Title Page

  • Conducted on

  • Prepared by

  • Location

Imminent Health Risk Item

  • Running hot and cold water is available

  • Manager and crew members are free of illness and symptoms

  • Free of adulterated/contaminated products

  • Free of sewer backups

  • Free of pest infestation leading to food/contact surface contamination

  • Restaurant has sanitizer

  • Free of flood

  • Hand washing sinks are provided

  • Time and Temperatures Controlled for Safety (TCS) Food are held at the proper temperature and documentation proves that the product has been held at the proper temperature for the last 4 hours or more

Food Safety Sanitation Item

  • Hot water reaches a minimum of 100°F at all sinks, 110°F at 3-compartment sink, and 160°F surface temperature in all dish washing machines

  • Sanitizer is at proper concentration at all sinks, buckets, and cups

  • Chemicals are all approved, properly labels, and stored correctly

  • Premises of exterior & interior (back of house) are cleaned and maintained

  • All components of the ware washing sink are setup correctly and used properly

  • In-use equipment and prep tables are cleaned and sanitized at proper frequency

  • In-use utensils and smallwares are clean and sanitized at proper frequency

Team Member Health Item

  • Person in charge understands Dunkin'/Baskin-Robbins standards for team member health

  • Hand washing sinks are fully stocked and used properly

  • No bare hand contact with ready-to-eat (RTE) food

  • Franchisee's team members are washing hands at proper frequency and hygienic practices are followed

Temperature Item

  • Refrigerated food is held at 41°F or below

  • Hot hold food is held at 140°F or above

  • Food cooked to the correct temperature

Good Retail Practice Item

  • Food is all approved, within date code, and labeled properly

  • Food and packaging are protected from contamination and allergen cross-contact

  • Packaging is used in an approved manner

  • Restaurant meets Dunkin'/Baskin-Robbins Pest Management standards

Documentation Item

  • Food Safety Self-Assessments are complete, accurate, and with corrective actions

  • Cold and hot holding temperature documents are complete, accurate, and with corrective actions

  • Receiving documents are complete, accurate, and with corrective actions

  • Additional required Food Safety documentation and resources are present and accessible as required.

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.