addressed?
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Explanation of issue
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Would you like to attach a picture?
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Any other personal practices that need to be addressed?
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Explanation of issue
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Would you like to attach a picture?