Physical Plant Inspection and Restaurant Hazard Assessment

• Conducted on

  Date

• Prepared by

• Location
  Address

Parking Lot & Surrounding Property

• Car Stops (condition) <br>

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Lot Surface

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Curbing <br>

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Striping <br>

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Fencing <br>

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Trash Receptacles

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Outside Patio Area

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Patio Tables

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Patio Chairs

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Patio Umbrellas

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Bike Rack

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Newspaper Rack

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Telephones

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Disabled Access Markings

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

Building Exterior

• Fascia

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Mansard (Trim and Shingles)

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Soffit|Gutters|Downspouts

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Walls

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Ledges and Mullions

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Back, Front, Side Entry Doors/Slabs

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Utility Doors

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Lighting

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Exterior Windows

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Walkways

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Railings/Protective Poles

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

Landscaping Appearance

• No Dead/Missing Plants

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Color/Arrangement

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Grass Areas/Ground Cover

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Edges/Containment Materials

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

Dumpster Area

• Fence/Walls (Paint/Repair)

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Gates (Paint/Repair)

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Slab

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Hardware (Locks/Hinges)

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Dumpster Can

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Grease Receptacle

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

Carport

• Slab

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Clearance Sign

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Guest Complaint Decal

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Operating Hours Posted

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Service Area

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Drive-Thru Window

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Overhang & Lighting

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Fly Fan

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

Signs & Lighting

• Building Logo/Poles/Monument

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Neon

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Preview Board

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Speaker Box

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Light Poles/Bases/Lenses

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Marquee Signs

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• "A" Frame Sign

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Directional/Other Signs

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

Ceiling

• Ceiling (Tile/Other)

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Grid Work

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Air Conditioning Vents

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Music Speaker Covers

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Music Audible and Appropriate

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Fans

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Exit signs

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

Lighting

• Parabolic/Recessed Lighting

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Pendant Lighting

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Globes

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

Tables/Chairs/Booths

• Cushions (Booth/Chairs)

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Table/Booth Tops (Defaced)

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Table Bases

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Chairs (Legs/Backs/Sides)

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• High Chairs

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Booth Dividers/Frames/Legs

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Park Benches

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

Floors

• Carpet/Edging

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Tile

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Coving (Tile/Rubber)

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Rugs

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

Walls

• Wallpaper

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Paneling

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Doors and Frames

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Operating Hours Posted

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Door Closure

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Windows (Frames and Ledges)

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Valances and Blinds

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Stone/Brick

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Temperature (Comfortable)

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Pictures

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

Condiment Counter

• Approved Condiment Center

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Properly Stocked

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Counter Surface (Chips)

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Napkins/Straw Dispenser

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Doors

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

Trash Receptacle

• Exterior (Chips/Dirt)

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Magnetic Catch

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Metal Door Ledge

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Interior

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Liner and Can

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Odor Free

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

Men's Restroom

• Floors

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Drains

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Walls (Tile/FRP/Other)

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Coving

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Ceiling

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Lights/Cover

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Exhaust Vents

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Mirrors

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Sink (Seal/Faucet/Plumbing)

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Toilet/Urinal (Plumbing)

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Hand Dryer/Paper Towel Dispenser

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Soap Dispenser

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Seat/Tissue Dispenser

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Hand Rail (Secured to Wall)

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Odor

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Doors/Locks

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Trash Cans

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Restroom Signs

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Employee Handwash Sign

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

Women's Restroom

• Floors

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Drains

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Walls (Tile/FRP/Other)

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Coving

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Ceiling

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Lights/Cover

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Exhaust Vents

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Mirrors

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Sink (Seal/Faucet/Plumbing)

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Toilet/Urinal (Plumbing)

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Hand Dryer/Paper Towel Dispenser

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Soap Dispenser

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Seat/Tissue Dispenser

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Hand Rail (Secured to Wall)

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Odor

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Doors/Locks

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Trash Cans

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Restroom Signs

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Employee Handwash Sign

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

Vestibule

• Restroom Signs

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Doors

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Floor

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Coving

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Walls

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Ceiling

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Vents

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Lights/Covers

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Exit Signs

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

Guest Service Area

• Wall (Tile/Wallpaper/other)

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Stainless

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Menu Board

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Lights/Covers

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Ceiling

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Floor/Coving

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Counter Tops

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Support Poles

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Air Conditioner Vents

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Cash Drawers (Secured)

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Cup Dispensers

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• General Appearance from Guest View

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Sanitizer Dispensers

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Hand sets/headsets

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Drive-Thru Window Frame

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• POS (Register/Monitor/cash Drawers)

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Valances/Blinds

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Iced Tea Dispensers

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Coffee Machines

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Air Pots- Visible in Racks

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

Shake machine

• Exterior

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Drip Pan

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Wheels/Legs

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Vita-Mixer-Splash Guard

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

Fryer Area

• Leaking

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Proper Cleaning Sponge Available

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Doors Clean

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Physical Condition

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Filter Supplies and Cart

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

Toasters

• Teflon condition

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Proper cleaning sponge available

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

• Working Properly

  Standard

  N/A

  Critical Defect

  Needs Attention

  Needs Cleaning

Postings and Support Materials Present

• Is "Safety and Health Protection on the Job" poster displayed?

  Yes

  No

  N/A

• Is the "Access to Medical and Exposure Records" poster Displayed?

  Yes

  No

  N/A

• Is the Emergency Evacuation Plan posted and a "designated meeting" spot marked?

  Yes

  No

  N/A

• Is name, number and directions to nearest approved industrial clinic posted?

  Yes

  No

  N/A

• Are all required OSHA (state/federal) posters displayed?

  Yes

  No

  N/A

• Is the SDS (Safety Data Sheet) right-to-know information binder present and current with the SDS of approved chemicals present

  Yes

  No

  N/A

• Is the Monthly Safety Training Calendar displayed on current month?

  Yes

  No

  N/A

• Are the Monthly Safety Training lesson plans and training records kept in the office and are appropriately signed up to current date?

  Yes

  No

  N/A

• Is the IIPP (Injury & Illness Prevention Program) binder present in the office and required pages properly updated?

  Yes

  No

  N/A

• Are the procedures for handling an employee or guest related incident clearly available in the office, along with the necessary paperwork to handle an incident?

  Yes

  No

  N/A

Front House

• Entrance Door areas, queue area, order area, seater area

  Yes

  No

  N/A

• Aisles and floor areas in dining areas free of slip, trip and fall hazards

  Yes

  No

  N/A

• Warning "Caution Wet floor Sign" being used properly and removed immediately after the hazard had been handled

  Yes

  No

  N/A

• Floor mats clean, Dry and Lying flat

  Yes

  No

  N/A

• Clear views through windows into parking lot areas views not inhibited by posters

  Yes

  No

  N/A

Restrooms

• Warning Caution Wet Floor Sign placed outside restroom door if restroom is being serviced

  Yes

  No

  N/A

• Warning Caution Wet Floor Sign placed inside restroom if restroom is being serviced

  Yes

  No

  N/A

• Restroom floor tile is free of water, trash, or any other slip, trip and fall hazards

  Yes

  No

  N/A

• Toilet Paper, soap, hot running water, paper towels (or air hand dryer) present

  Yes

  No

  N/A

• Toilet seats tightened to prevent skipping of toilet

  Yes

  No

  N/A

• Sink counter area free of water buildup

  Yes

  No

  N/A

Electrical Safety

• Cover plates present on all electrical and wall switches

  Yes

  No

  N/A

• Are all electrical cords from wall to equipment in safe working conditions, not frayed, etc.

  Yes

  No

  N/A

• 3 feet area in front of circuit panels kept clear of obstacles at all times

  Yes

  No

  N/A

• Are circuit panels covered with panel doors

  Yes

  No

  N/A

• All circuits are properly labeled

  Yes

  No

  N/A

• Metal ladders not used around electrical equipment

  Yes

  No

  N/A

• Lock out/block out procedures in place when appropriate

  Yes

  No

  N/A

Fire safety

• Fire extinguisher in their dedicated locations, inspected and recharged within the last year

  Yes

  No

  N/A

• Fire extinguisher inspection tag or paperwork present confirming date of last inspection

  Yes

  No

  N/A

• Automatic fire extinguishing system over cook area (Ansul System) fully charged and tag or paperwork present confirming date of last inspection

  Yes

  No

  N/A

• Hoods filters removed and cleaned as per a regular cleaning schedule

  Yes

  No

  N/A

• Hood exhausts turned on immediately upon arriving in the morning

  Yes

  No

  N/A

• Employees Trained on when/how to use fire extinguisher

  Yes

  No

  N/A

• Employee trained on when/how to use the automatic fire extinguisher system

  Yes

  No

  N/A

Compressed Gas Cylinders

• Gas Cylinder are secured so that they cannot fall or be knocked over

  Yes

  No

  N/A

• All cylinders are landlord at to their content

  Yes

  No

  N/A

• Cylinders marked full, in use, or empty

  Yes

  No

  N/A

• Caps are secured on cylinders when not on use

  Yes

  No

  N/A

Ladders and Step Stools

• Ladder and step Stools clean and in good condition (check for broken or missing steps, grease on steps or defects).

  Yes

  No

  N/A

• All rubber safety feet present, clean and uncracked

  Yes

  No

  N/A

• Employees Trained on proper use of letters and step Stools

  Yes

  No

  N/A

• Ladders used in our around electrical areas are non-conductive

  Yes

  No

  N/A

Walk-in Refrigerators and Freezers

• Proper lighting present in walk-ins

  Yes

  No

  N/A

• Floor areas maintained to prevent slip, trip and falls, no ice buildup or water present

  Yes

  No

  N/A

• Heavier items stored on lower shelves

  Yes

  No

  N/A

• Employees exiting the proper way to prevent struck-by injuries

  Yes

  No

  N/A

Chemical Safety

• Employees know the location of the SDS binder and how/what SDS are used for.

  Yes

  No

  N/A

• All Chemical containers labeled with the product name, manufacturer or distributors name and address and appropriate hazard warnings

  Yes

  No

  N/A

• When transferred to a secondary container, the container is labeled with the contents

  Yes

  No

  N/A

• Chemicals are stored properly and not present in food preparation or service areas

  Yes

  No

  N/A

• Employees using/wearing PPE, if required to as instructed on label

  Yes

  No

  N/A

Storage Areas

• Storage racks sturdy and good condition

  Yes

  No

  N/A

• Ladder or step stool accessible in storage areas

  Yes

  No

  N/A

• Dollies, hand trucks, or rolling carts clean, present and maintained for safe use

  Yes

  No

  N/A

• Heavy or bulky items stored on lower shelves

  Yes

  No

  N/A

• Items that are double stacked are stored level and in such a way to prevent falling

  Yes

  No

  N/A

Personal Protective Equipment and other safety aids

• Hot Pads, oven mitts or pan growers available for removing pans from cooking equipment

  Yes

  No

  N/A

• Cut-resistant gloves in good condition and being used where required

  Yes

  No

  N/A

• Chemical resistant gloves apron and face shield presents and used when using chemicals

  Yes

  No

  N/A

• Eye protection, heat resistant gloves and apron available

  Yes

  No

  N/A

• Slip resistant shows being worn by all employees and managers

  Yes

  No

  N/A

• Box cutter being used to open boxes

  Yes

  No

  N/A

• First aid box properly Stocked according to ANSI requirements

  Yes

  No

  N/A

• Bodily fluids or Bloodborne pathogens kit present

  Yes

  No

  N/A

Equipment

• Equipment safeguards present and in place

  Yes

  No

  N/A

• Knives sharpened, stored and used properly

  Yes

  No

  N/A

• Electric equipment powered off and unplugged when not in use

  Yes

  No

  N/A

• All equipment in safe operating condition PPE present and being used

  Yes

  No

  N/A

• Lock out block out being used on any equipment temporarily or of service

  Yes

  No

  N/A

• Equipment being used only by authorized and properly trained employees

  Yes

  No

  N/A

Back house

• Floor areas clean and dry, no slip, trip and fall hazards

  Yes

  No

  N/A

• Fatigue mats, waffle mats or area mats kept clean of debris and grease.

  Yes

  No

  N/A

• Equipment in safe and proper working condition

  Yes

  No

  N/A

• Equipment cleaned, stored and secured properly after each use.

  Yes

  No

  N/A