Title Page
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Cluster
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Site conducted
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Conducted on
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Prepared by
Checklist
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Nutrition Program - Please select the nutrition Programs that the school participates in.
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Average daily participation meals-(ADP) for breakfast
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Average daily participation meals-(ADP) for lunch
Manager's Office - Cleanliness
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Ceiling ( Missing tiles Water-stained tiles Loose or sagging tiles Dust and dirt on tiles)
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Walls ( Cracks Holes Water damage)
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Floor (Cracked tiles Missing floor tiles Uneven floor surfaces)
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Files Organization (All HACCP Logs, end of day, production report and EOM report) in order and organized by date.
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Cleanliness Notes:
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Determine if you think there is a place where we could install or keep a safe for cash and if there is already a place to store the change fund safely
Staff Presentation/Personal Hygiene - Do not correct staff
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Manager and All Food Assistants are in full uniform?
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Hairnet
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Natural eyelashes
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Nails short & unpolished
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No jewelry (except plain ring bands)
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No Visibile Headphones
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No Visible Cellphones
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Staff Presentation (Explain if additional detail, if needed)
Counting and Claiming
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Breakfast - Meal Counting and Claiming Process Review: Please note the meal counting procedure observed. **Please verify other meal locations outside of the classroom
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Lunch - Meal Counting and Claiming Process Review: Please note the meal counting procedure observed.
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Snack - Meal Counting and Claiming Process Review: Please note the meal counting procedure observed.
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Supper - Meal Counting and Claiming Process Review: Please note the meal counting procedure observed.
Serving Line Cleanliness
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Are the sneeze guards in good repair?
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Are the lights working and shielded?
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Are the steam wells and drains clean?
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Are the walls behind the serving line clean?
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Are the milk boxes clean?
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Are all gaskets clean and in good repair (milk boxes, cold pass through, hot pass through)?
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Is the bottom shelving clean?
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Are the knobs on the equipment clean or and in place?
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Serving line Cleanliness: (Add details if necessary)
Walk-in Cooler Cleanliness
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Ceiling (debris, mold, mildew, and substances)
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Floor (debris, mold, mildew, and substances)
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Walls (debris, mold, mildew, and substances)
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Shelving (debris, broken, mold, mildew, and substances)
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Walk-in cooler organized by FIFO method, and the labels facing forward?
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Clean and free of debris, mold, mildew, and substances
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Signage present for ( USDA, FFVP, Supper program…) to separate inventory
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Walk-in Cooler Cleanliness (Explain additional details, if needed)
Walk-in Freezer Cleanliness
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Ceiling (debris, Ice build-up, and substances)
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Floor (debris, Ice build-up, and substances)
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Walls (debris, Ice build-up, and substances)
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Shelving (debris, broken, Ice build-up, and substances)
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Walk-in Freezer organized by FIFO method, and the labels facing forward?
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Clean and free of debris, mold, mildew, and substances
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Signage present for ( USDA, FFVP, Supper program…) to separate inventory
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Walk-in Freezer Cleanliness (Explain additional details, if needed)
Dry Storage Cleanliness
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Ceiling ( Missing tiles Water-stained tiles Loose or sagging tiles Dust and dirt on tiles)
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Floor (Cracked tiles Missing floor tiles Uneven floor surfaces)
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Walls (Cracked tiles Missing floor tiles Uneven floor surfaces)
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Shelving (broken)
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Dry storage organized using the FIFO method and are labels facing forward?
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Clean and free of debris, mold, mildew, and substances
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Signage present for ( USDA, FFVP, Supper program…) to separate inventory
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Dry Storage Cleanliness (Explain additional details, if needed)
Dish Room Condition and Cleanliness
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Dish washer present?
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Dish washer area decluttered?
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Dishwasher working?
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Dish Room Cleanliness (Explain in detail, if needed)
Mop Room Condition and Cleanliness
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Clean and Organize ( No debris, trash, old tools that should be discarded)
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Is the mop hanging up right in the mop room to allow for drying?
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Are all chemicals present in the original container label?
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Are dust pans clean, and then hanging up in the mop room for proper organization.
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Mop Room Cleanliness (Explain in detail, if needed)
Large Equipment Cleanliness
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All large equipment is clean and orperational for service?
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Large Equipment Cleanliness (List Equipment that needs additional cleaning)
Confirmations
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I have verified the large equipment inventory by comparing to SNP records on file (See Equipment Team)
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The small wares count is complete.
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The Area Coordinator has met with school leadership.
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The Area Coordinator has reviewed the participation data, serving line set-up, and determined suggested staffing requirements. * Notes should be on separate staffing document.
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Additional Comments