Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Receiving Area

  • Receiving area/dock clean and orderly?

  • Select date

Storeroom

  • Orderly, free of empty cartons/boxes?

  • Items 6" off floor, 2" away from wall, 18" away from ceiling (spinkler heads)?<br>

  • Temperature between 50°F-70°F; Temperature recorded?

  • Temperature:

  • Wall clean, free off peeling paint, no holes or cracks?

  • Items in original containers or properly packaged/labeled?

  • No damaged cans for use and are damaged cans placed in a separate location labeled "damaged"?

  • No open containers or unwrapped food products?

  • Storage containers (rice, flour, beans, etc.) covered and labeled?

  • Shelving clean, free of corrosion and dust?

  • Floor/baseboards clean?

  • Stock dated and rotated properly? (First-in, First-out)

  • No chemicals in store room?

  • Free of rodent/insect activity?

  • Emergency food supply on hand (located in separate area)?

Walk in Refrigerator

  • Thermometer located to measure warmest part of cavity?

  • Current Temperature?

  • Refrigerator door/handles clean?

  • Floors clean/no rust?

  • Gaskets clean/not cracked/doors seal tightly?

  • Shelves clean/free of corrosion?

  • All food covered, labeled, and dated?

  • Is there any outdated food or beverages?

  • Any outside food or beverages?

  • Is anything stored within 6" of the floor?

  • Fans/Housing clean, no restricted air flow?

Freezer Walk-In

  • Thermometer located to measure warmest part of the cavity?

  • Current Temperature:

  • Doors and handles clean?

  • Floors clean, no rust?

  • Gaskets clean/not cracked/doors seal tightly?

  • Shelves clean, free of corrosion?

  • Food covered, labeled, and dated?

  • No outside food or beverages?

  • No outdated food?

  • Items stored within 6" of the floor?

  • Minimal ice build up?

  • Fans/Housing clean: Air flow unobstructed?

Mop Storage Closet

  • Mops clean/sanitized?

  • Mops/brooms/deck brushes etc. stored on wall?

  • Mop sink clean and odor free?

  • Used rags covered/stored away from food/supplies?

Second Walk-In Refrigerator (Prepped Food)

  • Food from appropriate sources?

  • Leftover perishable food used within 3 days?

  • Cooked food cooled rapidly (shallow pans)?

  • Frozen food thawed properly?

  • Thermometer located at warmest part of the cavity?

  • Current Temperature:

  • Doors/handles clean?

  • Floors clean, no rust?

  • Gaskets clean/Not cracked/Doors seal tightly?

  • Shelves clean, free of corrosion?

  • Food covered, labeled, and dated?

  • No outdated food or beverages?

  • No outside food/beverages?

  • Any items stored within 6" of the floor?

  • Fans/Housing clean; Air flow unrestricted?

12 Door Reach-In Refrigerator

  • Thermometer located to measure warmest part of the cavity?

  • Current Temperature:

  • Doors/handles clean?

  • Floors clean, no rust?

  • Gaskets clean/Not cracked/Doors seal tightly?

  • Shelves clean, free of corrosion?

  • Food covered, labeled, and dated?

  • No outdated food/beverages?

  • No outside food/beverages?

Staff Area, Recipes, Log Book

  • Temperature logs up to date for all freezers, refrigerators, warmers/equipment?

  • Temperature on freezers at or below 0°F?

  • Temperatures on refrigerators at or below 41°F?

  • Temperatures in hot food warmers 160°F or above?

  • Manuals, recipe books clean and organized?

  • Food, drinks, tobacco products used and stored in designated area only?

  • Microwave clean inside/out?

  • Food processor and blender clean, covered when not in use?

  • Mixer clean inside and out; covered when not in use?

  • Toaster clean?

  • Scales clean and working properly?

  • All food labeled, dated, no outdated food?

General Kitchen Area

  • Sprinkler heads dust free?

  • Fans dust free?

  • Fire extinguishers dust free and inspected?

  • Procedure for turning on and off gas posted?

  • Cleaning schedule dated, signed, and complete?

  • Lighting adequate, no bulbs out, lights covered with protective covering, no cracks?

  • Wall clean, free of peeling paint, no holes or cracks?

  • Floors clean?

  • Floor drains free of debris and draining adequately?

  • Vents free of dust?

  • Windows/window ledges clean/no clutter?

  • Doors clean?

  • Counter-tops clean/sanitized?

  • Table legs clean?

  • Shelves clean, free of rust, organized?

  • Drawers clean/organized?

  • Cabinets clean/organized?

  • Hand sink clean?

  • Hand sinks/dispensers stocked?

  • Food contact surfaces cleaned/sanitized?

  • Non-food contact surfaces clean?

  • Garbage cans clean with lids, no odors, not overfilled?

  • Dry rags stored in clean container?

  • Knife rack/Knives clean and dry?

  • Cutting boards clean/sanitized, no cross contamination?

  • Pots, pans, baking sheets clean, free of grease and food particles? Dry, not pitted?

  • Pitchers clean? No stains, dry?

  • Thermometers clean/sanitized/stored correctly/calibrated?

  • Plates, bowls, trays, glasses, mugs and silverware clean and dry?

Large Equipment, Misc.

  • Stove top clean/operates correctly?

  • Convection oven clean inside and out: operates correctly?

  • Hood/filter clean, no grease build up?

  • Broiler clean inside and outside; operates correctly?

  • Steamer clean inside and outside; operates correctly, de-limed?

  • Grill clean; operates correctly?

  • Deep fat fryer clean inside and outside; operates correctly?

  • Last time oil changed:

  • Steam table clean inside and outside; operates correctly?

  • Ice Machine clean/free of rust/gasket clean/makes adequate ice?

  • Ice scoop clean/stored separately in clean container with lid?

  • Can openers clean; blades not nicked/strained?

Three Compartment Sink

  • Cleaning procedures posted?

  • Pot washing technique correct? (scrape/wash/rinse/sanitize)

  • Test Kit present?

  • Chemical sanitize PPM recorded?

Warmers

  • Scales clean/working properly?

  • Current Temperature:

  • Handles and doors clean?

  • Floors clean, no rust?

  • Gaskets clean, not cracked, seal tightly?

  • Shelves clean, free of corrosion?

  • Food covered?

  • No outside food/beverages?

Dishwashing

  • Walls clean/free from dirt and build-up?

  • Floors/baseboards clean?

  • Floor mats clean and intact?

  • Dish machine clean inside and outside, de-limed/clear jets/nozzles clear?

  • Conveyor belt clean?

  • Sink clean?

  • Proper temperatures? (Pre-wash 120°F, Wash 160°F, Rinse 180°F, or proper PPM)

  • Proper dish washing techniques? (racking/loading/silverware washing)

  • Proper unloading techniques? (clean/dirty loading and unloading; no cross contamination)

  • Dish carts clean?

  • Trays clean/dry?

  • Plates, silverware, glasses clean and dry?

  • Dish storage orderly?

Chemical Storage and Handling

  • Chemicals organized?

  • Chemicals stored in labeled container only (including spray bottles)?

  • Chemicals stored separately from food or supplies?

  • Hazardous chemicals list posted?

  • MSDA sheets accessible?

  • Staff in-serviced on hazardous chemicals (documented)?

Tray Carts

  • Carts and wheels clean?

  • Dispensers and condiment caddies clean?

Cafeteria Service Area

  • Tray/tray slide clean/dry?

  • Counters clean?

  • Hot food wells clean?

  • Shelves under counters clean/orderly?

  • Display shelving clean/orderly?

  • Sneeze guards free of debris/dust/marks?

  • Plates, bowls, cups, silverware clean and dry?

  • Menu board/signs accurate and clean?

  • Posters/printed material clean/neatly posted?

  • Ticket stand clean and orderly?

  • Coffee dispensers clean inside and out? (gaskets, tubing)

  • Cold drink dispensers clean? (fountain heads/spray jets, etc.)

  • Syrup tank storage area clean and dry?

  • Salad bar tray slides clean?

  • All other counters clean?

  • Hot food and cold food wells clean?

  • Dining room tables and chairs clean, in good repair?

Employee Practices

  • Proper hair restraints?

  • Clean uniforms?

  • Appropriate hand washing?

  • Proper sanitary procedures used for handling /serving food?

  • Use of gloves, spoons, scrapers, tongs, etc. to minimize direct food contact?

  • Finger nails clean, trimmed, no polish, no artificial finger nails?

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.