JITB - Food Safety Assessment

• Conducted on

  Date

• Prepared by

• Location
  Address

1. GENERAL

• 1.1 - Manager Certification: Restaurant Manager and PIC (Person in Charge)/Team Leader has received a food safety management certification.

  Acceptable (2)

  Unacceptable

• 2. PIC Certification Bonus Points - for PICs/Team Leaders with food safety management certification (e.g. ServSafe).

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• 3. Team Leader Food Safety Certification Bonus Points - For Team Leaders with proof of current JIB TL Food Safety Certification

  Select 0 1 2 3 4 5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

• 4. Valid Food Permit Posted

  Acceptable (2)

  Unacceptable

• 5. The most recent Health Department inspection report is at the restaurant, and all noted deficiencies or corrective actions have been addressed.

  Acceptable (2)

  Unacceptable

  N/A

• 6. Food Safety Standards validated throughout the day. JIB Food Safety checklists and thermometer calibration pages available and completed to standards.

  Acceptable (5)

  Unacceptable

• 7. Corrective Action Plan: Previous Food Safety failure. A copy of a corrective action plan is available for all ‘Priority’ standards rated unacceptable during previous assessment.

  Acceptable (10)

  Unacceptable

  N/A

• 8. Corrective Action Improvement Bonus Points- ‘Pass’: Most recent NSF ‘passed’ food safety audit available and all identified issues (within manager control) addressed.

  Yes (5)

  No

• 9. Immediate Corrective Action - All items noted as unacceptable during today's assessment are corrected during the assessment.

  Acceptable (5)

  Unacceptable

• 10. Person in Charge can demonstrate they understand the requirements if a failed health department inspection occurs?

  Acceptable (2)

  Unacceptable

2. EMPLOYEE HEALTH & HYGIENE

• 1. Food handlers have no obvious signs of illness/ not working when sick

  Acceptable (10)

  Unacceptable

• 2. Eating, drinking, smoking, gum-chewing and personal belongings are kept separate from food and beverage areas.

  Acceptable (5)

  Unacceptable

• 3. Team Appearance - All restaurant employees follow dress code requirements.

  Acceptable (2)

  Unacceptable

• 4. The (PIC) can explain employee illness policy and when to restrict or exclude ill team members, or has ready access to an employee health policy.

  Acceptable (2)

  Unacceptable

3. PEST CONTROL

• 1. Pest Prevention - Restaurant is effectively controlling pests.

  Acceptable (5)

  Unacceptable

• 2. Pest Activity - The facility is free of signs of pest activity.

  Acceptable (10)

  Needs Improvement (5)

  Unacceptable

4. HANDWASHING/HAND SINKS

• 1. Handwashing Sink Availability - Handwashing sinks in kitchen areas are available, accessible, working, and properly set up.

  Acceptable (10)

  Needs Improvement (5)

  Unacceptable

• 2. Handwashing Sink Usage - Handwashing sinks are used only for handwashing.

  Acceptable (2)

  Unacceptable

• 3. Handwashing - All employees are observed washing hands properly and only in designated handwashing sinks.

  Acceptable (10)

  Unacceptable

• 4. Glove Usage - Employees are properly using disposable gloves.

  Acceptable (10)

  Unacceptable

5. FOOD RECEIVING AND STORAGE

• 1. Food Receiving - Evidence of food receiving to standard – Temperatures, condition, receiving and storage procedures to standard.

  Acceptable (10)

  Unacceptable

• 2. Expired Products/Ingredients - No expired products/ingredients are noted.

  Acceptable (5)

  Unacceptable

• 3. PIC Knowledge of Purchasing Food - PIC can describe the correct procedure to purchase foods.

  Acceptable (2)

  Unacceptable

6. FOOD CONTAMINATION PREVENTION & PROTECTION

• 1. Food and Packaging Are Stored Properly And Protected From Contamination - Adequately covered, RTE foods stored above raw foods.

  Acceptable (5)

  Unacceptable

• 2. No Food or Packaging Contamination Observed

  Acceptable (10)

  Unacceptable

• 3. Proper Washing - Fruits and vegetables are properly washed before use.

  Acceptable (10)

  Unacceptable

  Not Operational (10)

• 4. Lighting - Lighting is adequate, and all lights are clean and properly shielded or shatterproof.

  Acceptable (2)

  Unacceptable

• 5. 8 Major Food Allergens Job Aid - Job aid (TDC# 1273) is displayed for viewing by Team Members.

  Acceptable (2)

  Unacceptable

7. TEMPERATURE CONTROL/STORAGE

• 1. Food Thermometers - Are available, operational and accurate; employees can demonstrate the proper procedure to calibrate and use the instrument.

  Acceptable (5)

  Unacceptable

• 2. Equipment Thermometers - Are present, functional and located in the warmest part of the refrigerator or freezer unit.

  Acceptable (5)

  Unacceptable

• 3. Refrigerator and Freezer Equipment (Walk-in's and POU's) - are maintaining proper temperatures: 41oF (5oC) or below for coolers; 20oF (-6oC) or below for freezers.

  Acceptable (5)

  Unacceptable

• 4. Walk-in and Freezer Product Temperatures - TCS foods are at a temperature of 41oF (5oC) or below, and frozen foods are at a temperature of 20oF (or 7oC) or below.

  Acceptable (5)

  Unacceptable

• 5. Point of Use (POU) Refrigerated And Freezer Product Temperatures - Cold, TCS foods are maintained at a temperature of 41oF (5oC) or below, and frozen foods are maintained at a temperature of 20oF (or 7oC) or below.

  Acceptable (5)

  Unacceptable

8. TEMPERATURE CONTROL/PREPARATION/STAGING

• 1. Thawing - Foods are thawed under refrigeration.

  Acceptable (10)

  Unacceptable

• 2. Hold Times - Time and temperature of TCS foods is effectively managed during prep.

  Acceptable (10)

  Unacceptable

• 3. Time as a Control - Approved time as a public health control (TPHC) procedures are followed.

  Acceptable (10)

  Unacceptable

• 4. Hot, Staged Product Temperatures - Hot, TCS foods are held at a temperature of 135oF (57oC) or above.

  Acceptable (10)

  Unacceptable

9. COOKING TEMPERATURE

• Internal Temperature Preparation/Cooking - Required cooking time procedures for TCS foods are followed.

  Acceptable (10)

  Unacceptable

• Final Flip and Check - JIB final flip visual check followed.

  Acceptable (10)

  Unacceptable

• Temperature Evaluation - Team Member can independently and without Coaching demonstrate the correct procedure to take the temperature of a food item and grill.

  Acceptable (5)

  Unacceptable

• PIC Knowledge of Internal Cooking Temperature - PIC has knowledge of proper Internal Cooking Temperatures.

  Acceptable (2)

  Unacceptable

10. MAINTENANCE & REPAIR: NON-FOOD CONTACT, FACILITIES/EQUIPMENT

• 1. Non-Food Contact Surfaces Condition - Floors, walls, ceilings and other non- food contact surfaces are properly constructed and in good condition.

  Acceptable (5)

  Unacceptable

• 2. Restrooms - All restrooms are clean, stocked, and in good repair. Sinks, toilets, soap dispensers and paper towel holders are functioning properly, and hot and cold running water is available at the sink.

  Acceptable (5)

  Unacceptable

• 3. Doors and Windows - All doors and drive-thru windows to the outside are self- closing and/or maintained closed and tightly fitting with no gaps greater than 1/4”.

  Acceptable (2)

  Unacceptable

  N/A

• 4. Drains - Drains working properly, clean, and free of standing water.

  Acceptable (10)

  Needs Improvement (5)

  Unacceptable

• 5. Cleaning Tool Storage - Mops, brooms and cleaning tools are properly stored.

  Acceptable (2)

  Unacceptable

• 6. Back Flow Devices - All devices (e.g. air gap, vacuum breaker, etc.) are installed and working properly to prevent back siphonage where necessary.

  Acceptable (10)

  Unacceptable

• 7. Refrigerator and Freezer Condition - Walk-In and POU Refrigerators and Freezers are in good repair and condition. Observe water/leaks/condensation, and check gasket condition, shelving, fan, and fan guards.

  Acceptable (2)

  Unacceptable

11. CLEANLINESS: NON-FOOD CONTACT, FACILITIES & EQUIPMENT

• Clean Refrigerators and Freezers - Walk-In and POU Refrigerators and Freezers are clean, dry, and free of odor. Fans and gaskets clean.

  Acceptable (5)

  Unacceptable

• Waste Receptacles - Waste receptacles indoors and outdoors, are present, durable, insect/rodent resistant, leak proof, lined, maintained clean and kept covered.

  Acceptable (2)

  Unacceptable

• Non Food Contact Surfaces Clean - Floors, walls, ceilings and other non-food contact surfaces are CLEAN and kept free of an accumulation of dust, dirt, food residue, and other debris.

  Acceptable (5)

  Needs Improvement (3)

  Unacceptable

• Dumpster Area - Dumpsters, trash compactors and grease bins/containers are maintained, clean, closed, and in good repair. Surrounding areas are maintained and clean.

  Acceptable (5)

  Needs Improvement (3)

  Unacceptable

12. CONDITION AND SANITATION: FOOD CONTACT, EQUIPMENT AND UTENSILS

• Smallwares/Utensils Condition - Tools, utensils, smallwares and equipment are commercial grade and in good condition to ensure clean-ability and minimize risk of physical contamination.

  Acceptable (10)

  Unacceptable

• Smallwares / Utensils Clean - Tools, utensils, smallwares, and food-contact surfaces are cleaned at an appropriate frequency and are clean to sight and touch to prevent cross contamination.

  Acceptable (10)

  Unacceptable

• Equipment and Food Contact Surfaces Clean - All equipment and other food contact surfaces are cleaned at an appropriate frequency and are clean to sight and touch.

  Acceptable (10)

  Unacceptable

• Equipment and Utensils Air Dried - Equipment, smallwares, and utensils are properly stored and air dried.

  Acceptable (0)

  Unacceptable

• Ice Machines - Are clean inside and out; in good repair, buckets and scoops are properly stored in a sanitary manner.

  Acceptable (5)

  Unacceptable

• Beverage dispensers - Are clean and free of soil and mold buildup.

  Acceptable (5)

  Unacceptable

• PIC Knowledge of Water Outage - PIC has knowledge and can explain proper procedure(s) to ensure ice and water are safe.

  Acceptable (2)

  Unacceptable

• Team Knowledge of Allergen Awareness - Guest Service Team Member can answer Allergen Awareness question or refer to 8 Major Food Allergens Job Aid (TDC# 1273) and then answer correctly. Coach to select one.

  Acceptable (2)

  Unacceptable

13. SANITIZER/CHEMICALS

• 1. Chemicals Labeled - All chemical containers labeled

  Acceptable (2)

  Unacceptable

• 2. 3-Compartment Sinks - 3-Compartment sink and dish washing machines are properly maintained, with appropriate soap/sanitizing agents and adequate hot and cold running water. Test strips are available to test sanitizer concentration.

  Acceptable (10)

  Unacceptable

• 3. Sanitizer Containers and Wiping Towels - Are properly used and stored, and sanitizer is at proper concentration.

  Acceptable (2)

  Unacceptable

• 4. Approved Chemicals - Only approved chemicals are present, stored, and used properly in the restaurant.

  Acceptable (5)

  Unacceptable

• 5. PIC Knowledge of Proper Dishwashing - PIC and back of house Team Members correctly wash, rinse and sanitize dishes at the three-compartment sink.

  Acceptable (2)

  Unacceptable

• 6. PIC Knowledge of Bodily Fluids Cleanup - PIC can describe correct procedure or show written procedure and respond to properly clean areas exposed to vomit, blood or diarrheal events in the restaurant.

  Acceptable (2)

  Unacceptable

14. FOOD SECURITY

• Exterior of Facility - is secure; doors are closed and locked when not in use. The parking lot is properly illuminated at night.

  Acceptable (2)

  Unacceptable

• Unauthorized Personnel - Unauthorized personnel, including off duty personnel, are restricted from back areas, food preparation areas and storage areas.

  Acceptable (2)

  Unacceptable

15. IMMINENT HEALTH HAZARDS

• Imminent Health Hazards - Restaurant is free of any imminent health hazards while operating.

  Acceptable (20)

  Unacceptable

16. APPEAL

• Assessment Appeal - Does the PIC have any question results they wish to appeal?

  Yes

  No