Title Page

  • Conducted on

  • Prepared by

  • Location

Receiving

  • Is all product being received from a reputable approved vendor.

  • Is all product being received at the Back Door in Receiving?

  • Is each pallet being inspected and cases uponed for DSD purposes.

  • Is receiving process being completed and perishable product being placed in proper cold storage within 45 minutes?

  • Is receiving area maintained according to HACCP and free of potential Physical/Chemical/Biological Cross contaminants? Are wet floor signs available and in use when there is a spill of any sort.

  • IS all product stored in the receiving, Typically, DSD a minimum of 6 inches off the floor.

Meat

Temp Control and Storage

  • Are fan covers free of dust and build up and in good repair?

  • All lights working/covered and in good repair.

  • Is all product stored properly according to risk factors.

  • Is proper food rotation and dating being executed in all walk-in/reach in/stand alone coolers and freezers.

  • Is the condition/environment of cooler/freezer being maintained?

  • Is all product stored a minimum of 6 inches off the floor on proper racking (no milk crates).

Food Prep / Station / Kitchen Maintenance

  • Are only FSQA approved chemicals being used.

  • Is all cooking and production equipment in good repair and maintained according to cleaning and maintenance schedules?

  • Are temperature controlled prep rooms at proper temperature?

  • Are temperature control logs being properly managed?

  • Are grinder logs being properly managed and scanned at night?

  • Are all rep/workstations, including stations in temperature controlled settings properly set up and being maintained between tasks?

  • Is RAW PREP segregated from PREPARED PREP and READY TO EAT PREP?

  • Is time temp controls being managed? Are all cooked food temp minimums being achieved and documented on all cooked foods? Are temp logs in use and current?

  • Are small wares and in department supplies properly stored and free of build up, trash, debris and standing water?

  • Is knife/blade safety being exhibited? Are knives being cleaned and stored immediately after use? Are guards and push blocks in place and used? Is the equipment unplugged when being cleaned? Knives, blades, active saws/slicers, etc should never being unguarded or present in a 3 compartment sink.

  • Are all measures of glove safety being exhibited? Heat resistant gloves, cut resistant gloves, food service/prep gloves in use, in good repair and maintained to food safety standards,

  • Are hand sinks clean, stocked, unobstructed and used exclusively for washing hands?

  • Is hand washing and glove changing frequent and specifically when ending/starting a new task?

  • Are prep areas and service venues free of build up, trash, debris, boxes and standing water?

  • Is good service uniform and food safety hygiene policy being complied with? Is hair properly restrained with a hair net?

  • Are personal belongings in the department?

Salesfloor / Ready To Eat / Cold Food Holding / Fixtures

  • Are there spills/water on the sales-floor? Are wet floor signs/cones and carpet mats available through out store and/or in use as needed?

  • Is the produce floor inspection being maintained and current?

  • Are all fixtures, displays, signage, pallets, cases stacks, etc free of splintering and secured to minimize risk?

  • Sales floor and service counter areas are Free of build up, trash, debris, boxes and spills?

  • Are ice table displays being maintained with drain buckets and mats in place under all ice displays? Buckets and mats monitored every 2 hours and changed as needed.

  • Are all door seals and gaskets in good repair?

  • Is holding equipment maintaining proper temp and product being held at proper temp and rotated properly?

  • Is product in date and rotated properly?

  • Are produce tables being culled, rotated, and properly maintained?

  • Is production tool being used consistently and shrink being recorded?

  • Is tag integrity intact?

  • Is 7 day sheet being used and reviewed consistently?

Seafood

Temp Control and Storage

  • Are fan covers free of dust and build up and in good repair?

  • All lights working/covered and in good repair.

  • Is all product stored properly according to risk factors.

  • Is proper food rotation and dating being executed in all walk-in/reach in/stand alone coolers and freezers.

  • Is the condition/environment of cooler/freezer being maintained?

  • Is all product stored a minimum of 6 inches off the floor on proper racking (no milk crates).

Food Prep / Station / Kitchen Maintenance

  • Are only FSQA approved chemicals being used.

  • Is all cooking and production equipment in good repair and maintained according to cleaning and maintenance schedules?

  • Are temperature controlled prep rooms at proper temperature?

  • Are temperature control logs being properly managed?

  • Are grinder logs being properly managed and scanned at night?

  • Are all rep/workstations, including stations in temperature controlled settings properly set up and being maintained between tasks?

  • Is RAW PREP segregated from PREPARED PREP and READY TO EAT PREP?

  • Is time temp controls being managed? Are all cooked food temp minimums being achieved and documented on all cooked foods? Are temp logs in use and current?

  • Are small wares and in department supplies properly stored and free of build up, trash, debris and standing water?

  • Is knife/blade safety being exhibited? Are knives being cleaned and stored immediately after use? Are guards and push blocks in place and used? Is the equipment unplugged when being cleaned? Knives, blades, active saws/slicers, etc should never being unguarded or present in a 3 compartment sink.

  • Are all measures of glove safety being exhibited? Heat resistant gloves, cut resistant gloves, food service/prep gloves in use, in good repair and maintained to food safety standards,

  • Are hand sinks clean, stocked, unobstructed and used exclusively for washing hands?

  • Is hand washing and glove changing frequent and specifically when ending/starting a new task?

  • Are prep areas and service venues free of build up, trash, debris, boxes and standing water?

  • Is good service uniform and food safety hygiene policy being complied with? Is hair properly restrained with a hair net?

  • Are personal belongings in the department?

Salesfloor / Ready To Eat / Cold Food Holding / Fixtures

  • Are there spills/water on the sales-floor? Are wet floor signs/cones and carpet mats available through out store and/or in use as needed?

  • Is the produce floor inspection being maintained and current?

  • Are all fixtures, displays, signage, pallets, cases stacks, etc free of splintering and secured to minimize risk?

  • Sales floor and service counter areas are Free of build up, trash, debris, boxes and spills?

  • Are ice table displays being maintained with drain buckets and mats in place under all ice displays? Buckets and mats monitored every 2 hours and changed as needed.

  • Are all door seals and gaskets in good repair?

  • Is holding equipment maintaining proper temp and product being held at proper temp and rotated properly?

  • Is product in date and rotated properly?

  • Are produce tables being culled, rotated, and properly maintained?

  • Is production tool being used consistently and shrink being recorded?

  • Is tag integrity intact?

  • Is 7 day sheet being used and reviewed consistently?

Deli

Temp Control and Storage

  • Are fan covers free of dust and build up and in good repair?

  • All lights working/covered and in good repair.

  • Is all product stored properly according to risk factors.

  • Is proper food rotation and dating being executed in all walk-in/reach in/stand alone coolers and freezers.

  • Is the condition/environment of cooler/freezer being maintained?

  • Is all product stored a minimum of 6 inches off the floor on proper racking (no milk crates).

Food Prep / Station / Kitchen Maintenance

  • Are only FSQA approved chemicals being used.

  • Is all cooking and production equipment in good repair and maintained according to cleaning and maintenance schedules?

  • Are temperature controlled prep rooms at proper temperature?

  • Are temperature control logs being properly managed?

  • Are grinder logs being properly managed and scanned at night?

  • Are all rep/workstations, including stations in temperature controlled settings properly set up and being maintained between tasks?

  • Is RAW PREP segregated from PREPARED PREP and READY TO EAT PREP?

  • Is time temp controls being managed? Are all cooked food temp minimums being achieved and documented on all cooked foods? Are temp logs in use and current?

  • Are small wares and in department supplies properly stored and free of build up, trash, debris and standing water?

  • Is knife/blade safety being exhibited? Are knives being cleaned and stored immediately after use? Are guards and push blocks in place and used? Is the equipment unplugged when being cleaned? Knives, blades, active saws/slicers, etc should never being unguarded or present in a 3 compartment sink.

  • Are all measures of glove safety being exhibited? Heat resistant gloves, cut resistant gloves, food service/prep gloves in use, in good repair and maintained to food safety standards,

  • Are hand sinks clean, stocked, unobstructed and used exclusively for washing hands?

  • Is hand washing and glove changing frequent and specifically when ending/starting a new task?

  • Are prep areas and service venues free of build up, trash, debris, boxes and standing water?

  • Is good service uniform and food safety hygiene policy being complied with? Is hair properly restrained with a hair net?

  • Are personal belongings in the department?

Salesfloor / Ready To Eat / Cold Food Holding / Fixtures

  • Are there spills/water on the sales-floor? Are wet floor signs/cones and carpet mats available through out store and/or in use as needed?

  • Is the produce floor inspection being maintained and current?

  • Are all fixtures, displays, signage, pallets, cases stacks, etc free of splintering and secured to minimize risk?

  • Sales floor and service counter areas are Free of build up, trash, debris, boxes and spills?

  • Are ice table displays being maintained with drain buckets and mats in place under all ice displays? Buckets and mats monitored every 2 hours and changed as needed.

  • Are all door seals and gaskets in good repair?

  • Is holding equipment maintaining proper temp and product being held at proper temp and rotated properly?

  • Is product in date and rotated properly?

  • Are produce tables being culled, rotated, and properly maintained?

  • Is production tool being used consistently and shrink being recorded?

  • Is tag integrity intact?

  • Is 7 day sheet being used and reviewed consistently?

Cold Cuts

Temp Control and Storage

  • Are fan covers free of dust and build up and in good repair?

  • All lights working/covered and in good repair.

  • Is all product stored properly according to risk factors.

  • Is proper food rotation and dating being executed in all walk-in/reach in/stand alone coolers and freezers.

  • Is the condition/environment of cooler/freezer being maintained?

  • Is all product stored a minimum of 6 inches off the floor on proper racking (no milk crates).

Food Prep / Station / Kitchen Maintenance

  • Are only FSQA approved chemicals being used.

  • Is all cooking and production equipment in good repair and maintained according to cleaning and maintenance schedules?

  • Are temperature controlled prep rooms at proper temperature?

  • Are temperature control logs being properly managed?

  • Are grinder logs being properly managed and scanned at night?

  • Are all rep/workstations, including stations in temperature controlled settings properly set up and being maintained between tasks?

  • Is RAW PREP segregated from PREPARED PREP and READY TO EAT PREP?

  • Is time temp controls being managed? Are all cooked food temp minimums being achieved and documented on all cooked foods? Are temp logs in use and current?

  • Are small wares and in department supplies properly stored and free of build up, trash, debris and standing water?

  • Is knife/blade safety being exhibited? Are knives being cleaned and stored immediately after use? Are guards and push blocks in place and used? Is the equipment unplugged when being cleaned? Knives, blades, active saws/slicers, etc should never being unguarded or present in a 3 compartment sink.

  • Are all measures of glove safety being exhibited? Heat resistant gloves, cut resistant gloves, food service/prep gloves in use, in good repair and maintained to food safety standards,

  • Are hand sinks clean, stocked, unobstructed and used exclusively for washing hands?

  • Is hand washing and glove changing frequent and specifically when ending/starting a new task?

  • Are prep areas and service venues free of build up, trash, debris, boxes and standing water?

  • Is good service uniform and food safety hygiene policy being complied with? Is hair properly restrained with a hair net?

  • Are personal belongings in the department?

Salesfloor / Ready To Eat / Cold Food Holding / Fixtures

  • Are there spills/water on the sales-floor? Are wet floor signs/cones and carpet mats available through out store and/or in use as needed?

  • Is the produce floor inspection being maintained and current?

  • Are all fixtures, displays, signage, pallets, cases stacks, etc free of splintering and secured to minimize risk?

  • Sales floor and service counter areas are Free of build up, trash, debris, boxes and spills?

  • Are ice table displays being maintained with drain buckets and mats in place under all ice displays? Buckets and mats monitored every 2 hours and changed as needed.

  • Are all door seals and gaskets in good repair?

  • Is holding equipment maintaining proper temp and product being held at proper temp and rotated properly?

  • Is product in date and rotated properly?

  • Are produce tables being culled, rotated, and properly maintained?

  • Is production tool being used consistently and shrink being recorded?

  • Is tag integrity intact?

  • Is 7 day sheet being used and reviewed consistently?

Bakery

Temp Control and Storage

  • Are fan covers free of dust and build up and in good repair?

  • All lights working/covered and in good repair.

  • Is all product stored properly according to risk factors.

  • Is proper food rotation and dating being executed in all walk-in/reach in/stand alone coolers and freezers.

  • Is the condition/environment of cooler/freezer being maintained?

  • Is all product stored a minimum of 6 inches off the floor on proper racking (no milk crates).

Food Prep / Station / Kitchen Maintenance

  • Are only FSQA approved chemicals being used.

  • Is all cooking and production equipment in good repair and maintained according to cleaning and maintenance schedules?

  • Are temperature controlled prep rooms at proper temperature?

  • Are temperature control logs being properly managed?

  • Are grinder logs being properly managed and scanned at night?

  • Are all rep/workstations, including stations in temperature controlled settings properly set up and being maintained between tasks?

  • Is RAW PREP segregated from PREPARED PREP and READY TO EAT PREP?

  • Is time temp controls being managed? Are all cooked food temp minimums being achieved and documented on all cooked foods? Are temp logs in use and current?

  • Are small wares and in department supplies properly stored and free of build up, trash, debris and standing water?

  • Is knife/blade safety being exhibited? Are knives being cleaned and stored immediately after use? Are guards and push blocks in place and used? Is the equipment unplugged when being cleaned? Knives, blades, active saws/slicers, etc should never being unguarded or present in a 3 compartment sink.

  • Are all measures of glove safety being exhibited? Heat resistant gloves, cut resistant gloves, food service/prep gloves in use, in good repair and maintained to food safety standards,

  • Are hand sinks clean, stocked, unobstructed and used exclusively for washing hands?

  • Is hand washing and glove changing frequent and specifically when ending/starting a new task?

  • Are prep areas and service venues free of build up, trash, debris, boxes and standing water?

  • Is good service uniform and food safety hygiene policy being complied with? Is hair properly restrained with a hair net?

  • Are personal belongings in the department?

Salesfloor / Ready To Eat / Cold Food Holding / Fixtures

  • Are there spills/water on the sales-floor? Are wet floor signs/cones and carpet mats available through out store and/or in use as needed?

  • Is the produce floor inspection being maintained and current?

  • Are all fixtures, displays, signage, pallets, cases stacks, etc free of splintering and secured to minimize risk?

  • Sales floor and service counter areas are Free of build up, trash, debris, boxes and spills?

  • Are ice table displays being maintained with drain buckets and mats in place under all ice displays? Buckets and mats monitored every 2 hours and changed as needed.

  • Are all door seals and gaskets in good repair?

  • Is holding equipment maintaining proper temp and product being held at proper temp and rotated properly?

  • Is product in date and rotated properly?

  • Are produce tables being culled, rotated, and properly maintained?

  • Is production tool being used consistently and shrink being recorded?

  • Is tag integrity intact?

  • Is 7 day sheet being used and reviewed consistently?

Produce

Temp Control and Storage

  • Are fan covers free of dust and build up and in good repair?

  • All lights working/covered and in good repair.

  • Is all product stored properly according to risk factors.

  • Is proper food rotation and dating being executed in all walk-in/reach in/stand alone coolers and freezers.

  • Is the condition/environment of cooler/freezer being maintained?

  • Is all product stored a minimum of 6 inches off the floor on proper racking (no milk crates).

Food Prep / Station / Kitchen Maintenance

  • Are only FSQA approved chemicals being used.

  • Is all cooking and production equipment in good repair and maintained according to cleaning and maintenance schedules?

  • Are temperature controlled prep rooms at proper temperature?

  • Are temperature control logs being properly managed?

  • Are grinder logs being properly managed and scanned at night?

  • Are all rep/workstations, including stations in temperature controlled settings properly set up and being maintained between tasks?

  • Is RAW PREP segregated from PREPARED PREP and READY TO EAT PREP?

  • Is time temp controls being managed? Are all cooked food temp minimums being achieved and documented on all cooked foods? Are temp logs in use and current?

  • Are small wares and in department supplies properly stored and free of build up, trash, debris and standing water?

  • Is knife/blade safety being exhibited? Are knives being cleaned and stored immediately after use? Are guards and push blocks in place and used? Is the equipment unplugged when being cleaned? Knives, blades, active saws/slicers, etc should never being unguarded or present in a 3 compartment sink.

  • Are all measures of glove safety being exhibited? Heat resistant gloves, cut resistant gloves, food service/prep gloves in use, in good repair and maintained to food safety standards,

  • Are hand sinks clean, stocked, unobstructed and used exclusively for washing hands?

  • Is hand washing and glove changing frequent and specifically when ending/starting a new task?

  • Are prep areas and service venues free of build up, trash, debris, boxes and standing water?

  • Is good service uniform and food safety hygiene policy being complied with? Is hair properly restrained with a hair net?

  • Are personal belongings in the department?

Salesfloor / Ready To Eat / Cold Food Holding / Fixtures

  • Are there spills/water on the sales-floor? Are wet floor signs/cones and carpet mats available through out store and/or in use as needed?

  • Is the produce floor inspection being maintained and current?

  • Are all fixtures, displays, signage, pallets, cases stacks, etc free of splintering and secured to minimize risk?

  • Sales floor and service counter areas are Free of build up, trash, debris, boxes and spills?

  • Are ice table displays being maintained with drain buckets and mats in place under all ice displays? Buckets and mats monitored every 2 hours and changed as needed.

  • Are all door seals and gaskets in good repair?

  • Is holding equipment maintaining proper temp and product being held at proper temp and rotated properly?

  • Is product in date and rotated properly?

  • Are produce tables being culled, rotated, and properly maintained?

  • Is production tool being used consistently and shrink being recorded?

  • Is tag integrity intact?

  • Is 7 day sheet being used and reviewed consistently?

General Risk Management

  • Are all empty pallets and pallet jacks removed from sales floor immediately, are empty pallets and jacks attended at all times?

  • Are U Boats and Backstock carts being pulled not pushed (including DSD personnel)

  • Are fork lifts maintained and in proper working order?

  • Are forklifts secure and forks to a wall when not being used?

  • Are step stools available, in use and in good working condition in all departments?

  • Are all floor displays a minimum of 24 inches?

  • Are wine displays cut no lower than 3 inches?

  • Does the MOD know the name electronic file location of all current state specific Workmans Comp Documents?

  • Fire extinguishers are properly mounted, highly visible, unobstructed and properly tagged?

  • Are the Store Management SafeServ certifications (With LA Gold Seal in LA only) Prominently displayed? Do all food handlers in MOBILE county have the proper credentials?

Supplies / Dry Storage

  • Are supplies, Dry Stores and Coats/Smocks properly stored and rotated according to receiving date on

  • Is the general condition of Supply Storage / Dry Storage / Hallways being maintained

  • Are all chemicals, approved, segregated from all other supplies and products and stored properly with MSDS available.

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.