Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

GENERAL INFORMATION

  • Date and Time audit began

  • Name(s) of MIC/person(s) in charge (ServSafe certification or equal)

  • ServSafe certifications appropriately displayed

  • Employee food handlers cards available

  • Time/Temp/Taste Log completed daily

  • Recipe cards are used everyday, recipe book is available.

  • MSDS Sheets available in binder for all chemicals used

PROCUREMENT and RECEIVING FOOD

  • Food items are purchased from OWC approved source. (licensed by the county, state, or federal government)

  • Deliveries are accepted at non peak times

  • Food is inspected before placed into storage (free from damage, contamination, adulteration and spoilage)

  • Food deliveries are kept 6" off the floor before being stored

  • Potentially Hazardous Food (PHF) received at temperature < 41° F or below

  • Frozen food received at temperature < 0° F or below

PERSONNEL HYGIENE PRACTICES

  • Employees wear proper uniform including proper shoes

  • Hair restraint is worn

  • Fingernails are short, unpolished and clean

  • Jewelry is limited to watch, simple earrings and plain rings

  • Hands are washed or gloves are changed at critical points

  • Open sores, cuts, or splints and bandages on hands are completely covered while handling food

  • Hands are washed thoroughly using proper hand-washing procedures at critical points

  • Eating or Drinking are observed only in designated areas away from work areas. No gum chewing on shift.

  • Staff beverages are covered with a lid and straw and stored away from food preparation area

  • Staff take appropriate action when coughing or sneezing

  • Disposal tissues are used and disposed of when coughing/blowing nose

HANDWASHING

  • Hand sinks accessible and stocked with soap, sanitizer, and paper towels

  • Staff wash hands in hand-washing sinks only

  • Staff observed washing hands between tasks (handling raw meat, seafood, mops, garbage, ect...

  • Employees wash hands before starting work and returning from break

PREP AREA

  • Food prep areas are kept clean and sanitized at all times?

  • Walls are clean from debris and splatter?

  • Floors are swept and mopped?

  • Prep List followed correctly?

  • No cross-contamination observed?

  • All equipment is cleaned and sanitized after use?

  • Product is dated/labeled correctly?

DRY FOOD STORAGE

  • Temperature is appropriate?<br>between 50° F and 70° F

  • Is storage area well lit?

  • Protective light shields cover all light sources?

  • All food is labeled with name and delivery date?

  • No cross-contamination is observed?

  • All food and paper supplies are 6" off the floor?

  • Bulk foods are labeled with common name if not in original container?<br>(Flour, rice, sugar, ect)

  • There is no bulging, dented or leaking canned goods in storage?

  • Food is protected from contamination?

  • All surfaces and floor are clean?

  • Chemicals are stored away from food and other food related supplies?

COLD FOOD STORAGE

  • WALK IN FREEZER

  • Thermometer is conspicuous and accurate

  • Evidence that temperatures are monitored and recorded

  • Record temperature here. (must be < 0° F)

  • Food is stored 6" off floor

  • All food is properly wrapped, labeled and dated

  • No cross-contamination is observed

  • Unit is clean inside and out

  • Floors are swept and mopped

  • Shelves and walls are clean and organized

  • WALK IN REFRIGERATOR

  • Thermometer is conspicuous and accurate

  • Food is stored 6" off floor

  • Evidence that temperatures are monitored and recorded

  • Record temperature here. (must be < 41° F)

  • All food is properly wrapped, labeled and dated

  • Open product is sealed and labeled in ziploc bags

  • No cross-contamination is observed

  • Raw meats are stored on bottom shelf, away from other product

  • Pre-Cooked meats are stored on shelf above raw meats

  • Food being thawed is on lowest shelf(s)

  • Unit is clean inside and out

  • Gaskets are clean and in good repair

  • Floors swept and mopped

  • Walls and shelving is clean

  • REACH IN FREEZER

  • Thermometer is conspicuous and accurate

  • Record temperature here. (must be < 0° F)

  • Evidence that temperatures are monitored and recorded

  • All food is properly wrapped, labeled and dated

  • Open product is sealed and labeled in ziploc bags

  • No cross-contamination is observed

  • Unit is clean inside and out

  • REACH IN REFRIGERATOR

  • Thermometer is conspicuous and accurate

  • Evidence that temperatures are monitored and recorded

  • Record temperature here. (must be < 41° F)

  • All food is properly wrapped, labeled and dated

  • Open product is sealed and labeled in ziploc bags

  • No cross-contamination is observed

  • Food being thawed is on lowest shelf(s)

  • Unit is clean inside and out

  • COLD PREP LINE

  • Thermometer is conspicuous and accurate<br>

  • Evidence that unit/product temperatures are monitored and recorded

  • Record temperature here. (must be < 41° F)

  • Product is covered/sealed

  • Product is dated/labeled

  • Open product is sealed and labeled in ziploc bags

  • No cross-contamination is observed

  • Unit is clean inside and out

FOOD HANDLING

  • Frozen food is thawed under refrigeration or in cold running water

  • Food is not allowed to become cross contaminated

  • Food is handled with utensils, clean gloved hands or clean hands

  • Utensils are handled to avoid touching parts that will be in direct contact with food

  • Reusable towels in red sanitizer bucket are used only for sanitizing equipment surfaces and not for drying hands, utensils, floors and ect...

  • Open food product stored in approved sealed bag/container

UTENSILS and EQUIPMENT

  • Storage Rack(s) are labeled, clean and organized

  • Chef Base Drawer(s) are clean and organized

  • Equipment is covered when clean and not in use

  • Utensils are stored correctly by hanging on a rack, not in a bulk container

  • Ice scoops are stored in appropriate container and not in ice machine

  • Dishes/coffee cups are free of stains and food debris

  • Pots and pans are free of carbon build up, stains and food debris

  • EQUIPMENT OPERATION

  • Any broken equipment has been reported in a timely manner

  • Inoperative equipment has been repaired, replaced, labeled or removed from the location

  • No broken or unusable equipment

  • Only OWC approved equipment are installed in an approved manner

GARBAGE STORAGE and DISPOSAL

  • Kitchen garbage cans are clean and covered when not in use?

  • Garbage cans are emptied as necessary?

  • Boxes and containers are broken down and disposed of?

  • Dumpster lid(s) are closed?

  • Dumpster area is swept and clean daily?

  • Grease is disposed of in approved grease receptacle, not in dumpster?

  • Grease container is clean, closed, and no grease is on ground?

INTEGRATED PEST CONTROL

  • Pest Control Log Book on site and updated

  • Screens are on open windows and doors are in good repair

  • Door sweeps restrict the passage of light

  • No evidence of insect or pests is present

SIGNATURES

  • Signature of PIC

  • Signature of Auditor

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.