Title Page
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Client / Site
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Conducted on
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Prepared by
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Location
Customer Area
Exterior of the Store
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Drive Thru Lane
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Drive thru menu boards/speakers are clean
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Drive thru lane does not have trash/cigarettes on ground
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Drive thru window area clean
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Drive thru window is closed when no cars are in queue
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Drive thru trash can is not overflowing
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Drive thru menu boards in good repair
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Dumpster/Trash Area
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External recycling/compost bins present and in use or curbside pickup used where applicable
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Entrance and patio of the Store
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Doors/Windows below 12 feet clean
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Exterior door is not left open without air curtain operating
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Sidewalk/patio have no recent spills/no excessive trash on the ground
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Trash can(s) are not over flowing
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Tables/chairs are clean and in good repair
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Planters are clean and in good repair
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Umbrellas clean and in good repair, locked into place
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Building awnings/soffit in good condition/not weathered
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Exterior walls in good repair
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Landscaping clean and in good condition
Café: Entrance and Customer
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General Cleanliness and Condition
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Walk off mat clean
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Walk off mats in good repair
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Door threshold is clean
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Doors are in good repair and rodent proof
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No Smoking signage posted at all customer entrances (leading outdoors) (NA - CA, FL, CO)
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Café ledges clean and windows below 12 feet are clean
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Windows above 12 feet clean
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Café Ceiling/Ducting/Lighting/Vents below 12 feet clean and lights are not out or missing
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No dust build up/splatter on ceiling/vents/lighting in FOH above 12 feet
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No lighting burned out at or above 12 feet
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Café chairs/tables/lamps clean and in good repair
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Café floor fixtures (baskets/newspaper stands/black apron rack) are clean
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Café retail shelving clean
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Retail shelving not damaged
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Food
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Retail packaged coffee within code date
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Ambient pre-packaged RTE food within code date (Madelines date coded)
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Recycling/Compost Bins
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Customer recycling and/or compost bin is present near the condiment bar or entrance with dividers and appropriate bags, where applicable (Bags: blue=recycling, green=compost, clear=trash)
Restrooms
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Fixtures and condition
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Restroom fixtures clean (Hand sink / faucets/toilet/mirror/air fresheners/handrails/baby changing table)
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Restroom faucets/drainpipes are not dripping/secure/free of damage/scald guard present
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Approved soap/paper towel dispensers properly stocked and working
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Soap is not stored in caramel bottle/syrup bottle at hand sink
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Handwashing signs are present at hand sinks
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Hand sink(s) have warm water 100-120 °F (38-49 °C)
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Restroom fixtures are in good repair and free of graffiti (Handsink /faucets / toilet / mirror/ baby changing table/doors)
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Paper towel/soap/toilet paper dispensers/sconce shade/garbage cans are in good repair and free of graffiti
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Toilet tissue is loaded into the dispenser and not available to customers outside of the dispenser.
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No odor present
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General Cleanliness
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Restroom ceiling/lighting/walls in good repair with no graffiti present
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No Smoking signage posted in restrooms where required (NYC & NM)
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Food/food contact equipment not stored in restroom
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Floor/Walls/Ceiling
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Floors are free of excessive crumbs/trash/debris
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Floors are free of dark encrusted build-up
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Floors/cove molding/concrete in good repair
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Trash cans not overflowing
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Ceiling/Lighting/Vents below 12 feet maintained clean and no lights are out/missing
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Ceiling is free of water damage and chipped paint/paint repair color matches
Condiment Bar
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General Cleanliness and Condition
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Condiment bar is free of excessive spills
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No build up under napkin holders/in trash cabinet/under trash ring/under sugar/sweetener pack container
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No encrusted buildup in sugar/sweetener pack container
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Condiment/stir stick containers clean
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Cabinet with trash can is clean
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Smallwares
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Condiment bar shaker tops are not dented or otherwise damaged
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All condiment bar shaker(s) labeled
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Condiment bar shakers/carafes labels are not peeling/worn/not readable
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Condiment bar shakers/Carafes are not visibly dirty
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Condiment bar carafes are not chipped/scratched/dented or otherwise damaged
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Condiment bar carafes do not have adhesive buildup
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Condiment bar bulk sugar container labeled
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Food
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Condiment bar packages within code date and open packages dated vanilla/chocolate/cinnamon/nutmeg
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Food items stored protected, approved food covering used (indicate product improperly stored)
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Food contact items properly stored
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All Carafes are <41°F (Canada 40°F/4°C)
Pastry Case Station
Pastry Case
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General Food Safety
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Ambient pre-packaged RTE food within code date at the POS
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All products within the pastry case have signage
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Allergen Signage present in pastry case
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Warming display sticker present For Display Only
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Non-PHF RTD within code date
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Sandwiches/Boxes/Salads/Fruit Cups/Yogurt Parfaits within expiration date
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Product is not stored over front vents in the RTD&E case
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Stored multi-day pastries dated and within code date
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Food items stored protected, approved food covering used (indicate product improperly stored)
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Butter/Cream Cheese are not stored at room temperature in the upper portion of the pastry case
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Potentially hazardous samples are actively sampled and not left at room temperature
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No product above 41°F (Canada 401/4°C) in RTD/E case
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Equipment and Smallwares
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Pastry tongs are free of multiple dried on product build up
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In-use tongs stored in a clean designated container
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External rear grill area (vent/condenser coils) and filter cover clean/free of dust
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No damaged shelves, broken pieces
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Internal lighting working in case
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Pastry cart clean/free of dust
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Baskets on front of pastry case are clean and free of crumbs
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Thermocouple present in the store/working/in good repair/calibrated (Sandwich stores only) (Critical)
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General Cleanliness
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Top portion of the pastry case clean and free of crumbs
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Floor/Walls/Ceiling
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Floors are free of excessive crumbs/trash/debris (including under refrigerators and cabinetry)
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Floors are free of dark encrusted build-up (including under refrigerators and cabinetry)
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Floors/cove molding/concrete in good repair
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Trash/Recycling/Compost cans not overflowing
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Recycling and/or compost bins are present where applicable and have appropriate bags and labels on designated bins and/or cabinet doors (Bags: blue=recycling, green=compost, clear=trash)
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Cabinet doors/drawers/hinges/facings/handles in good repair
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Cabinets are free of water damage/rot and no bare wood exposed
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Cabinets and drawers clean
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Countertops (including under equipment) clean
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Countertops have no peeling stickers/adhesive residue on counter
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Countertops sealed to wall/splash guard juncture/horizontal gaps
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Countertops not excessively worn/damaged/pitted and facings in good repair
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Signage clean
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Walls clean
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Walls free of bare wood/exposed dry wall/covering are secure and intact/chipped paint/holes
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Ceiling/Lighting/Vents below 12 feet maintained clean and no lights are out/missing
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Ceiling/Lighting/Vents at or above 12 feet maintained clean and no lights are out/missing
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Ceiling is free of water damage and chipped paint/paint repair color matches
REFRIGERATORS, FREEZERS and CHILLED CASES
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Thermometer located in front of case or refrigerator
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Thermometer does not have any breaks or gaps in the red "gauge" line /All broken thermometers removed from the equipment
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Refrigerator/food case is not above 41°F (Canada 401/4°C)
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Refrigerator is clean (shelves/fan guards/ interior/exterior/floor)
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Refrigerator shelves/door free of damage
Warming Station
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Smallwares
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For-here cups and plates are not chipped/cracked
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For-here serveware stored clean
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Cutlery free of rust and not bent
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Warming tongs/knives are free of multiple dried on product build up
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In-use tongs stored on a clean cutting board or other clean surface
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Utensil holder not rusting/in poor repair
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Cutting boards are free of visible dried build up in grooves
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Food contact items are from an approved source and food grade
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Silverware/unwrapped plasticware stored handles up
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Silverware/ unwrapped plasticware not Stored with handles in multiple directions if laid flat
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Silverware/ plasticware stored in clean container
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Plexi cubes not cracked/chipped
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In use plexi cubes are clean
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Oven
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Warming oven interior/hinges/back of oven clean/under tray
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Warming oven exterior/vents clean
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Oven tray is not cracked/chipped
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Food
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Non-PHF food within code date
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PHF foods within code date
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Food items stored protected, approved food covering used (indicate product improperly stored)
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Food contact items properly stored
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Floor/Walls/Ceiling
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Floors are free of excessive crumbs/trash/debris (including under refrigerators and cabinetry)
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Floors are free of dark encrusted build-up (including under refrigerators and cabinetry)
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Floors/cove molding/concrete in good repair
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Trash/Recycling/Compost cans not overflowing
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Recycling and/or compost bins are present where applicable and have appropriate bags and labels on designated bins and/or cabinet doors (Bags: blue=recycling, green=compost, clear=trash)
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Drains clean/no strong odors present
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Cabinet doors/drawers/hinges/facings/handles in good repair
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Cabinets are free of water damage/rot and no bare wood exposed/no cabinet built over drain with no access
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Cabinets and drawers clean
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Countertops (including under equipment) clean
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Shelving not damaged in cabinetry
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Countertops have no peeling stickers/adhesive residue on counter
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Countertops sealed to wall/splash guard juncture/horizontal gaps
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Countertops not excessively worn/damaged/pitted and facings in good repair
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Sink/ice bin/drain pan sealed to counter top
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Signage clean
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Walls clean including behind oven (free of grease & splatter)
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Walls free of bare wood/exposed dry wall/covering are secure and intact/chipped paint/holes
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Ceiling/Lighting/Vents below 12 feet maintained clean and no lights are out/missing
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Ceiling/Lighting/Vents at or above 12 feet maintained clean and no lights are out/missing
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Ceiling is free of water damage and chipped paint/paint repair color matches
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No ceiling tiles missing/dislodged, sprinkler rings not missing
REFRIGERATORS, FREEZERS and CHILLED CASES
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Thermometer located in front of case or refrigerator
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Thermometer does not have any breaks or gaps in the red "gauge" line /All broken thermometers removed from the equipment
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Refrigerator/food case is not above 41°F (Canada 40°F/4°C)
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Product temperature is at or below 41°F (Canada 40°F/4°C)
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Refrigerator is clean (shelves/fan guards/ interior/exterior/floor)
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FOH Refrigerator gaskets clean and not damaged (ordered/replaced by store)
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Refrigerator shelves/door free of damage
Brewing Station
Brewing Station/Backline
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Fixtures and condition
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Faucet fixtures secure/free of damage/not dripping (including drainpipes)
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Sink/faucet is clean
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Sink/drain pan sealed to counter top
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Equipment
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Coffee Brewer maintained clean
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Coffee warmers maintained clean
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Coffee grinder and scale maintained clean
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Bunn membrane discolored or damaged
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Clover machine maintained clean
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Smallwares
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Spoodle/coffee scale scoop clean and free of chips/dents
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Spoodle stored in a clean designated storage container
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Tea tongs are stored in a clean designated storage container
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8 qt. cubes/lids are free of adhesive build up/stains/scratches/chips
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Coffee filters stored covered and protected
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Food contact items not stored under dripping condensate or sewage lines
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Food contact items are from an approved source and food grade
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Stored smallwares are clean
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Clean smallwares stored covered/inverted/on a clean surface
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Clean smallwares stored separated from non -food related items
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Unpackaged cups/lids are stored inverted and in plexi cubes
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Plexi cubes not cracked/broken/no peeling tape
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In use plexi cubes are clean
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Single use cups/lids/reusable cups are free of splash/splatter and stored away from splash range of sinks
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Exposed lids store sip side up
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Sample cups stored protected
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Pour Over Brewing smallwares are clean and free of damage
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Pour over brewing coffee scoop stored in clean designated container
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Airpots not chipped/excessively dented
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Airpots labeled
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Clover whisk and scraper clean, stored properly
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Coffee
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Ground coffee and whole bean coffee stored protected
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Ground coffee for pour over dated
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Tea and whole bean coffee (including 5 pound bullets) is dated and within code date
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Food
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Food items stored protected, approved food covering used (indicate product improperly stored)
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Food items not stored under dripping condensate or sewage lines (specify location)
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Floor/Walls/Ceiling
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Floors are free of excessive crumbs/trash/debris (including under refrigerators and cabinetry)
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Floors are free of dark encrusted build-up (including under refrigerators and cabinetry)
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Floors/cove molding/concrete in good repair
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Trash/Recycling/Compost cans not overflowing
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Recycling and/or compost bins are present where applicable and have appropriate bags and labels on designated bins and/or cabinet doors (Bags: blue=recycling, green=compost, clear=trash)
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Drains clean/no strong odors present
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Cabinet doors/drawers/hinges/facings/handles in good repair
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Cabinets are free of water damage/rot and no bare wood exposed/no cabinet built over drain with no access
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Cabinets and drawers clean
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Countertops (including under equipment) clean
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Shelving not damaged in cabinetry
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Countertops have no peeling stickers/adhesive residue on counter
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Countertops sealed to wall/splash guard juncture/horizontal gaps
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Countertops not excessively worn/damaged/pitted and facings in good repair
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Signage clean
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Walls clean
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Walls free of bare wood/exposed dry wall/covering are secure and intact/chipped paint/holes
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Ceiling/Lighting/Vents below 12 feet maintained clean and no lights are out/missing
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Ceiling/Lighting/Vents at or above 12 feet maintained clean and no lights are out/missing
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Ceiling is free of water damage and chipped paint/paint repair color matches
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No ceiling tiles missing/dislodged, sprinkler rings not missing
CBS Station
Cold Beverage Station
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General Cleanliness and Condition
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Sure Shot FMD is not above 41° F (Canada 407/4°C)
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Blender(s)/housing clean
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Blender shroud free of cracks or pieces missing
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Blender Pitcher Rinser (BPR) clean including underside/no major leaks
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Smallwares
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Ice scoops at CBS are stored in clean designated container
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Ice scoops at CBS are free of chips and handle is not broken
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Ice scoop is clean and free of splatter and adhesive build up, sanitized every 2 hours
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Unpackaged cups/lids are stored inverted and in plexi cubes
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Plexi cubes not cracked/broken
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In use plexi cubes are clean
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Single use cups/lids/reusable cups are free of splash/splatter and stored away from splash range of sinks
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Exposed lids store sip side up
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Sample cups stored protected
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CBS pitchers/8 qt. cubes/lids are free of adhesive build up/stains/scratches or chips
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Blender Pitchers/shakers/lids are free of stains/scratched/chips
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In use banana tongs do not have multiple use build up and stored in a clean designated container
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CBS for-here serveware cups/plates are not chipped/cracked and stored clean
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FIZZIO lids are stored in a separate container, not in water
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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
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Equipment
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CBS ice bins/caddies/FoH ice machine is absent of mold/slime build up
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CBS ice bins/caddies covered and protected , in good condition
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FIZZIO carbonation machine clean, clamp without build up
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Sure Shot Frappuccino Milk Dispenser (FMD) and cream dispensers labeled with contents on exterior of unit
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Sure Shot/Frappuccino Milk Dispenser (FMD) is clean
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Thermometer located in Sure Shot/Frappuccino Milk Dispenser (FMD)
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Nitro cold brew unit interior and exterior clean, gaskets in good condition
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Thermometer does not have any breaks or gaps in the red "gauge" line
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Food
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Dairy/Soy in reach in within date code
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Tea and coffee pitcher(s) dated
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Opened dry inclusion bags/pouches dated
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CBS beverage syrups within code date and dated
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CBS sauces/concentrates (specify product)/soda mixes/refreshers mixes within code date and dated
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CBS powders/mocha with in code date and dated
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Peeled bananas dated and within code date
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CBS dry inclusions(DIDs)/protein powder/shakers labeled with contents
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All squeeze bottles labeled
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Food items stored protected, approved food covering used (indicate product improperly stored)
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PHF are not left on counter above 41°F (Canada 407/4°C) (milk/soy/coconut/ whipped cream )
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PHF samples are not left on the counter at room temperature
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Floor/Walls/Ceiling
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Floors are free of excessive crumbs/trash/debris (including under refrigerators and cabinetry)
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Floors are free of dark encrusted build-up (including under refrigerators and cabinetry)
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Floors/cove molding/concrete in good repair
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Trash/Recycling/Compost cans not overflowing
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Recycling and/or compost bins are present where applicable and have appropriate bags and labels on designated bins and/or cabinet doors (Bags: blue=recycling, green=compost, clear=trash)
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Drains clean/no strong odors present
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Cabinet doors/drawers/hinges/facings/handles in good repair
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Cabinets are free of water damage/rot and no bare wood exposed/no cabinet built over drain with no access
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Cabinets and drawers clean
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Countertops (including under equipment) clean
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Shelving not damaged in cabinetry
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Countertops have no peeling stickers/adhesive residue on counter
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Countertops sealed to wall/splash guard juncture/horizontal gaps
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Countertops not excessively worn/damaged/pitted and facings in good repair
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Sink/ice bin/drain pan sealed to counter top
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Signage clean
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Walls clean
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Walls free of bare wood/exposed dry wall/covering are secure and intact/chipped paint/holes
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Ceiling/Lighting/Vents below 12 feet maintained clean and no lights are out/missing
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Ceiling/Lighting/Vents at or above 12 feet maintained clean and no lights are out/missing
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Ceiling is free of water damage and chipped paint/paint repair color matches
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No ceiling tiles missing/dislodged, sprinkler rings not missing
REFRIGERATORS, FREEZERS and CHILLED
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Thermometer located in front of case or refrigerator
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Thermometer does not have any breaks or gaps in the red "gauge" line /All broken thermometers removed from the equipment
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Refrigerator/food case is not above 41°F (Canada 407/4°C)
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Product temperature is at or below 41°F (Canada 407/4°C)
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Refrigerator is clean (shelves/fan guards/ interior/exterior/floor)
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FOH Refrigerator gaskets clean and not damaged (ordered/replaced by store)
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Refrigerator shelves/door free of damage
Espresso Bar Station
Espresso Bar
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Equipment
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Bar ice bins/caddies is absent of mold/slime build up
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Bar ice bins/caddies covered and protected
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Blender Pitcher Rinser (BPR) clean/no leaks from base or unit
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Espresso Machine Clean
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Top of espresso machine clean/no dust
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Espresso machine food parts clean-bean hopper clean and not damaged, and espresso pour spout clean and not damaged
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Espresso machine steam wand and area above steam wand is free of dried on/encrusted build-up
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Espresso drain pan and plug present, Mastrena logo present
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Dish area clean (if in FoH)
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Food
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Milk/soy within code date
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Steaming pitchers are labeled with product type and correct pitcher used when steaming beverage
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Bar vanilla/chocolate/cinnamon/ sugar/cinnamon dolce/pumpkin spice powder shaker(s) labeled
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Bar caramel/mocha squeeze bottles labeled
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Food items stored protected at the bar, approved food covering used (indicate product improperly stored)
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Food contact items are from and approved source and food grade
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Food items not stored under dripping condensate or sewage lines at the bar
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Samples not left uncovered on counter at the bar/handoff plane
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PHF are not left on counter above 41°F (Canada 40°F/4°C) (milk/soy/cocount/ whipped cream )
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PHF samples are not left on the counter at room temperature
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Beverage syrups within code date and dated - list flavor
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Sauces (specify product) within code date and dated
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Powders/mocha with in code date and dated
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Whole bean coffee within code date (including 5 lb bullets)
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Milk and Soy is not below 150°F/65.5°C
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Milk is never re-steamed/no new milk added to steamed milk
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Sanitizer and Wiping Cloths
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No wiping cloths left sitting on counters/shelves/on or in sink
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Wiping cloths are stored in container with sanitizes solution
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Smallwares
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Food contact items not stored under dripping condensate or sewage lines at the bar
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Bar area stored smallwares put away clean
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Bar area clean smallwares stored covered/inverted/on a clean surface
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Bar area clean smallwares stored separated from non-food related items
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Bar area smallwares have no peeling stickers/tape/adhesive residue
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Single use cups/lids/reusable cups are free of splash/splatter and stored away from splash range of sinks
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Exposed lids store sip side up
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Sample cups stored protected
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Splash sticks stored siren-side up
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Ice scoops at bar are stored in clean designated storage container between use
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Ice scoops at bar are free of chips/handle is not broken
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Ice scoops are clean and free of splatter and adhesive build up, sanitized every 2 hours
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Steaming pitchers/spoons are free of permanent milk build-up
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Steaming pitchers/thermometers are rinsed after each use, sanitized every 2 hours
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Dipper well does not contain any utensils/thermometers
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Utensils/thermometers are not stored in container with stagnant water
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Smallwares 2 hour timer is in place and running
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In-use smallwares are washed, rinsed and sanitized every 2 hours.
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All thermometers within calibration and are being used when required
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Unpackaged cups/lids are stored inverted and in plexi cubes
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Plexi cubes not cracked/broken/no peeling tape
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In use plexi cubes are clean
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Floor/Walls/Ceiling
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Floors are free of excessive crumbs/trash/debris (including under refrigerators and cabinetry)
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Floors are free of dark encrusted build-up (including under refrigerators and cabinetry)
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Floors/cove molding/concrete in good repair
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Trash/Recycling/Compost cans not overflowing
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Recycling and/or compost bins are labeled/present where applicable
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Drains clean/no strong odors present
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Cabinet doors/drawers/hinges/facings/handles in good repair
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Cabinets are free of water damage/rot and no bare wood exposed/no cabinet built over drain with no access
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Cabinets and drawers clean
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Countertops (including under equipment) clean
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Shelving not damaged in cabinetry
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Countertops have no peeling stickers/adhesive residue on counter
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Countertops sealed to wall/splash guard juncture/horizontal gaps
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Countertops not excessively worn/damaged/pitted and facings in good repair
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Sink/ice bin/drain pan sealed to counter top
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Signage clean
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Walls clean
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Walls free of bare wood/exposed dry wall/covering are secure and intact/chipped paint/holes
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Ceiling/Lighting/Vents below 12 feet maintained clean and no lights are out/missing
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Ceiling/Lighting/Vents at or above 12 feet maintained clean and no lights are out/missing
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Ceiling is free of water damage and chipped paint/paint repair color matches
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No ceiling tiles missing/dislodged, sprinkler rings not missing
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Recycling/Compost Bins
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Partner facing sorting guide magnet present on an under counter refrigerator
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Recycling and/or compost bins are present where applicable and have appropriate bags and labels on designated bins and/or cabinet doors (Bags: blue=recycling, green=compost, clear=trash)
REFRIGERATORS, FREEZERS and CHILLED
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Thermometer located in front of case or refrigerator
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Thermometer does not have any breaks or gaps in the red "gauge" line /All broken thermometers removed from the equipment
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Refrigerator/food case is not above 41°F (Canada 40°F/4°C)
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Product temperature is at or below 41°F (Canada 40°F/4°C)
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Refrigerator is clean (shelves/fan guards/ interior/exterior/floor)
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FOH Refrigerator gaskets clean and not damaged (ordered/replaced by store)
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Refrigerator shelves/door free of damage
DT Area Behind Counter Station
Drive Thru Area Behind Counter
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General Cleanliness and Condition
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Drive thru window area clean handoff plane/window ledges/register area
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Drive thru window is not left except during window interactions
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Faucet fixtures secure/free of damage/not dripping (including drainpipes)
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Cream dispenser clean
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Espresso Machine Clean
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Top of espresso machine clean/no dust
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Espresso machine food parts clean-bean hopper clean and not damaged, and espresso pour spout clean and not damaged
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Espresso machine steam wand and area above steam wand is free of dried on/encrusted build-up
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Espresso drain pan and plug present, Mastrena logo present
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No lighting burned out at or above 12 feet. Drive-thru display and equipment clean
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Food
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Food items stored protected, approved food covering used (indicate product improperly stored)
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Non-PHF RTD dated and within code date
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Ambient pre-packaged RTE food within code date
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Cream dispenser labeled with contents on exterior of unit
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Thermometer located in the front of Cream Dispenser (where applicable)
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Thermometer does not have any breaks or gaps in the red "gauge" line
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Cream dispenser is not above 41°F (Canada 401/4°C)
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Cream dispenser contents dated and within code date
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PHF are not left on counter above 41°F (Canada 40°F/4°C) (milk/soy/cocount/ whipped cream )
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PHF samples are not left on the counter at room temperature
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Floor/Walls/Ceiling
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Floors are free of excessive crumbs/trash/debris (including under refrigerators and cabinetry)
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Floors are free of dark encrusted build-up (including under refrigerators and cabinetry)
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Floors/cove molding/concrete in good repair
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Trash/Recycling/Compost cans not overflowing
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Recycling and/or compost bins are present where applicable and have appropriate bags and labels on designated bins and/or cabinet doors (Bags: blue=recycling, green=compost, clear=trash)
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Drains clean/no strong odors present
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Cabinet doors/drawers/hinges/facings/handles in good repair
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FY17 QASA Self Assessment
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Cabinets and drawers clean
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Countertops (including under equipment) clean
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Shelving not damaged in cabinetry
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Countertops have no peeling stickers/adhesive residue on counter
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Countertops sealed to wall/splash guard juncture/horizontal gaps
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Countertops not excessively worn/damaged/pitted and facings in good repair
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Sink/ice bin/drain pan sealed to counter top
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Signage clean
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Walls clean
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Walls free of bare wood/exposed dry wall/covering are secure and intact/chipped paint/holes
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Ceiling/Lighting/Vents below 12 feet maintained clean and no lights are out/missing
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Ceiling/Lighting/Vents at or above 12 feet maintained clean and no lights are out/missing
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Ceiling is free of water damage and chipped paint/paint repair color matches
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No ceiling tiles missing/dislodged, sprinkler rings not missing
REFRIGERATORS, FREEZERS and CHILLED
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Thermometer located in front of case or refrigerator
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Thermometer does not have any breaks or gaps in the red "gauge" line /All broken thermometers removed from the equipment
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Refrigerator/food case is not above 41°F (Canada 40°F/4°C)
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Product temperature is at or below 41°F (Canada 40°F/4°C)
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Refrigerator is clean (shelves/fan guards/ interior/exterior/floor)
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FOH Refrigerator gaskets clean and not damaged (ordered/replaced by store)
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Refrigerator shelves/door free of damage
BOH Dry Storage and Refrigeration
BOH Dry Storage
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General Cleanliness and Condition
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Items are not stored on floor preventing cleaning
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Dry storage shelving/BOH prep station clean
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Water filtration system clean/no dust
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No Dust build up/splatter on ceiling/vents/lighting in BOH over 12 feet
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Doors are in good repair and rodent-proof
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No lighting burned out at or above 12 feet
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No bags of trash stored on floor in back room
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Lid closed on back room wheeled trash can
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Smallwares
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Food contact items are from an approved source and food grade
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Cambros or single use Coffee Travelers stored at least 6" (15 cm) off floor and not on merchandise risers/milk crates
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Cups, lids, napkins, pastry bags stored at least 6" (15 cm) off floor and not on merchandise risers/milk crates
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Clean smallwares stored clean and inverted on a clean surface or covered, not mingled with non-food contact items
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Food scoops (non-ice) stored in a clean, designated container or in the food with handle extended
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Food
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Stored thawed multi-day pastries dated and within code date
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Packaged coffee/unopened soy/juice VIA/syrups/other within code date
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RTD beverage/whole bean coffee/packaged food/pastry for donation stored at least 6" (15 cm) off floor
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Dairy/Soy in reach in within date code
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Salt used for water sofeners stored 6" off the floor and away from chemicals or contamination
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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
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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
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No Drinking/Eating (or evidence of) in food storage/food prep area
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Mop Sink Area
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Mop sink area clean
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No strong odors from drain
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Wet floor signs/brooms/dust pans/vacuums/mop bucket clean and mop not stored in dirty water
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Trash/recycling/compost can(s) not over flowing
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Floor/Walls/Ceiling
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Floors are free of excessive crumbs/trash/debris (including under refrigerators and cabinetry)
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Floors are free of dark encrusted build-up (including under refrigerators and cabinetry)
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Trash/recycling/compost cans not overflowing
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Recycling and/or compost bins are labeled/present where appliable
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Drains clean/no strong odors present
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Walls clean
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Walls free of bare wood/exposed dry wall/covering are secure and intact/chipped paint/holes
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Ceiling/Lighting/Vents below 12 feet maintained clean and no lights are out/missing
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Ceiling/Lighting/Vents at or above 12 feet maintained clean and no lights are out/missing
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Ceiling is free of water damage and chipped paint/paint repair color matches
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No ceiling tiles missing/dislodged, sprinkler rings not missing
BOH Refrigeration Equipment
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Food
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Dairy in BoH refrigerator is within code date
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Sandwiches/salads/yogurts are dated and within code date
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No product above 41°F (Canada 40°F/4°C) In BoH refrigerator
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Non PHF RTD within code date
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Ice Machine
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BOH ice machine has no mold/slime build up
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BOH ice machine lid is closed
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No evidence of paint peeling/rust on outside of ice machine
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Interior of ice machine in good repair/free of damage and chips/gasket in good condition
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BOH ice scoop is stored in designated storage container between use
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BOH ice scoop is not chipped or handle broken and is clean and free of adhesive build-up
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BOH ice scoop storage container/bucket interior clean
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BOH ice bucket labeled "Ice Only
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BOH Ice bucket is free of chips/cracks
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BOH ice bucket is not used for something other than ice
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Ice machine exterior dirty
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Partner Habits
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Partner food/beverage stored in a labeled/lidded container on the bottom shelf /ledge of refrigerator/freezer
REFRIGERATORS, FREEZERS and CHILLED CASES
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Thermometer located in front of case or refrigerator/freezer
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Thermometer does not have any breaks or gaps in the red "gauge" line /All broken thermometers removed from the equipment
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Refrigerator/food case is not above 41°F (Canada 40°F/4°C)
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Product temperature is at or below 41°F (Canada 40°F/4°C)
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Refrigerator/freezer is clean (shelves/fan guards/ interior/exterior/floor)
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Freezer air temperature below 0°F (-18°C)
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Light working in BoH refrigerator/ freezer
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BOH refrigerator/freezer gasket present and free of damage (ordered/replaced by store)
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Refrigerator/freezer shelves/door free of damage
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Items are not stored on top of BOH refrigerator or freezer blocking vents
Dishwashing and Handsinks Station
Dishwashing Area
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General Cleanliness and Condition
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Equipment drain lines from dishwasher/ice machine not placed in sewer pipe
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Dish sink/sprayer clean
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No soft sponges/magic eraser-like pads in food prep area/dish area
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Approved scouring pad/brushes are free of damage
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Clean drain board free of anything other than clean dishes
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WASH/RINSE/SANITIZE labels present/in correct order/free of damage
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Dish compartment sink has hot water (120 °F in CA)
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Shelving above dish sink clean
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No towels left sitting on counters/shelves/on or in sink
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Smallwares
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Smallwares are not chipped/cracked and stored clean
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Clean smallwares stored clean and inverted on a clean surface or covered, not mingled with non-food contact items
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Dishmachine
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Dishmachine and dishmachine door is clean
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At least 3.4" of detergent is present in the auto feed container of
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detergent/pump available in stores without red auto-feed tube
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Rinse-Aid auto-feed (blue) tube coiled and tucked behind machine (BOTH Low Temp and High Temp Dishmachines)
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Rinse cycle did reach 180°F on panel read-out for high temp machine (HTM)
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Sani-NC (US)/UltraSan (CAN) is present in auto feed container for low temp machines
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Chlorine sanitizer concentration is 50-200ppm for low temp dishmachine only
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Clear auto-feed tube is not in detergent (clear is for chlorine sanitizer low temp machines only)
Hand Sinks (FOH and BOH)
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Accessible and used properly
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Handwashing is not taking place in FOH dump sink (and dedicated hand sink present)
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Dumping or rinsing is not taking place in dedicated hand sink
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Access to hand sink is not blocked by trash cans/product
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Smallwares/Product/food/drinks are not stored in or on designated hand sink
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Hand sink/faucet is clean
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All hand sinks properly stocked soap/paper towel dispenser functioning properly
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Approved soap/paper towel dispensers properly stocked and working
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Soap is not stored in squeeze bottle/syrup bottle at hand sink
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No Scented hand lotion/unapproved hand soap/hand sanitizer present
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Handwashing signs are present at hand sinks
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Hot water available in store at hand sink 100-120°F (38-49 °C)
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Floor/Walls/Ceiling
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Floors are free of excessive crumbs/trash/debris (including under refrigerators and cabinetry)
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Floors are free of dark encrusted build-up (including under refrigerators and cabinetry)
-
Floors/cove molding/concrete in good repair
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Trash/Recycling/Compost cans not overflowing
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Recycling and/or compost cans are labled where appliable
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Drains clean/no strong odors present
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Walls clean
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Walls free of bare wood/exposed dry wall/covering are secure and intact/chipped paint/holes
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Ceiling/Lighting/Vents below 12 feet maintained clean and no lights are out/missing
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Ceiling is free of water damage and chipped paint/paint repair color matches
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No ceiling tiles missing/dislodged, sprinkler rings not missing
-
Floor/Walls/Ceiling
-
Floors are free of excessive crumbs/trash/debris (including under refrigerators and cabinetry)
-
Floors are free of dark encrusted build-up (including under refrigerators and cabinetry)
-
Floors/cove molding/concrete in good repair
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Trash cans not overflowing
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Walls clean
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Ceiling/Lighting/Vents below 12 feet maintained clean and no lights are out/missing
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Ceiling is free of water damage and chipped paint/paint repair color matches
PIC Only - Complete as needed (Daily, Weekly, Monthly)
Chemicals
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Chemicals are not stored on or above food preparation counters
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Chemicals are stored below or 12 inches away from food/single use items/clean dishes
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Chemicals are not stored on or above dishmachine
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Chemicals are not stored on/above clean drain board or sanitize basin of dish sink
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Chemicals are in labeled spray bottle/container
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Chemicals are covered/sealed (excluding sanitizer bucket)
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No bleach/unapproved pesticide/drain cleaner/ unapproved chemical present
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No Scented hand lotion/unapproved hand soap/hand sanitizer present
-
Esteem Sani-NC (US)/UltraSan (CAN) not observed in store with high-temp dishmachine
Sanitizer Buckets and Bar Towels
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Sanitizer container is properly labeled
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Proper test strips are available and free of water damage and not expired
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Quat- solution between 200 and 400ppm
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Chlorine- solution between 100 and 200ppm
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No towels left sitting on counters/shelves/on or in sink
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In container with sanitizer solution
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Large red sanitizer bucket not stored on counter or in sink
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Clean towels/linens not stored with chemicals or a contamination potential/stored at least 12" away from any contamination potential
Handwashing
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Handwashing taking place at appropriate times
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After wiping hands on apron
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After handling trash, recycling, or compost
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After coughing/sneezing into hands
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After touching face/hair/skin
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After eating/drinking
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After breaks
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After handling dirty dishes or equipment
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After blowing nose
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After cleaning tasks
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Before starting shift
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Before putting gloves on
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After using restroom
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Partners washing hands are using soap and proper technique (incl. 10-15 second scrub)
Documentation
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Food service permit is current and locatable.
-
Expires:
-
One partner in charge per store with valid food safety certification , or more if your jurisdiction requires it (note expiration date)
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All partners have valid food worker cards if required
-
All partners serving alcohol have appropriate alcohol training completed and current
-
Allergen certification adequate per jurisdiction (MA)
-
Allergen Poster present in BoH
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Heimlich maneuver signage posted where required (CA, CT, GA, MI, MD, NJ, NY, TX) Order at signage@starbucks.com
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Most recent Health inspection report posted or on file
-
Most recent pest report is within 60 days/and available for review
-
Select date
-
Alcohol signage d posted as required
-
Temp log complete, no entries missing/when required, corrective action noted
Food Safety and Partner Habits
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Food Handling & Food Safety
-
Smallwares 2 hour timer is in place and running
-
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
-
No Drinking/Eating (or evidence of) in food storage/food prep area
-
Partner belongings are not stored while partner is not scheduled to work
-
Partner belongings are not stored with dry goods, clean
-
smallwares, and/or clean linens on metro shelving, BOH prep station and at least 12" below and away
-
Partners are not touching pastries/sandwiches/beverage ingredients/mouth contact parts of items with bare hands
-
Hot water available in the store (100-120F/38-49C)
-
No sewage back up in store
-
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)
-
Partner in charge knowledgeable of proper dishwashing procedures-Wash, Rinse, Sanitize, then Air Dry
-
Recycling
-
Identify which bins are used for recycling and/or compost behind the bar where applicable
-
Identify where recycling and/or compost should be placed for pick-up outside of the store or building where applicable
-
Pest Control
-
No evidence of mice/rats, flying insects, cockroaches, ants
-
Partner Uniforms
-
Aprons/cloths are clean and do not have more than one shifts accumulation of spills and splashes
-
Long hair beyond shoulder length is tied back/hair restraints are worn per jurisdictional requirement
-
Partners not wearing watches, wearing plain band only (reference partner dress code on acrylic nails, hand wrap/cast and jewelry)
-
Partner Health
-
Not working with severe chest congestion/severe runny nose
-
Not working with acute diarrhea/ vomiting/jaundice
-
Not working with fever/chills
Sign off
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Name and Signature of Assesssor