Title Page

  • Client / Site

  • Date and Time of Inspection

  • Inspected by

  • Location

Management of Physical Facility

  • Is there debris or garbage accumulation around outside of the building?

  • Are outside garbage containers clean and properly covered?

  • Are the doors or other openings to the outside of the building tightly fitted (no visible light showing through)?

  • Are all screens for windows and doors in place and tightly fitted and in good repair?

  • Is there an accumulation of spilled food, liquid, or dust?

  • Do all food containers have lids?

  • Are all food products stored off the floor?

  • Are all interior garbage‚Äôs being emptied and removed from the facility daily?

  • Are dirty dishes being cleaned prior to closing the facility at night?

  • Are all hard to reach areas of the facility (under grill lines, prep tables, and shelving units) being cleaned on a frequent enough basis to prevent build up?

Investigating for Evidence of Pests

  • Is there any evidence of mouse droppings or mouse urine staining?

  • Are chew marks visible on any boxes or materials in the facility?

  • Are there insects present on sticky traps throughout the facility?

  • Is there evidence of nesting (piles of dust, debris, insulation etc in quiet areas)?


  • Recommendations

  • Inspector's Full Name and Signature

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