Information
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Client / Site
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Registration Number
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Prepared by
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Select date
Sanitation
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Why:
Remove bacteria or viruses that may cause foodborne illness from food contact surfaces.
Clean and sanitize utensils and equipment:
After each use.
Every 4 hours if used to prepare Potentially Hazardous Foods (PHF) on a
continuous basis.
Clean and sanitize utensils and equipment between preparing raw and
Ready-to-Eat foods.
DAILY CLEANING
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Cleaning Log
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Equipment or Area being Cleaned
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Food contact surface cleaning
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Floor and walls cleaned
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Sanitary Condition of Facility (Comment)
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Date & Time
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Name & Signature
EQUIPMENT and BUILDING MAINTENANCE
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Facility Checklist
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No evidence of flaking paint
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Building meets local building codes
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Floors, walls and ceiling meets local safety codes
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Food contact surfaces meet safety standards
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Water Quality meets Safety Standards
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Regular Maintenance on building
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Inoperative equipment has been repaired, replaced or removed
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Regular Maintenance on critical equipment
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Date & Time
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Name & Signature
CHEMICALS
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Chemical Checklist
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Chemicals are properly stored
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Cleaning compounds and sanitizers meet standards
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Concentrations meet standards
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Chemicals are properly labeled
POWER EQUIPMENT
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Power Equipment Maintenance
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Only approved equipment is used
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Power Equipment is clean and maintained
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Power equipment shows no signs of fluid leaks
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Equipment Maintenance Comments
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Date & Time
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Name & Signature
UTENSILS and EQUIPMENT
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Utensils & Equipment
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Equipment is covered when clean and not in use
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Utensils for food handling are clean
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Drawers are clean
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Racks are clean
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Pallets are maintained and clean
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Date & Time
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Name & Signature
GARBAGE STORAGE and DISPOSAL
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Garbage Disposal Checlist
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Garbage containers are emptied as necessary
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Refuse and garbage containers are clean and covered when not in use
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Dumpster lids are closed
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Boxes and containers are removed as necessary
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Dumpster is located not near access to facility
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Dumpster area is clean
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Date & Time
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Name & Signature
Signatures
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Person in Charge
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Supervisor