QASA sbux

• QASA

• Store

• Conducted on

  Date

• Prepared by

• Personnel

Self Assessment

Chemicals

• Chemicals are not stored on or above food preparation counters.

  Yes

  No

  N/A

• Chemicals are stored below or 12 inches away from food/single use items/clean dishes<br><br>

  Yes

  No

  N/A

• Chemicals are not stored on or above dishmachine

  Yes

  No

  N/A

• Chemicals are not stored on/above clean drain board or sanitize basin of dish sink

  Yes

  No

  N/A

• Chemicals are in labeled spray bottle/container

  Yes

  No

  N/A

• Chemicals are covered/sealed (excluding sanitizer bucket)

  Yes

  No

  N/A

• No bleach/unapproved pesticide/drain cleaner/ unapproved chemical present

  Yes

  No

  N/A

• No Scented hand lotion/unapproved hand soap/hand sanitizer present

  Yes

  No

  N/A

• Esteem Sani-NC (US)/UltraSan (CAN) not observed in store with high-temp dishmachine

  Yes

  No

  N/A

Sanitizer Buckets and Bar Towels

• Sanitizer container is properly labeled

  Yes

  No

  N/A

• Proper test strips are available and free of water damage

  Yes

  No

  N/A

• Quat- solution between 200 and 400ppm

  Yes

  No

  N/A

• Chlorine- solution between 100 and 200ppm

  Yes

  No

  N/A

• No towels left sitting on counters/shelves/on or in sink

  Yes

  No

  N/A

• In container with sanitizer solution

  Yes

  No

  N/A

• Large red sanitizer bucket not stored on counter or in sink

  Yes

  No

  N/A

• Clean towels/linens not stored with chemicals or a contamination potential/stored at least 12” away from any contamination potential

  Yes

  No

  N/A

Handwashing

Handwashing taking place at appropriate times

• After wiping hands on apron

  Yes

  No

  N/A

• After handling trash

  Yes

  No

  N/A

• After coughing/sneezing into hands

  Yes

  No

  N/A

• After touching face/hair/skin

  Yes

  No

  N/A

• After eating/drinking

  Yes

  No

  N/A

• After breaks

  Yes

  No

  N/A

• After handling dirty dishes or equipment

  Yes

  No

  N/A

• After blowing nose

  Yes

  No

  N/A

• After cleaning tasks

  Yes

  No

  N/A

• Before starting shift

  Yes

  No

  N/A

• Before putting gloves on

  Yes

  No

  N/A

• After using restroom

  Yes

  No

  N/A

• Partners washing hands are using soap and proper technique (incl. 10-15 second scrub)

  Yes

  No

  N/A

Documentation

• Food service permit is current (note expiration date)

  Yes

  No

  N/A

• One partner in charge per store with valid food safety certification , or more if your jurisdiction requires it

  Yes

  No

  N/A

• All partners have valid food worker cards if required

  Yes

  No

  N/A

• Allergen certification adequate per jurisdiction (MA)

  Yes

  No

  N/A

• Allergen Poster present in BoH

  Yes

  No

  N/A

• Heimlich maneuver signage posted where required (CA, CT, GA, MI, MD, NJ, NY, TX)

  Yes

  No

  N/A

• Most recent Health inspection report posted or on file

  Yes

  No

  N/A

• Most recent pest report is within 60 days/and available for review

  Yes

  No

  N/A

• Temp log complete, no entries missing/when required, corrective action noted

  Yes

  No

  N/A

Food Safety and Partner Habits

Food Handling & Food Safety

• Partner food/beverage is not stored on shelving next to dry goods, clean smallwares, or single use items shelving and at least 12” below and away

  Yes

  No

  N/A

• No Drinking/Eating (or evidence of) in food storage/food prep area

  Yes

  No

  N/A

• Partner belongings are not stored while partner is not scheduled to work

  Yes

  No

  N/A

• Partner belongings are not stored with dry goods, clean smallwares and/or clean linens on metro shelving and at least 12” below and away

  Yes

  No

  N/A

• Partners are not touching pastries/sandwiches/beverage ingredients/mouth contact parts of items with bare hands

  Yes

  No

  N/A

• Hot water available in the store (100- 120F/38-49C)

  Yes

  No

  N/A

• No sewage back up in store

  Yes

  No

  N/A

• Partner in charge can identify all smallwares that need to be washed, rinsed, and sanitized every 2 hours (ice scoops, in-use utensils, pitcher, spoons, lids)

  Yes

  No

  N/A

• Partner in charge knowledgable of proper dishwashing procedures-Wash, Rinse, Sanitize, then Air Dry

  Yes

  No

  N/A

Pest Control

• No evidence of mice/rats, flying insects, cockroaches, ants

  Yes

  No

  N/A

Partner Uniforms

• Aprons/cloths are clean and do not have more than one shift's accumulation of spills and splashes

  Yes

  No

  N/A

• Long hair beyond shoulder length is tied back/hair restraints are worn per jurisdictional requirement

  Yes

  No

  N/A

• Partner hands are cleanable, (reference partner handbook, acrylic nails, hand wrap/cast and jewelry)

  Yes

  No

  N/A

Partner Health

• Not working with severe chest congestion/severe runny nose

  Yes

  No

  N/A

• Not working with acute diarrhea/ vomiting/jaundice

  Yes

  No

  N/A

• Not working with fever/chills

  Yes

  No

  N/A

• Not working with any exposed infected lesion on hand/wrist/arm

  Yes

  No

  N/A

• Exposed bandages on hand/wrist are covered by single use glove

  Yes

  No

  N/A

Operations

Exterior of the Store

Drive Thru Lane

• Drive thru menu boards/speakers are clean

  Yes

  No

  N/A

• Drive thru lane does not have trash/cigarettes on ground

  Yes

  No

  N/A

• Drive thru window is closed when no cars are in queue

  Yes

  No

  N/A

• Drive thru trash can is not overflowing

  Yes

  No

  N/A

• Drive thru equipment in good repair

  Yes

  No

  N/A

• Drive thru window is closed when no cars are in queue

  Yes

  No

  N/A

Entrance and patio of the Store

• Doors/Windows below 12 feet clean

  Yes

  No

  N/A

• Exterior door is not left open without air<br>curtain operating

  Yes

  No

  N/A

• Sidewalk/patio have no recent spills/no excessive trash on the ground

  Yes

  No

  N/A

• Trash can(s) are not over flowing

  Yes

  No

  N/A

• Tables/chairs are clean and in good repair

  Yes

  No

  N/A

• Umbrellas clean and in good repair

  Yes

  No

  N/A

• Building awnings/soffit in good condition/not weathered

  Yes

  No

  N/A

• Exterior walls in good repair

  Yes

  No

  N/A

• Awnings not excessively dirty

  Yes

  No

  N/A

Café: Entrance and Customer Seating Area

• Walk off mat clean

  Yes

  No

  N/A

• Walk off mats in good repair

  Yes

  No

  N/A

• Door threshold is clean

  Yes

  No

  N/A

• Doors are in good repair and rodent proof

  Yes

  No

  N/A

• No Smoking signage posted at all customer entrances (leading outdoors) and patio seating (NA - CA, FL, CO)

  Yes

  No

  N/A

• Café ledges clean and windows below 12 feet are clean

  Yes

  No

  N/A

• Windows above 12 feet clean

  Yes

  No

  N/A

• Café Ceiling/Ducting/Lighting/Vents below 12 feet clean and lights are not out or missing

  Yes

  No

  N/A

• No dust build up/splatter on 12.8 ceiling/vents/lighting in FOH above 12 feet

  Yes

  No

  N/A

• Café chairs/tables/lamps clean and in good<br>repair

  Yes

  No

  N/A

• Café floor fixtures (baskets/newspaper stands/black apron rack) are clean

  Yes

  No

  N/A

• Café retail shelving clean

  Yes

  No

  N/A

• Retail shelving not damaged

  Yes

  No

  N/A

Condiment Bar

General Cleanliness and Condition

• Condiment bar is free of excessive spills

  Yes

  No

  N/A

• No build up under napkin holders/in trash cabinet/under trash ring/under 11.1 sugar/sweetener pack container

  Yes

  No

  N/A

• No encrusted buildup in sugar/sweetener pack container

  Yes

  No

  N/A

• Condiment/stir stick containers clean

  Yes

  No

  N/A

• Condiment bar service plane is not excessively worn and is free of scuffs and gouges

  Yes

  No

  N/A

• Cabinet facings/hinges in good repair

  Yes

  No

  N/A

• Condiment bar is free of paint peeling

  Yes

  No

  N/A

• Cabinet with trash can is clean

  Yes

  No

  N/A

• Shelving not damaged

  Yes

  No

  N/A

• Check floors, walls, countertops, ceilings (refer<br>to page 8)

  Yes

  No

  N/A

Smallwares

• Condiment bar shaker tops are not dented or<br>otherwise damaged

  Yes

  No

  N/A

• All condiment bar shaker(s) labeled

  Yes

  No

  N/A

• Condiment bar shakers/carafes labels are not 1.1 peeling/worn/not readable

  Yes

  No

  N/A

• Exterior door is not left open without air curtain operating

  Yes

  No

  N/A

• Sidewalk/patio have no recent spills/no excessive trash on the ground

  Yes

  No

  N/A

• Trash can(s) are not over flowing

  Yes

  No

  N/A

• Tables/chairs are clean and in good repair

  Yes

  No

  N/A

• Umbrellas clean and in good repair

  Yes

  No

  N/A

• Building awnings/soffit in good condition/not weathered

  Yes

  No

  N/A

• Exterior walls in good repair

  Yes

  No

  N/A

• Awnings not excessively dirty

  Yes

  No

  N/A

Restrooms

Fixtures and condition

• Restroom fixtures clean (Hand sink / faucets/toilet/mirror/air fresheners/handrails/baby changing table)

  Yes

  No

  N/A

• Restroom faucets/drainpipes are not dripping/secure/free of damage

  Yes

  No

  N/A

• Approved soap/paper towel dispensers properly stocked and working

  Yes

  No

  N/A

• Soap is not stored in caramel bottle/syrup bottle at hand sink

  Yes

  No

  N/A

• Handwashing signs are present at hand sinks

  Yes

  No

  N/A

• Hand sink(s) have warm water 100-120 °F (38-49 °C)

  Yes

  No

  N/A

• Restroom fixtures are in good repair and free of graffiti (Handsink / faucets / toilet / mirror/ baby changing table/doors)

  Yes

  No

  N/A

• Paper towel/soap/toilet paper dispensers/sconce shade/garbage cans are in good repair and free of graffiti

  Yes

  No

  N/A

• Toilet tissue is loaded into the dispenser

  Yes

  No

  N/A

• No odor present

  Yes

  No

  N/A

General Cleanliness

• Restroom ceiling/lighting/walls in good repair with no graffiti present

  Yes

  No

  N/A

• No Smoking signage posted in restrooms where required (NYC & NM)

  Yes

  No

  N/A

• Food/food contact equipment not stored in restroom

  Yes

  No

  N/A

Pastry Case General Food Safety

• Ambient pre-packaged RTE food within code date at the POS

  Yes

  No

  N/A

• All products within the pastry case have signage

  Yes

  No

  N/A

• Allergen Signage present in pastry case

  Yes

  No

  N/A

• Warming display signage present 'For Display Only' (where applicable)

  Yes

  No

  N/A

• Non-PHF RTD within code date

  Yes

  No

  N/A

• Sandwiches/Boxes/Salads/Fruit Cups/Yogurt/Yogurt Parfaits within expiration date

  Yes

  No

  N/A

• Product is not stored over front vents in the RTD&E case

  Yes

  No

  N/A

• Stored multi-day pastries dated and within code date

  Yes

  No

  N/A

• Food items stored protected, approved food covering used (indicate product improperly stored)

  Yes

  No

  N/A

• Butter/Cream Cheese are not stored at room temperature in the upper portion of the pastry case

  Yes

  No

  N/A

• Potentially hazardous samples are actively sampled and not left at room temperature

  Yes

  No

  N/A

• No product above 41°F (Canada 40°F/4°C) in RTD/E case

  Yes

  No

  N/A

"Hand Sinks (FOH and BOH) Accessible and used properly "

• Handwashing is not taking place in FOH dump sink (and dedicated hand sink present)

  Yes

  No

  N/A

• Dumping or rinsing is not taking place in dedicated hand sink

  Yes

  No

  N/A

• Access to hand sink is not blocked by trash cans/product

  Yes

  No

  N/A

• Smallwares/Product/food/drinks are not stored in or on designated hand sink

  Yes

  No

  N/A

• Hand sink/faucet is clean

  Yes

  No

  N/A

• Faucets/drainpipes are not dripping/secure/free of damage

  Yes

  No

  N/A

All hand sinks properly stocked soap/paper towel dispenser functioning properly

• Approved soap/paper towel dispensers properly stocked and working (

  Yes

  No

  N/A

• Approved soap/paper towel dispensers properly stocked and working (

  Yes

  No

  N/A

• Soap is not stored in caramel bottle/syrup bottle at hand sink

  Yes

  No

  N/A

• No Scented hand lotion/unapproved hand soap/hand sanitizer present

  Yes

  No

  N/A

• Handwashing signs are present at hand sinks

  Yes

  No

  N/A

• Hot water available in store at hand sink 100-120°F (38-49 °C)

  Yes

  No

  N/A

"Warming Station Smallwares "

• For-here cups and plates are not chipped/cracked

  Yes

  No

  N/A

• For-here serveware stored clean

  Yes

  No

  N/A

• Cutlery free of rust and not bent

  Yes

  No

  N/A

• Warming tongs/knives are free of multiple dried on product build up

  Yes

  No

  N/A

• In-use tongs stored on a clean cutting board or other clean surface

  Yes

  No

  N/A

• Utensil holder not rusting/in poor repair

  Yes

  No

  N/A

• Cutting boards are free of visible dried build up in grooves

  Yes

  No

  N/A

• Food contact items are from an approved source and food grade

  Yes

  No

  N/A

• Silverware/unwrapped plasticware stored handles up

  Yes

  No

  N/A

• Silverware/ unwrapped plasticware not Stored with handles in multiple directions if laid flat

  Yes

  No

  N/A

• Silverware/ plasticware stored in clean container

  Yes

  No

  N/A

• Plexi cubes not cracked/chipped

  Yes

  No

  N/A

• In use plexi cubes are clean

  Yes

  No

  N/A

Oven

• Warming oven interior/hinges/back of oven clean/under tray

  Yes

  No

  N/A

• Oven tray is not cracked/chipped

  Yes

  No

  N/A

• Warming oven exterior/vents clean

  Yes

  No

  N/A

"Check floors, walls, countertops, ceilings (refer to page 8) Check refrigerator condition and cleanliness (refer to page 9) "

• Non-PHF food within code date

  Yes

  No

  N/A

• PHF foods within code date

  Yes

  No

  N/A

• Food items stored protected, approved food covering used (indicate product improperly stored)

  Yes

  No

  N/A

• Food contact items properly stored

  Yes

  No

  N/A

"Brewing Station/Backline Fixtures and condition "

• Faucet fixtures secure/free of damage/not dripping (including drainpipes)

  Yes

  No

  N/A

• Sink/faucet is clean

  Yes

  No

  N/A

• Sink/drain pan sealed to counter top

  Yes

  No

  N/A

Equipment

• Coffee Brewer maintained clean

  Yes

  No

  N/A

• Coffee grinder and scale maintained clean

  Yes

  No

  N/A

• Clover machine maintained clean

  Yes

  No

  N/A

Smallwares

• Spoodle/coffee scale scoop clean and free of chips/dents

  Yes

  No

  N/A

• Spoodle stored in a clean designated storage container

  Yes

  No

  N/A

• Tea tongs are stored in a clean designated storage container

  Yes

  No

  N/A

• 8 qt. cubes/lids are free of adhesive build up/stains/scratches/chips

  Yes

  No

  N/A

• Coffee filters stored covered and protected

  Yes

  No

  N/A

• Food contact items not stored under dripping condensate or sewage lines

  Yes

  No

  N/A

• Food contact items are from an approved source and food grade

  Yes

  No

  N/A

• Stored smallwares are clean

  Yes

  No

  N/A

• Clean smallwares stored covered/inverted/on a clean surface

  Yes

  No

  N/A

• Clean smallwares stored separated from non -food related items

  Yes

  No

  N/A

• Unpackaged cups/lids are stored inverted and in plexi cubes

  Yes

  No

  N/A

• Plexi cubes not cracked/broken/no peeling tape

  Yes

  No

  N/A

• In use plexi cubes are clean

  Yes

  No

  N/A

• Single use cups/lids/reusable cups are free of splash/splatter and stored away from splash range of sinks

  Yes

  No

  N/A

• Exposed lids store sip side up

  Yes

  No

  N/A

• Sample cups stored protected

  Yes

  No

  N/A

• Pour Over Brewing smallwares are clean and free of damage

  Yes

  No

  N/A

• Pour over brewing coffee scoop stored in clean designated container.

  Yes

  No

  N/A

• Pour over Brew graduated pitcher stored inverted

  Yes

  No

  N/A

• Airpots not chipped/excessively dented

  Yes

  No

  N/A

• Clover whisk and scraper clean, stored properly

  Yes

  No

  N/A

Food

• Food items stored protected, approved food covering used (indicate product improperly stored)

  Yes

  No

  N/A

• Food items not stored under dripping condensate or sewage lines (specify location)

  Yes

  No

  N/A

Coffee

• Ground coffee and whole bean coffee stored protected

  Yes

  No

  N/A

• Tea and whole bean coffee (including 5 pound bullets) is dated and within code date

  Yes

  No

  N/A

Operations

"DTO General Cleanliness and Condition "

• Drive thru window area clean handoff plane/window ledges/register area

  Yes

  No

  N/A

• Drive thru window is not left except during window interactions

  Yes

  No

  N/A

• Faucet fixtures secure/free of damage/not dripping (including drainpipes)

  Yes

  No

  N/A

• Cream dispenser clean

  Yes

  No

  N/A

• Check floors, walls, countertops, ceilings (refer to page 8)

  Yes

  No

  N/A

• Drive-thru display and equipment clean

  Yes

  No

  N/A

Under counters

• Gaskets clean and in good repair

  Yes

  No

  N/A

• Food items stored protected, approved food covering used (indicate product improperly stored)

  Yes

  No

  N/A

• Non-PHF RTD dated and within code date

  Yes

  No

  N/A

• Ambient pre-packaged RTE food within code date

  Yes

  No

  N/A

• Cream dispenser labeled with contents on exterior of unit

  Yes

  No

  N/A

• Thermometer does not have any breaks or gaps in the red gauge" line " in front

  Yes

  No

  N/A

• Cream dispenser is not above 41°F (Canada 40°F/4°C) not expired

  Yes

  No

  N/A

"Espresso Bar Equipment "

• Bar ice bins/caddies is absent of mold/slime build up

  Yes

  No

  N/A

• Bar ice bins/caddies covered and protected

  Yes

  No

  N/A

• Blender Pitcher Rinser (BPR) clean/no leaks from base or unit

  Yes

  No

  N/A

• Espresso Machine Clean top, sides, underneath, no dust or buildup

  Yes

  No

  N/A

• Espresso machine food parts clean-bean hopper clean and not damabed, and espresso pour spout clean and not damaged

  Yes

  No

  N/A

• Espresso machine steam wand and area above steam wand is free of dried on/encrusted build-up

  Yes

  No

  N/A

Food

• Milk/soy within code date

  Yes

  No

  N/A

• Steaming pitchers are labeled with product type and correct pitcher used when steaming beverage

  Yes

  No

  N/A

• Bar vanilla/chocolate/cinnamon/ sugar/cinnamon dolce/pumpkin spice powder shaker(s) labeled

  Yes

  No

  N/A

• Bar caramel/mocha squeeze bottles labeled

  Yes

  No

  N/A

• Food items stored protected at the bar, approved food covering used (indicate product improperly stored)

  Yes

  No

  N/A

• Food contact items are from and approved source and food grade

  Yes

  No

  N/A

• Food items not stored under dripping condensate or sewage lines at the bar

  Yes

  No

  N/A

• Samples not left uncovered on counter at the bar/handoff plane

  Yes

  No

  N/A

• PHF are not left on counter above 41°F (Canada 40°F/4°C) (milk/soy/Frappuccino/ whipped cream )

  Yes

  No

  N/A

• PHF samples are not left on the counter at room temperature

  Yes

  No

  N/A

• Beverage syrups within code date and dated - list flavor

  Yes

  No

  N/A

• Sauces (specify product) within code date and dated

  Yes

  No

  N/A

• Powders/mocha with in code date and dated

  Yes

  No

  N/A

• Whole bean coffee within code date (including 5 lb bullets)

  Yes

  No

  N/A

• Milk and Soy is not below 150°F/65.5°C

  Yes

  No

  N/A

• Milk is never re-steamed/no new milk added to steamed milk

  Yes

  No

  N/A

Sanitizer and Wiping Cloths

• No wiping cloths left sitting on counters/shelves/on or in sink

  Yes

  No

  N/A

• Wiping cloths are stored in container with sanitizer solution

  Yes

  No

  N/A

Smallwares

• Food contact items not stored under dripping condensate or sewage lines at the bar

  Yes

  No

  N/A

• Bar area stored smallwares put away clean

  Yes

  No

  N/A

• Bar area clean smallwares stored covered/inverted/on a clean surface

  Yes

  No

  N/A

• Bar area clean smallwares stored separated from non-food related items

  Yes

  No

  N/A

• Bar area smallwares have no peeling stickers/tape/adhesive residue

  Yes

  No

  N/A

• Single use cups/lids/reusable cups are free of splash/splatter and stored away from splash range of sinks

  Yes

  No

  N/A

• Exposed lids store sip side up

  Yes

  No

  N/A

• Sample cups stored protected

  Yes

  No

  N/A

• Splash sticks stored siren-side up

  Yes

  No

  N/A

• Ice scoops at bar are stored in clean designated storage container between use

  Yes

  No

  N/A

• Ice scoops at bar are free of chips/handle is not broken

  Yes

  No

  N/A

• Ice scoops are clean and free of splatter and adhesive build up, sanitized every 2 hours

  Yes

  No

  N/A

• Steaming pitchers/spoons are free of permanent milk build-up

  Yes

  No

  N/A

• Steaming pitchers/thermometers are rinsed after each use, sanitized every 2 hours

  Yes

  No

  N/A

• Dipper well does not contain any utensils/thermometers

  Yes

  No

  N/A

• Smallwares/sanitizer 2 hour timer is in place and running

  Yes

  No

  N/A

• In-use smallwares are washed, rinsed and sanitized every 2 hours.

  Yes

  No

  N/A

• All thermometers within calibration and are being used when required

  Yes

  No

  N/A

• Unpackaged cups/lids are stored inverted and in plexi cubes

  Yes

  No

  N/A

• Plexi cubes not cracked/broken/no peeling tape

  Yes

  No

  N/A

• In use plexi cubes are clean

  Yes

  No

  N/A

"Cold Beverage Station General Cleanliness and Condition "

• Blender(s)/housing clean

  Yes

  No

  N/A

• Blender shroud free of cracks or pieces missing

  Yes

  No

  N/A

• Blender Pitcher Rinser (BPR) clean including underside/no major leaks

  Yes

  No

  N/A

Equipment

• CBS ice bins/caddies/FoH ice machine is absent of mold/slime build up

  Yes

  No

  N/A

• CBS ice bins/caddies covered and protected

  Yes

  No

  N/A

• Thermometer does not have any breaks or gaps in the red gauge" line "

  Yes

  No

  N/A

Smallwares

• Ice scoops at CBS are stored in clean designated container

  Yes

  No

  N/A

• Ice scoops at CBS are free of chips and handle is not broken

  Yes

  No

  N/A

• Ice scoop is clean and free of splatter and adhesive build up, santized every 2 hours

  Yes

  No

  N/A

• Unpackaged cups/lids are stored inverted and in plexi cubes

  Yes

  No

  N/A

• Plexi cubes not cracked/broken

  Yes

  No

  N/A

• In use plexi cubes are clean

  Yes

  No

  N/A

• Single use cups/lids/reusable cups are free of splash/splatter and stored away from splash range of sinks

  Yes

  No

  N/A

• Exposed lids store sip side up

  Yes

  No

  N/A

• Sample cups stored protected

  Yes

  No

  N/A

• CBS pitchers/8 qt. cubes/lids are free of adhesive build up/stains/scratches or chips

  Yes

  No

  N/A

• Blender Pitchers/shakers/lids are free of stains/scratched/chips

  Yes

  No

  N/A

• In use banana tongs do not have multiple use build up and stored in a clean designated container

  Yes

  No

  N/A

• CBS for-here serveware cups/plates are not chipped/cracked and stored clean

  Yes

  No

  N/A

• In use blender pitchers and shaker lids stored properly/blender pitchers and shakers not stored stacked on top of another/pitcher or shaker lids not stored on the bottom of the overturned pitcher or shaker

  Yes

  No

  N/A

Food

• Dairy/Soy in reach in within date code

  Yes

  No

  N/A

• Tea and coffee pitcher(s) dated

  Yes

  No

  N/A

• Opened dry inclusion bags/pouches dated

  Yes

  No

  N/A

• CBS beverage syrups within code date and dated

  Yes

  No

  N/A

• CBS sauces/concentrates (specify product) within code date and dated

  Yes

  No

  N/A

• CBS powders/mocha with in code date and dated

  Yes

  No

  N/A

• Peeled bananas dated and within code date

  Yes

  No

  N/A

• CBS dry inclusions(DIDs)/protein powder/shakers labeled with contents

  Yes

  No

  N/A

• Caramel/mocha squeeze bottles labeled

  Yes

  No

  N/A

• Food items stored protected, approved food covering used (indicate product improperly stored)

  Yes

  No

  N/A

• In use banana tongs do not have multiple use build up and stored in a clean designated container

  Yes

  No

  N/A

• CBS for-here serveware cups/plates are not chipped/cracked and stored clean

  Yes

  No

  N/A

• In use blender pitchers and shaker lids stored properly/blender pitchers and shakers not stored stacked on top of another/pitcher or shaker lids not stored on the bottom of the overturned pitcher or shaker

  Yes

  No

  N/A

"BOH Dry Storage General Cleanliness and Condition "

• Shelving labeled and stocked appropriately

  Yes

  No

  N/A

• Items are not stored on floor preventing cleaning

  Yes

  No

  N/A

• Dry storage shelving clean

  Yes

  No

  N/A

• Water filtration system clean/no dust

  Yes

  No

  N/A

• No Dust build up/splatter on ceiling/vents/lighting in BOH over 12 feet

  Yes

  No

  N/A

• Doors are in good repair and rodent-proof

  Yes

  No

  N/A

• No bags of trash stored on floor in back room

  Yes

  No

  N/A

• Lid closed on back room wheeled trash can

  Yes

  No

  N/A

Smallwares

• Food contact items are from an approved source and food grade

  Yes

  No

  N/A

• Cambros or single use Coffee Travelers stored at least 6 (15 cm) off floor and not on merchandise risers/milk crates "

  Yes

  No

  N/A

• Cups, lids, napkins, pastry bags stored at least 6 (15 cm) off floor and not on merchandise risers/milk crates "

  Yes

  No

  N/A

• Clean smallwares stored clean and inverted on a clean surface or covered, not mingled with non-food contact items

  Yes

  No

  N/A

• Food scoops (non-ice) stored in a clean, designated container or in the food with handle extended

  Yes

  No

  N/A

Food

• Stored thawed multi-day pastries dated and within code date

  Yes

  No

  N/A

• Packaged coffee/unopend soy/juice VIA/syrups/other within code date

  Yes

  No

  N/A

• RTD beverage/whole bean coffee/packaged food/pastry for donation stored at least 6 (15 cm) off floor "

  Yes

  No

  N/A

• Dairy/Soy in reach in within date code

  Yes

  No

  N/A

• Food not stored on top of turned over milk crates/brown merchandise risers /FOH retail shelving/pastry trays on the floor, approved food covering used

  Yes

  No

  N/A

• Partner food/beverage is not stored on shelving next to dry goods, clean smallwares, or single use items and at least 12” below and away

  Yes

  No

  N/A

• No Drinking/Eating (or evidence of) in food storage/food prep area

  Yes

  No

  N/A

Mop Sink Area

• Mop sink area clean

  Yes

  No

  N/A

• No strong odors from drain

  Yes

  No

  N/A

• Wet floor signs/brooms/dust pans/vacuums/mop bucket clean and mop not stored in dirty water

  Yes

  No

  N/A

• Trash can(s) not over flowing

  Yes

  No

  N/A

"BOH Refrigeration Equipment Food "

• Check refrigerator/freezer condition and cleanliness

  Yes

  No

  N/A

• Dairy in BoH cooler is within code date

  Yes

  No

  N/A

• Trash can(s) not over flowing

  Yes

  No

  N/A

• Baskets clean and in good repair

  Yes

  No

  N/A

• No product above 41°F (Canada 40°F/4°C) In BoH refrigerator

  Yes

  No

  N/A

• Sandwiches/salads/yogurts are dated and within code date

  Yes

  No

  N/A

Ice Machine

• BOH ice machine has no mold/slime build up

  Yes

  No

  N/A

• BOH ice machine lid is closed

  Yes

  No

  N/A

• No evidence of paint peeling/rust on outside of ice machine

  Yes

  No

  N/A

• Interior of ice machine in good repair/free of damage and chips/gasket in good condition

  Yes

  No

  N/A

• BOH ice scoop is stored in designated storage container between use

  Yes

  No

  N/A

• BOH ice scoop is not chipped or handle broken and is clean and free of adhesive build-up

  Yes

  No

  N/A

• BOH ice scoop storage container/bucket interior clean

  Yes

  No

  N/A

• BOH ice bucket labeled Ice Only" "

  Yes

  No

  N/A

• BOH Ice bucket is free of chips/cracks

  Yes

  No

  N/A

• BOH ice bucket is not used for something other than ice

  Yes

  No

  N/A

• Ice machine exterior dirty

  Yes

  No

  N/A

Partner Habits

• Partner food/beverage stored in a labeled/lidded container on the bottom shelf /ledge of refrigerator/freezer

  Yes

  No

  N/A

"Dishwashing Area General Cleanliness and Condition "

• Flex drain hose not placed in sewer pipe

  Yes

  No

  N/A

• No sewage back up present in facility

  Yes

  No

  N/A

• Dish sink/sprayer clean

  Yes

  No

  N/A

• No soft sponges/magic eraser-like pads in food prep area/dish area

  Yes

  No

  N/A

• Approved scouring pad/brushes are free of damage

  Yes

  No

  N/A

• Clean drain board free of anything other than clean dishes

  Yes

  No

  N/A

• WASH/RINSE/SANITIZE labels present/in correct order/free of damage

  Yes

  No

  N/A

• Dish compartment sink has hot water (120 °F in CA)

  Yes

  No

  N/A

• Faucets/drainpipes are not dripping/secure/free of damage

  Yes

  No

  N/A

• Shelving above dish sink clean

  Yes

  No

  N/A

• No towels left sitting on counters/shelves/on or in sink

  Yes

  No

  N/A

• Check floors, walls, countertops, ceilings

  Yes

  No

  N/A

Dishmachine

• Dishmachine and dishmachine door is clean

  Yes

  No

  N/A

• At least ½” of Supra is present in the auto feed container of detergent/pump for Supra available in stores without red auto-feed tube

  Yes

  No

  N/A

• Rinse cycle did reach 180°F on panel read-out for high temp machine (HTM)

  Yes

  No

  N/A

• Sani-NC (US)/UltraSan (CAN) is present in auto feed container for low temp machines

  Yes

  No

  N/A

• Chlorine sanitizer concentration is 50-200ppm for low temp dishmachine only

  Yes

  No

  N/A

• Clear auto-feed tube is not in Supra (clear is for chlorine sanitizer low temp machines only)

  Yes

  No

  N/A

• Rinse-Aid auto-feed (blue) tube coiled and tucked behind machine

  Yes

  No

  N/A

• Feed back

• Sm or supervisor signature

  Sign

• Dm signature

  Sign