Title Page

  • Cluster

  • Site conducted

  • Conducted on

  • Prepared by

Checklist

  • Nutrition Program - Please select the nutrition Programs that the school participates in.

  • Average daily participation meals-(ADP) for breakfast

  • Average daily participation meals-(ADP) for lunch

Manager's Office - Cleanliness

  • Ceiling ( Missing tiles Water-stained tiles Loose or sagging tiles Dust and dirt on tiles)

  • Walls ( Cracks Holes Water damage)

  • Floor (Cracked tiles Missing floor tiles Uneven floor surfaces)

  • Files Organization (All HACCP Logs, end of day, production report and EOM report) in order and organized by date.

  • Cleanliness Notes:

  • 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

  • Manager and All Food Assistants are in full uniform?

  • Hairnet

  • Natural eyelashes

  • Nails short & unpolished

  • No jewelry (except plain ring bands)

  • No Visibile Headphones

  • No Visible Cellphones

  • Staff Presentation (Explain if additional detail, if needed)

Counting and Claiming

  • Breakfast - Meal Counting and Claiming Process Review: Please note the meal counting procedure observed. **Please verify other meal locations outside of the classroom

  • Lunch - Meal Counting and Claiming Process Review: Please note the meal counting procedure observed.

  • Snack - Meal Counting and Claiming Process Review: Please note the meal counting procedure observed.

  • Supper - Meal Counting and Claiming Process Review: Please note the meal counting procedure observed.

Serving Line Cleanliness

  • Are the sneeze guards in good repair?

  • Are the lights working and shielded?

  • Are the steam wells and drains clean?

  • Are the walls behind the serving line clean?

  • Are the milk boxes clean?

  • Are all gaskets clean and in good repair (milk boxes, cold pass through, hot pass through)?

  • Is the bottom shelving clean?

  • Are the knobs on the equipment clean or and in place?

  • Serving line Cleanliness: (Add details if necessary)

Walk-in Cooler Cleanliness

  • Ceiling (debris, mold, mildew, and substances)

  • Floor (debris, mold, mildew, and substances)

  • Walls (debris, mold, mildew, and substances)

  • Shelving (debris, broken, mold, mildew, and substances)

  • Walk-in cooler organized by FIFO method, and the labels facing forward?

  • Clean and free of debris, mold, mildew, and substances

  • Signage present for ( USDA, FFVP, Supper program…) to separate inventory

  • Walk-in Cooler Cleanliness (Explain additional details, if needed)

Walk-in Freezer Cleanliness

  • Ceiling (debris, Ice build-up, and substances)

  • Floor (debris, Ice build-up, and substances)

  • Walls (debris, Ice build-up, and substances)

  • Shelving (debris, broken, Ice build-up, and substances)

  • Walk-in Freezer organized by FIFO method, and the labels facing forward?

  • Clean and free of debris, mold, mildew, and substances

  • Signage present for ( USDA, FFVP, Supper program…) to separate inventory

  • Walk-in Freezer Cleanliness (Explain additional details, if needed)

Dry Storage Cleanliness

  • Ceiling ( Missing tiles Water-stained tiles Loose or sagging tiles Dust and dirt on tiles)

  • Floor (Cracked tiles Missing floor tiles Uneven floor surfaces)

  • Walls (Cracked tiles Missing floor tiles Uneven floor surfaces)

  • Shelving (broken)

  • Dry storage organized using the FIFO method and are labels facing forward?

  • Clean and free of debris, mold, mildew, and substances

  • Signage present for ( USDA, FFVP, Supper program…) to separate inventory

  • Dry Storage Cleanliness (Explain additional details, if needed)

Dish Room Condition and Cleanliness

  • Dish washer present?

  • Dish washer area decluttered?

  • Dishwasher working?

  • Dish Room Cleanliness (Explain in detail, if needed)

Mop Room Condition and Cleanliness

  • Clean and Organize ( No debris, trash, old tools that should be discarded)

  • Is the mop hanging up right in the mop room to allow for drying?

  • Are all chemicals present in the original container label?

  • Are dust pans clean, and then hanging up in the mop room for proper organization.

  • Mop Room Cleanliness (Explain in detail, if needed)

Large Equipment Cleanliness

  • All large equipment is clean and orperational for service?

  • Large Equipment Cleanliness (List Equipment that needs additional cleaning)

Confirmations

  • I have verified the large equipment inventory by comparing to SNP records on file (See Equipment Team)

  • The small wares count is complete.

  • The Area Coordinator has met with school leadership.

  • The Area Coordinator has reviewed the participation data, serving line set-up, and determined suggested staffing requirements. * Notes should be on separate staffing document.

  • Additional Comments

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