• Enter Date & Time


  • Proper Hand Washing Observed

  • Staff only wash hands in handwash sink

  • Employees wear appropriate uniform
    including proper shoes

  • Hair restraints worn

  • Fingernails trimmed

  • Jewelry is restricted

  • Glove use policy followed

  • Open sores, cuts, or bandages
    completely covered while handling food

  • Eating, drinking or Chewing gum
    prohibited in food prep areas

  • Staff take appropriate action
    when coughing or sneezing


  • Hand wash stations available & stocked
    with anti-microbial hand soap, hand sanitizer
    and single-use towels?

  • Hand Washing signage displayed

  • Sanitizing solution available in critical areas


  • Hoses stored on racks when not in use

  • Doors kept closed when not being used

  • No overflowing garbage cans, employees placing garbage in appropriate bins

  • Employees removing waste during production followed proper procedures

  • Thawed/thawing product handled/stored properly

  • Employees following proper pallet handling procedures

VERIFICATION - Must be two different names and signatures

  • Assessor Name & Signature

  • Supervisor Name & Signature

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