Information
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
Fire Zone
Ansuls
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Ansul Inspection in date range?<br>
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Date of last Inspection?(Kimbrough) Semi-Annual<br>
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Select date
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Ansuls above grill zone fryer clear/maintained?<br>
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Ansuls above grill clear/maintained?<br>
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Ansuls above French Fry fryer clear/maintained?<br>
Fire Extinguishers
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All fire extinguisher inspections within date range?<br>
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Last Date of Fire Extinguisher Inspection?<br>
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Select date
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Fire extinguishers clearly marked?<br>
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Fire extinguishers are in easy to reach location?<br>
Fryers
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Are fryers in good working condition?<br>
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(Pull Out) Build up on the back/sides of the fryers?<br>
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(Under) Well maintained under the fryers, wheels, etc?<br>
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Wall behind fryers well maintained?<br>
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Drip pan on side of fryers emptied often?<br>
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Basket hangs are free of build up?<br>
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Gas lines and cords clear of debris and build up?<br>
Grills
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Date of last Grill Certification? In Range?<br>
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Select date
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Grills are in good repair and properly working?<br>
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Grills are clean with little to no bulidup on the platens or behind the platens?<br>
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(Pull Out) Back side and sides of the Grills are being maintained?<br>
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(Under) Well maintained under the Grills, wheels, etc?<br>
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Walls behind grill are clear of build up?<br>
Vent Hoods
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Date of last Vent Hood Cleaning? In Range?<br>
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Select date
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Vent hood covers clean and maintained?<br>
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All Vent Hoods are functioning properly?<br>
Detex Alarms
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Back door Detex alarms working properly and in use?<br>
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Play Place Detex Alarms are working properly and in use?<br>
Emergency Evacuation Plan
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Emergency evacuation plan is posted in lobby?<br>
Emergency Exit Signs
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All emergency exit signs are above exits and lit?<br>
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Fire Zones General Notes
Beverage System
Coke
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R/O filters are with in date?<br>
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Date of last QMC? (COKE)<br>
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Select date
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Main CO2 tank is properly bolted to the floor or wall?<br>
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Back-up CO2 tank is full and properly secured to the wall?<br>
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Muliplex is functioning properly?<br>
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Muliplex is clean and free of debris and build up?<br>
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ABS is functioning properly?<br>
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Automated Beverage System(ABS) is clean and maintained?<br>
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Control panel of ABS is working properly?<br>
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Peripherals of ABS are functioning properly? Arm, Turret, Belt System, Etc?<br>
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Ice Dispenser above the ABS is functioning Properly?<br>
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Self Serve Beverage Station is clean, well maintained and working properly?<br>
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Lighted sign on the beverage station is in good repair and light up?(if no type of replacement bulb)<br>
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Ice Dispencer above the beverage station is in functioning properly and maintained?<br>
Orange Juice Dispenser
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OJ Dispenser is in good repair?<br>
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OJ Dispenser is well maintained?<br>
Blended Ice Machine
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BIM has 2 functioning pitchers? (Note cracks, chips, etc.)<br>
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BIM Lid is in good repair?<br>
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BIM is well maintained?<br>
Melitta Machine
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Melitta machine is in good repair?<br>
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Melitta Machine is well maintained?<br>
Creamer Machine
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Creamer Machine is in good repair?<br>
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Creamer Machine is well maintained?<br>
Ice Dispensers
Back of Restaurant
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Manitowoc large ice dispenser is in good repair?<br>
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Manitowoc large ice dispenser is well maintained?<br>
Drive Thru
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Manitowoc ABS ice dispenser is in good repair? <br>
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Manitowoc ABS ice dispenser is well maintained?<br>
Lobby
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Manitowoc beverage station ice dispenser is in good repair?<br>
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Manitowoc beverage station ice dispenser is well maintained?<br>
Coffee Brewers
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Coffee brewers are in good repair?<br>
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Coffee brewers are well maintained?<br>
Shake Machine
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Shake machine is in good repair?<br>
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Shake machine is well maintained?<br>
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Beverage General Notes
General Kitchen Maintenance
Walk-In Freezer
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Walk in freezer is well lit? (if No note the type of bulb needing replacement)<br>
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Walk in freezer curtians are in good repair?<br>
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Walk in freezer is well maintained?<br>
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Walk in freezer is free of any ice build up?<br>
Walk-In Refrigerator
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Walk in refrigerator is well lit? (if No note the type of bulb needing replacement)<br>
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Walk in refrigerator curtians are in good repair?<br>
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Walk in refrigerator is well maintained?<br>
Grill Area Freezers
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All grill area freezers are in good repair?<br>
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All grill area freezers are well maintained?<br>
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All grill area freezers are free of ice build up internally?<br>
Grill Area Refrigerators
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All grill area refrigerators are in good repair?<br>
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All grill area refrigerators are well maintained?<br>
Q-ing Oven
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Qing ovens are in good repair?<br>
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Qing ovens are well maintained?<br>
Oven
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Oven is in good repair?<br>
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Oven is well maintained?<br>
Toaster
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Toaster is in good repair?<br>
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Toaster is well maintained?<br>
UHC
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UHC Controls are in working condition?<br>
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UHCs are well maintained?<br>
French Fry Dispenser
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French fry dispenser is in good repair?<br>
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French fry dispenser is well maintained?<br>
Grill Hand Wash Sink
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Grill hand wash sink is properly affixed to the wall?<br>
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Grill hand wash sink is clean and used for hand washing only?<br><br>
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Grill hand wash sink is stocked for proper hand washing?<br>
Back Sink
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Sink chemicals are functioning properly and dispensers are well maintained?<br>
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Drain under sink is free of build up and debris?<br>
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Tanks are clear of build up?<br>
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Kitchen Maintenance General Notes
Guest Areas
Lobby
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Lobby tables are stable and well maintained? (No lose feet or wobbling)<br>
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Floors are clean of build up? (Under tables/booths/chair legs)<br>
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Door signage is clear? (hours of operation/ events/ etc)<br>
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Walls are clean and free of build up, holes, and tears?<br>
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All lighting in the lobby is working? (list bulbs if needed)<br>
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Trash cans are clear of build up and in working order?<br>
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Lobby A/C vents are free of dust build up?<br>
Playplace
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Playplace tables are stable and well maintained? (No lose feet or wobbling)<br>
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Playplace are clean of build up? (Under tables/booths/chair legs)<br>
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Playplace walls are clean and free of build up, holes, and tears?<br>
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Playplace Toy is in good condition?<br>
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Interior of playplace toy is clean and free of build up?<br>
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Exterior of playplace toy is clean and in good repair?<br>
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All playplace netting is secure and free of rips or tears?<br>
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Date of last Playplace Sanitization?<br>
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Select date
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Playplace lights are working? (list bulbs if needed)<br>
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Playplace A/C vents are free of dust build up?<br>
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Trash cans are clear of build up and in working order?<br>
Restrooms
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Restrooms are in general good condition?<br>
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Restroom mirrors are free of graffiti and clear of build up?<br>
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Restroom sinks are clean and functioning properly?<br>
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Restroom hand dryers are secure to wall and functioning properly?<br>
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Restroom changing station is in good repair and straps are functioning properly?<br>
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Toilets are in working order and free of leaks?<br>
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Toilets are secure to the floor and caulked all the way around?<br>
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Restroom doors and signage are in good repair?<br>
Maintenance Closet
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Is closet clean and free of build up on floors, baseboards, and walls?<br>
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Are the mop sinks clean and free of build up?<br>
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Are chemicals being stored properly?<br>
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Guest Area General Notes
Front Counter
Refrigerator
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F/C Refrigerators are in good repair?<br>
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F/C refrigerators are well maintained?<br>
Front Counter - Hand Wash Sink
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F/C hand wash sink is properly affixed to the wall?<br>
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F/C hand wash sink is clean and used for hand washing only?<br>
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F/C hand wash sink is stocked for proper hand washing?<br>
HLZ
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HLZs are free of build up?<br>
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HLZ cords are in good condition?<br>
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Front Counter General Notes
Building Exterior
Roof
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Is roof clean and free of debris? Is cleaning routine in place?<br>
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A/C air filters are clean? A maintenance routine is in place and executed?<br>
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A/C Condensers are well maintained and functioning properly? Maintenance Routine in place?<br>
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Roof ladder is in compliance and is accessible?<br><br>
Trash Corral
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Ground around trash dumpsters is clean and free of build up?<br>
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Trash dumpsters are well maintained and lids are in place and closed?<br>
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Walls around the trash corral are free of equipment and well maintained?<br>
Storage Unit
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Storage unit is clean and well maintained?<br>
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All lights and light fixtures are in proper working order?<br>
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Lot is clear of oil spots and parking lot lines are clearly visible?<br>
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Building Exterior General Notes
Safety
First Aid Kit
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Supplies are full and First Aid kit is accessible? (List what is needed if No)<br>
OSHA Safety Sign Off
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OSHA sign off is completed by all employees for the current month?<br>
Safety Sign Off Sheet
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Safety sign off sheet has been signed by all employees for the current month?<br>
Safety Equipment
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Is safety equipment (i.e. Face shield, Gloves, apron, etc.) available and utilized?<br>
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Safety Section General Notes
Miscellaneous
Grease Trap
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Date of last grease trap maintenance?<br>
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Select date
Technology
CDP
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CDP is functioning properly and up to date?<br>
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All peripheral are attached an in good condition?<br>
POS
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All registers are functioning properly?<br>
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All registers are well maintained?<br>
Cash Drawers
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All cash drawers are working properly?<br>
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All cash drawers are well maintained?<br>
Coin Changer
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Coin changer is functioning properly?<br>
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Coin changers is well maintained?<br>
KVS Monitors
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All KVS monitors are functioning properly?<br>
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All KVS monitors are well maintained?<br>
KVS Controllers
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All KVS controllers are functioning properly and updated to nest NewPOS Version?<br>
KVS Bump Bars
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Bump bars are in good condition and functioning properly? (buttons, cords, mounts, etc) <br>
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Bump bars are wrapped to avoid grease and build up?<br>
POS/Grill Printers
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Printers are functioning properly?<br>
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Printers are well maintained and free of build up? (Inside and out)<br>
PED
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F/C Printers are functioning properly?<br>
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F/C Printers are well maintained and free of build up? (Inside and out)<br>
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Technology General Notes