Title Page
-
Conducted on
-
Prepared by
-
Location
Personal Hygiene/ Employee Practices
-
Are hand-washing sinks clean, unobstructed, and stocked with soap, paper towels, and hand-washing signage?
-
Are employees properly washing hands?
-
Are employees wearing gloves, cutting gloves, and are changing gloves when required?
-
Are employees following the illness, hair restraint, and jewelry policies?
-
Are employees eating, chewing gum, or using tobacco in the department?
-
Are drinks properly covered and stored away from food preparation?
-
Is the department is free of personal items?
Sanitation
-
Are food contact surfaces clean to sight and touch, and cleaned using proper methods?
- Yes
- No - Deduct 1 Point
- No - Deduct 2 Points
- No - Deduct 3 Points
- No - Deduct 4 Points
- No - Deduct 5 Points
- No - Deduct 6 Points
-
Are test strips available and being used?
-
Are cleaning and sanitizing solutions maintained clean, properly mixed, and replaced at the proper frequency?
-
Are thermometers sanitized before and after each use, and stored in a sanitary manner?
-
Are only authorized chemicals are being used?
Product Identification and Date Coding
-
Are food and ingredient containers clean, and labeled with an identity?
-
Are food items date marked with a preparation date and an expiration or sell by date?
-
Are store-packaged items properly labeled?
-
Are food items held past the expiration or sell by date?
-
Are all spray bottles and chemical containers properly labeled?
Temperature Control
-
Are food thermometers available and properly calibrated?
-
Are cold foods held and received at 41 degrees F or below?
- Yes
- No - Deduct 1 Point
- No - Deduct 2 Points
- No - Deduct 3 Points
- No - Deduct 4 Points
- No - Deduct 5 Points
- No - Deduct 6 Points
-
Are perishable foods kept out of temperature control for longer than 30 minutes when processing or stocking?
-
Are foods thawed properly?
-
Are foods stored above fill lines or past the load limits of display cases?
-
Is airflow blocked in refrigeration units?
Preventing Contamination and Cross Contact
-
Are food, utensils and packaging protected from contamination during preparation, storage, and display?
-
Are food and supplies stored at least 6" off of the floor?
-
Are chemicals stored away from food, single-service items, and equipment?
-
Is the Allergen Chart present in the department?
-
Is cross contact of allergens prevented during preparation, storage, and display?
Physical Facilities and Equipment
-
Are floors, walls, and ceilings maintained clean?
-
Are non-food contact surfaces maintained clean?
-
Are hand-contact surface maintained clean?
-
Are cutting boards, utensils, or pieces of food equipment chipped, heavily scratched, scored, or stained?
-
Are trash cans and compost bins clean and not overflowing?
-
Are drains maintained clean?
-
Are coolers and freezers maintained clean and free of odors?
-
Are sales floor cases and display cases maintained clean?
Logs and Certification
-
Are grind logs and temperatures logs complete, accurate, and maintained on file in chronological order?
-
Are ZEP logs and cleaning charts complete, accurate. and maintained on file in chronological order?
-
Do department managers demonstrate active managerial control and understanding of food safety principles?