Title Page
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Client / Site
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Date and Time of Inspection
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Inspected by
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Location
Management of Physical Facility
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Is there debris or garbage accumulation around outside of the building?
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Are outside garbage containers clean and properly covered?
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Are the doors or other openings to the outside of the building tightly fitted (no visible light showing through)?
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Are all screens for windows and doors in place and tightly fitted and in good repair?
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Is there an accumulation of spilled food, liquid, or dust?
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Do all food containers have lids?
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Are all food products stored off the floor?
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Are all interior garbage’s being emptied and removed from the facility daily?
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Are dirty dishes being cleaned prior to closing the facility at night?
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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
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Is there any evidence of mouse droppings or mouse urine staining?
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Are chew marks visible on any boxes or materials in the facility?
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Are there insects present on sticky traps throughout the facility?
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Is there evidence of nesting (piles of dust, debris, insulation etc in quiet areas)?
Completion
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Recommendations
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Inspector's Full Name and Signature