QASA Starbucks Self Assessment

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

Customer Area

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 area clean

  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 menu boards in good repair

  Yes

  No

  N/A

• Dumpster/Trash Area

• External recycling/compost bins present and in use or curbside pickup used where applicable

  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 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

• Planters are clean and in good repair

  Yes

  No

  N/A

• Umbrellas clean and in good repair, locked into place

  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

• Landscaping clean and in good condition

  Yes

  No

  N/A

Café: Entrance and Customer

• General Cleanliness and Condition

• 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) (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 ceiling/vents/lighting in FOH above 12 feet

  Yes

  No

  N/A

• No lighting burned out at or above 12 feet

  Yes

  No

  N/A

• Café chairs/tables/lamps clean and in good 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

• Food

• Retail packaged coffee within code date

  Yes

  No

  N/A

• Ambient pre-packaged RTE food within code date (Madelines date coded)

  Yes

  No

  N/A

• Recycling/Compost Bins

• 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)

  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/scald guard present

  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 and not available to customers outside of 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

• Floor/Walls/Ceiling

• Floors are free of excessive crumbs/trash/debris

  Yes

  No

  N/A

• Floors are free of dark encrusted build-up

  Yes

  No

  N/A

• Floors/cove molding/concrete in good repair

  Yes

  No

  N/A

• Trash cans not overflowing

  Yes

  No

  N/A

• Ceiling/Lighting/Vents below 12 feet maintained clean and no lights are out/missing

  Yes

  No

  N/A

• Ceiling is free of water damage and chipped paint/paint repair color matches

  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 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

• Cabinet with trash can is clean

  Yes

  No

  N/A

• Smallwares

• Condiment bar shaker tops are not dented or otherwise damaged

  Yes

  No

  N/A

• All condiment bar shaker(s) labeled

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Condiment bar shakers/Carafes are not visibly dirty

  Yes

  No

  N/A

• Condiment bar carafes are not chipped/scratched/dented or otherwise damaged

  Yes

  No

  N/A

• Condiment bar carafes do not have adhesive buildup

  Yes

  No

  N/A

• Condiment bar bulk sugar container labeled

  Yes

  No

  N/A

• Food

• Condiment bar packages within code date and open packages dated vanilla/chocolate/cinnamon/nutmeg

  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

• All Carafes are <41°F (Canada 40°F/4°C)

  Yes

  No

  N/A

Pastry Case Station

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 sticker present For Display Only

  Yes

  No

  N/A

• Non-PHF RTD within code date

  Yes

  No

  N/A

• Sandwiches/Boxes/Salads/Fruit Cups/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 401/4°C) in RTD/E case

  Yes

  No

  N/A

• Equipment and Smallwares

• Pastry tongs are free of multiple dried on product build up

  Yes

  No

  N/A

• In-use tongs stored in a clean designated container

  Yes

  No

  N/A

• External rear grill area (vent/condenser coils) and filter cover clean/free of dust

  Yes

  No

  N/A

• No damaged shelves, broken pieces

  Yes

  No

  N/A

• Internal lighting working in case

  Yes

  No

  N/A

• Pastry cart clean/free of dust

  Yes

  No

  N/A

• Baskets on front of pastry case are clean and free of crumbs

  Yes

  No

  N/A

• Thermocouple present in the store/working/in good repair/calibrated (Sandwich stores only) (Critical)

  Yes

  No

  N/A

• General Cleanliness

• Top portion of the pastry case clean and free of crumbs

  Yes

  No

  N/A

• Floor/Walls/Ceiling

• Floors are free of excessive crumbs/trash/debris (including under refrigerators and cabinetry)

  Yes

  No

  N/A

• Floors are free of dark encrusted build-up (including under refrigerators and cabinetry)

  Yes

  No

  N/A

• Floors/cove molding/concrete in good repair

  Yes

  No

  N/A

• Trash/Recycling/Compost cans not overflowing

  Yes

  No

  N/A

• 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)

  Yes

  No

  N/A

• Cabinet doors/drawers/hinges/facings/handles in good repair

  Yes

  No

  N/A

• Cabinets are free of water damage/rot and no bare wood exposed

  Yes

  No

  N/A

• Cabinets and drawers clean

  Yes

  No

  N/A

• Countertops (including under equipment) clean

  Yes

  No

  N/A

• Countertops have no peeling stickers/adhesive residue on counter

  Yes

  No

  N/A

• Countertops sealed to wall/splash guard juncture/horizontal gaps

  Yes

  No

  N/A

• Countertops not excessively worn/damaged/pitted and facings in good repair

  Yes

  No

  N/A

• Signage clean

  Yes

  No

  N/A

• Walls clean

  Yes

  No

  N/A

• Walls free of bare wood/exposed dry wall/covering are secure and intact/chipped paint/holes

  Yes

  No

  N/A

• Ceiling/Lighting/Vents below 12 feet maintained clean and no lights are out/missing

  Yes

  No

  N/A

• Ceiling/Lighting/Vents at or above 12 feet maintained clean and no lights are out/missing

  Yes

  No

  N/A

• Ceiling is free of water damage and chipped paint/paint repair color matches

  Yes

  No

  N/A

REFRIGERATORS, FREEZERS and CHILLED CASES

• Thermometer located in front of case or refrigerator

  Yes

  No

  N/A

• Thermometer does not have any breaks or gaps in the red "gauge" line /All broken thermometers removed from the equipment

  Yes

  No

  N/A

• Refrigerator/food case is not above 41°F (Canada 401/4°C)

  Yes

  No

  N/A

• Refrigerator is clean (shelves/fan guards/ interior/exterior/floor)

  Yes

  No

  N/A

• Refrigerator shelves/door free of damage

  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

• Warming oven exterior/vents clean

  Yes

  No

  N/A

• Oven tray is not cracked/chipped

  Yes

  No

  N/A

• Food

• 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

• Floor/Walls/Ceiling

• Floors are free of excessive crumbs/trash/debris (including under refrigerators and cabinetry)

  Yes

  No

  N/A

• Floors are free of dark encrusted build-up (including under refrigerators and cabinetry)

  Yes

  No

  N/A

• Floors/cove molding/concrete in good repair

  Yes

  No

  N/A

• Trash/Recycling/Compost cans not overflowing

  Yes

  No

  N/A

• 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)

  Yes

  No

  N/A

• Drains clean/no strong odors present

  Yes

  No

  N/A

• Cabinet doors/drawers/hinges/facings/handles in good repair

  Yes

  No

  N/A

• Cabinets are free of water damage/rot and no bare wood exposed/no cabinet built over drain with no access

  Yes

  No

  N/A

• Cabinets and drawers clean

  Yes

  No

  N/A

• Countertops (including under equipment) clean

  Yes

  No

  N/A

• Shelving not damaged in cabinetry

  Yes

  No

  N/A

• Countertops have no peeling stickers/adhesive residue on counter

  Yes

  No

  N/A

• Countertops sealed to wall/splash guard juncture/horizontal gaps

  Yes

  No

  N/A

• Countertops not excessively worn/damaged/pitted and facings in good repair

  Yes

  No

  N/A

• Sink/ice bin/drain pan sealed to counter top

  Yes

  No

  N/A

• Signage clean

  Yes

  No

  N/A

• Walls clean including behind oven (free of grease & splatter)

  Yes

  No

  N/A

• Walls free of bare wood/exposed dry wall/covering are secure and intact/chipped paint/holes

  Yes

  No

  N/A

• Ceiling/Lighting/Vents below 12 feet maintained clean and no lights are out/missing

  Yes

  No

  N/A

• Ceiling/Lighting/Vents at or above 12 feet maintained clean and no lights are out/missing

  Yes

  No

  N/A

• Ceiling is free of water damage and chipped paint/paint repair color matches

  Yes

  No

  N/A

• No ceiling tiles missing/dislodged, sprinkler rings not missing

  Yes

  No

  N/A

REFRIGERATORS, FREEZERS and CHILLED CASES

• Thermometer located in front of case or refrigerator

  Yes

  No

  N/A

• Thermometer does not have any breaks or gaps in the red "gauge" line /All broken thermometers removed from the equipment

  Yes

  No

  N/A

• Refrigerator/food case is not above 41°F (Canada 40°F/4°C)

  Yes

  No

  N/A

• Product temperature is at or below 41°F (Canada 40°F/4°C)

  Yes

  No

  N/A

• Refrigerator is clean (shelves/fan guards/ interior/exterior/floor)

  Yes

  No

  N/A

• FOH Refrigerator gaskets clean and not damaged (ordered/replaced by store)

  Yes

  No

  N/A

• Refrigerator shelves/door free of damage

  Yes

  No

  N/A

Brewing Station

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 warmers maintained clean

  Yes

  No

  N/A

• Coffee grinder and scale maintained clean

  Yes

  No

  N/A

• Bunn membrane discolored or damaged

  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

• Airpots not chipped/excessively dented

  Yes

  No

  N/A

• Airpots labeled

  Yes

  No

  N/A

• Clover whisk and scraper clean, stored properly

  Yes

  No

  N/A

• Coffee

• Ground coffee and whole bean coffee stored protected

  Yes

  No

  N/A

• Ground coffee for pour over dated

  Yes

  No

  N/A

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

  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

• Floor/Walls/Ceiling

• Floors are free of excessive crumbs/trash/debris (including under refrigerators and cabinetry)

  Yes

  No

  N/A

• Floors are free of dark encrusted build-up (including under refrigerators and cabinetry)

  Yes

  No

  N/A

• Floors/cove molding/concrete in good repair

  Yes

  No

  N/A

• Trash/Recycling/Compost cans not overflowing

  Yes

  No

  N/A

• 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)

  Yes

  No

  N/A

• Drains clean/no strong odors present

  Yes

  No

  N/A

• Cabinet doors/drawers/hinges/facings/handles in good repair

  Yes

  No

  N/A

• Cabinets are free of water damage/rot and no bare wood exposed/no cabinet built over drain with no access

  Yes

  No

  N/A

• Cabinets and drawers clean

  Yes

  No

  N/A

• Countertops (including under equipment) clean

  Yes

  No

  N/A

• Shelving not damaged in cabinetry

  Yes

  No

  N/A

• Countertops have no peeling stickers/adhesive residue on counter

  Yes

  No

  N/A

• Countertops sealed to wall/splash guard juncture/horizontal gaps

  Yes

  No

  N/A

• Countertops not excessively worn/damaged/pitted and facings in good repair

  Yes

  No

  N/A

• Signage clean

  Yes

  No

  N/A

• Walls clean

  Yes

  No

  N/A

• Walls free of bare wood/exposed dry wall/covering are secure and intact/chipped paint/holes

  Yes

  No

  N/A

• Ceiling/Lighting/Vents below 12 feet maintained clean and no lights are out/missing

  Yes

  No

  N/A

• Ceiling/Lighting/Vents at or above 12 feet maintained clean and no lights are out/missing

  Yes

  No

  N/A

• Ceiling is free of water damage and chipped paint/paint repair color matches

  Yes

  No

  N/A

• No ceiling tiles missing/dislodged, sprinkler rings not missing

  Yes

  No

  N/A

CBS Station

Cold Beverage Station

• General Cleanliness and Condition

• Sure Shot FMD is not above 41° F (Canada 407/4°C)

  Yes

  No

  N/A

• 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

• 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, sanitized 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

• FIZZIO lids are stored in a separate container, not in water

  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

• 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 , in good condition

  Yes

  No

  N/A

• FIZZIO carbonation machine clean, clamp without build up

  Yes

  No

  N/A

• Sure Shot Frappuccino Milk Dispenser (FMD) and cream dispensers labeled with contents on exterior of unit

  Yes

  No

  N/A

• Sure Shot/Frappuccino Milk Dispenser (FMD) is clean

  Yes

  No

  N/A

• Thermometer located in Sure Shot/Frappuccino Milk Dispenser (FMD)

  Yes

  No

  N/A

• Nitro cold brew unit interior and exterior clean, gaskets in good condition

  Yes

  No

  N/A

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

  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)/soda mixes/refreshers mixes 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

• All squeeze bottles labeled

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• PHF are not left on counter above 41°F (Canada 407/4°C) (milk/soy/coconut/ whipped cream )

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Floor/Walls/Ceiling

• Floors are free of excessive crumbs/trash/debris (including under refrigerators and cabinetry)

  Yes

  No

  N/A

• Floors are free of dark encrusted build-up (including under refrigerators and cabinetry)

  Yes

  No

  N/A

• Floors/cove molding/concrete in good repair

  Yes

  No

  N/A

• Trash/Recycling/Compost cans not overflowing

  Yes

  No

  N/A

• 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)

  Yes

  No

  N/A

• Drains clean/no strong odors present

  Yes

  No

  N/A

• Cabinet doors/drawers/hinges/facings/handles in good repair

  Yes

  No

  N/A

• Cabinets are free of water damage/rot and no bare wood exposed/no cabinet built over drain with no access

  Yes

  No

  N/A

• Cabinets and drawers clean

  Yes

  No

  N/A

• Countertops (including under equipment) clean

  Yes

  No

  N/A

• Shelving not damaged in cabinetry

  Yes

  No

  N/A

• Countertops have no peeling stickers/adhesive residue on counter

  Yes

  No

  N/A

• Countertops sealed to wall/splash guard juncture/horizontal gaps

  Yes

  No

  N/A

• Countertops not excessively worn/damaged/pitted and facings in good repair

  Yes

  No

  N/A

• Sink/ice bin/drain pan sealed to counter top

  Yes

  No

  N/A

• Signage clean

  Yes

  No

  N/A

• Walls clean

  Yes

  No

  N/A

• Walls free of bare wood/exposed dry wall/covering are secure and intact/chipped paint/holes

  Yes

  No

  N/A

• Ceiling/Lighting/Vents below 12 feet maintained clean and no lights are out/missing

  Yes

  No

  N/A

• Ceiling/Lighting/Vents at or above 12 feet maintained clean and no lights are out/missing

  Yes

  No

  N/A

• Ceiling is free of water damage and chipped paint/paint repair color matches

  Yes

  No

  N/A

• No ceiling tiles missing/dislodged, sprinkler rings not missing

  Yes

  No

  N/A

REFRIGERATORS, FREEZERS and CHILLED

• Thermometer located in front of case or refrigerator

  Yes

  No

  N/A

• Thermometer does not have any breaks or gaps in the red "gauge" line /All broken thermometers removed from the equipment

  Yes

  No

  N/A

• Refrigerator/food case is not above 41°F (Canada 407/4°C)

  Yes

  No

  N/A

• Product temperature is at or below 41°F (Canada 407/4°C)

  Yes

  No

  N/A

• Refrigerator is clean (shelves/fan guards/ interior/exterior/floor)

  Yes

  No

  N/A

• FOH Refrigerator gaskets clean and not damaged (ordered/replaced by store)

  Yes

  No

  N/A

• Refrigerator shelves/door free of damage

  Yes

  No

  N/A

Espresso Bar Station

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

  Yes

  No

  N/A

• Top of espresso machine clean/no dust

  Yes

  No

  N/A

• Espresso machine food parts clean-bean hopper clean and not damaged, 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

• Espresso drain pan and plug present, Mastrena logo present

  Yes

  No

  N/A

• Dish area clean (if in FoH)

  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/cocount/ 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 sanitizes 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

• Utensils/thermometers are not stored in container with stagnant water

  Yes

  No

  N/A

• Smallwares 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

• Floor/Walls/Ceiling

• Floors are free of excessive crumbs/trash/debris (including under refrigerators and cabinetry)

  Yes

  No

  N/A

• Floors are free of dark encrusted build-up (including under refrigerators and cabinetry)

  Yes

  No

  N/A

• Floors/cove molding/concrete in good repair

  Yes

  No

  N/A

• Trash/Recycling/Compost cans not overflowing

  Yes

  No

  N/A

• Recycling and/or compost bins are labeled/present where applicable

  Yes

  No

  N/A

• Drains clean/no strong odors present

  Yes

  No

  N/A

• Cabinet doors/drawers/hinges/facings/handles in good repair

  Yes

  No

  N/A

• Cabinets are free of water damage/rot and no bare wood exposed/no cabinet built over drain with no access

  Yes

  No

  N/A

• Cabinets and drawers clean

  Yes

  No

  N/A

• Countertops (including under equipment) clean

  Yes

  No

  N/A

• Shelving not damaged in cabinetry

  Yes

  No

  N/A

• Countertops have no peeling stickers/adhesive residue on counter

  Yes

  No

  N/A

• Countertops sealed to wall/splash guard juncture/horizontal gaps

  Yes

  No

  N/A

• Countertops not excessively worn/damaged/pitted and facings in good repair

  Yes

  No

  N/A

• Sink/ice bin/drain pan sealed to counter top

  Yes

  No

  N/A

• Signage clean

  Yes

  No

  N/A

• Walls clean

  Yes

  No

  N/A

• Walls free of bare wood/exposed dry wall/covering are secure and intact/chipped paint/holes

  Yes

  No

  N/A

• Ceiling/Lighting/Vents below 12 feet maintained clean and no lights are out/missing

  Yes

  No

  N/A

• Ceiling/Lighting/Vents at or above 12 feet maintained clean and no lights are out/missing

  Yes

  No

  N/A

• Ceiling is free of water damage and chipped paint/paint repair color matches

  Yes

  No

  N/A

• No ceiling tiles missing/dislodged, sprinkler rings not missing

  Yes

  No

  N/A

• Recycling/Compost Bins

• Partner facing sorting guide magnet present on an under counter refrigerator

  Yes

  No

  N/A

• 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)

  Yes

  No

  N/A

REFRIGERATORS, FREEZERS and CHILLED

• Thermometer located in front of case or refrigerator

  Yes

  No

  N/A

• Thermometer does not have any breaks or gaps in the red "gauge" line /All broken thermometers removed from the equipment

  Yes

  No

  N/A

• Refrigerator/food case is not above 41°F (Canada 40°F/4°C)

  Yes

  No

  N/A

• Product temperature is at or below 41°F (Canada 40°F/4°C)

  Yes

  No

  N/A

• Refrigerator is clean (shelves/fan guards/ interior/exterior/floor)

  Yes

  No

  N/A

• FOH Refrigerator gaskets clean and not damaged (ordered/replaced by store)

  Yes

  No

  N/A

• Refrigerator shelves/door free of damage

  Yes

  No

  N/A

DT Area Behind Counter Station

Drive Thru Area Behind Counter

• 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

• Espresso Machine Clean

  Yes

  No

  N/A

• Top of espresso machine clean/no dust

  Yes

  No

  N/A

• Espresso machine food parts clean-bean hopper clean and not damaged, 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

• Espresso drain pan and plug present, Mastrena logo present

  Yes

  No

  N/A

• No lighting burned out at or above 12 feet. Drive-thru display and equipment clean

  Yes

  No

  N/A

• Food

• 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 located in the front of Cream Dispenser (where applicable)

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Cream dispenser is not above 41°F (Canada 401/4°C)

  Yes

  No

  N/A

• Cream dispenser contents dated and within code date

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Floor/Walls/Ceiling

• Floors are free of excessive crumbs/trash/debris (including under refrigerators and cabinetry)

  Yes

  No

  N/A

• Floors are free of dark encrusted build-up (including under refrigerators and cabinetry)

  Yes

  No

  N/A

• Floors/cove molding/concrete in good repair

  Yes

  No

  N/A

• Trash/Recycling/Compost cans not overflowing

  Yes

  No

  N/A

• 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)

  Yes

  No

  N/A

• Drains clean/no strong odors present

  Yes

  No

  N/A

• Cabinet doors/drawers/hinges/facings/handles in good repair

  Yes

  No

  N/A

• FY17 QASA Self Assessment

  Yes

  No

  N/A

• Cabinets and drawers clean

  Yes

  No

  N/A

• Countertops (including under equipment) clean

  Yes

  No

  N/A

• Shelving not damaged in cabinetry

  Yes

  No

  N/A

• Countertops have no peeling stickers/adhesive residue on counter

  Yes

  No

  N/A

• Countertops sealed to wall/splash guard juncture/horizontal gaps

  Yes

  No

  N/A

• Countertops not excessively worn/damaged/pitted and facings in good repair

  Yes

  No

  N/A

• Sink/ice bin/drain pan sealed to counter top

  Yes

  No

  N/A

• Signage clean

  Yes

  No

  N/A

• Walls clean

  Yes

  No

  N/A

• Walls free of bare wood/exposed dry wall/covering are secure and intact/chipped paint/holes

  Yes

  No

  N/A

• Ceiling/Lighting/Vents below 12 feet maintained clean and no lights are out/missing

  Yes

  No

  N/A

• Ceiling/Lighting/Vents at or above 12 feet maintained clean and no lights are out/missing

  Yes

  No

  N/A

• Ceiling is free of water damage and chipped paint/paint repair color matches

  Yes

  No

  N/A

• No ceiling tiles missing/dislodged, sprinkler rings not missing

  Yes

  No

  N/A

REFRIGERATORS, FREEZERS and CHILLED

• Thermometer located in front of case or refrigerator

  Yes

  No

  N/A

• Thermometer does not have any breaks or gaps in the red "gauge" line /All broken thermometers removed from the equipment

  Yes

  No

  N/A

• Refrigerator/food case is not above 41°F (Canada 40°F/4°C)

  Yes

  No

  N/A

• Product temperature is at or below 41°F (Canada 40°F/4°C)

  Yes

  No

  N/A

• Refrigerator is clean (shelves/fan guards/ interior/exterior/floor)

  Yes

  No

  N/A

• FOH Refrigerator gaskets clean and not damaged (ordered/replaced by store)

  Yes

  No

  N/A

• Refrigerator shelves/door free of damage

  Yes

  No

  N/A

BOH Dry Storage and Refrigeration

BOH Dry Storage

• General Cleanliness and Condition

• Items are not stored on floor preventing cleaning

  Yes

  No

  N/A

• Dry storage shelving/BOH prep station 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 lighting burned out at or above 12 feet

  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/unopened 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

• Salt used for water sofeners stored 6" off the floor and away from chemicals or contamination

  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/recycling/compost can(s) not over flowing

  Yes

  No

  N/A

• Floor/Walls/Ceiling

• Floors are free of excessive crumbs/trash/debris (including under refrigerators and cabinetry)

  Yes

  No

  N/A

• Floors are free of dark encrusted build-up (including under refrigerators and cabinetry)

  Yes

  No

  N/A

• Trash/recycling/compost cans not overflowing

  Yes

  No

  N/A

• Recycling and/or compost bins are labeled/present where appliable

  Yes

  No

  N/A

• Drains clean/no strong odors present

  Yes

  No

  N/A

• Walls clean

  Yes

  No

  N/A

• Walls free of bare wood/exposed dry wall/covering are secure and intact/chipped paint/holes

  Yes

  No

  N/A

• Ceiling/Lighting/Vents below 12 feet maintained clean and no lights are out/missing

  Yes

  No

  N/A

• Ceiling/Lighting/Vents at or above 12 feet maintained clean and no lights are out/missing

  Yes

  No

  N/A

• Ceiling is free of water damage and chipped paint/paint repair color matches

  Yes

  No

  N/A

• No ceiling tiles missing/dislodged, sprinkler rings not missing

  Yes

  No

  N/A

BOH Refrigeration Equipment

• Food

• Dairy in BoH refrigerator is within code date

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Non PHF RTD 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

REFRIGERATORS, FREEZERS and CHILLED CASES

• Thermometer located in front of case or refrigerator/freezer

  Yes

  No

  N/A

• Thermometer does not have any breaks or gaps in the red "gauge" line /All broken thermometers removed from the equipment

  Yes

  No

  N/A

• Refrigerator/food case is not above 41°F (Canada 40°F/4°C)

  Yes

  No

  N/A

• Product temperature is at or below 41°F (Canada 40°F/4°C)

  Yes

  No

  N/A

• Refrigerator/freezer is clean (shelves/fan guards/ interior/exterior/floor)

  Yes

  No

  N/A

• Freezer air temperature below 0°F (-18°C)

  Yes

  No

  N/A

• Light working in BoH refrigerator/ freezer

  Yes

  No

  N/A

• BOH refrigerator/freezer gasket present and free of damage (ordered/replaced by store)

  Yes

  No

  N/A

• Refrigerator/freezer shelves/door free of damage

  Yes

  No

  N/A

• Items are not stored on top of BOH refrigerator or freezer blocking vents

  Yes

  No

  N/A

Dishwashing and Handsinks Station

Dishwashing Area

• General Cleanliness and Condition

• Equipment drain lines from dishwasher/ice machine not placed in sewer pipe

  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

• Shelving above dish sink clean

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Smallwares

• Smallwares are not chipped/cracked and stored clean

  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

• Dishmachine

• Dishmachine and dishmachine door is clean

  Yes

  No

  N/A

• At least 3.4" of detergent is present in the auto feed container of

  Yes

  No

  N/A

• detergent/pump available in stores without red auto-feed tube

  Yes

  No

  N/A

• Rinse-Aid auto-feed (blue) tube coiled and tucked behind machine (BOTH Low Temp and High Temp Dishmachines)

  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 detergent (clear is for chlorine sanitizer low temp machines only)

  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

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

• Approved soap/paper towel dispensers properly stocked and working

  Yes

  No

  N/A

• Soap is not stored in squeeze 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

• Floor/Walls/Ceiling

• Floors are free of excessive crumbs/trash/debris (including under refrigerators and cabinetry)

  Yes

  No

  N/A

• Floors are free of dark encrusted build-up (including under refrigerators and cabinetry)

  Yes

  No

  N/A

• Floors/cove molding/concrete in good repair

  Yes

  No

  N/A

• Trash/Recycling/Compost cans not overflowing

  Yes

  No

  N/A

• Recycling and/or compost cans are labled where appliable

  Yes

  No

  N/A

• Drains clean/no strong odors present

  Yes

  No

  N/A

• Walls clean

  Yes

  No

  N/A

• Walls free of bare wood/exposed dry wall/covering are secure and intact/chipped paint/holes

  Yes

  No

  N/A

• Ceiling/Lighting/Vents below 12 feet maintained clean and no lights are out/missing

  Yes

  No

  N/A

• Ceiling is free of water damage and chipped paint/paint repair color matches

  Yes

  No

  N/A

• No ceiling tiles missing/dislodged, sprinkler rings not missing

  Yes

  No

  N/A

• Floor/Walls/Ceiling

• Floors are free of excessive crumbs/trash/debris (including under refrigerators and cabinetry)

  Yes

  No

  N/A

• Floors are free of dark encrusted build-up (including under refrigerators and cabinetry)

  Yes

  No

  N/A

• Floors/cove molding/concrete in good repair

  Yes

  No

  N/A

• Trash cans not overflowing

  Yes

  No

  N/A

• Walls clean

  Yes

  No

  N/A

• Ceiling/Lighting/Vents below 12 feet maintained clean and no lights are out/missing

  Yes

  No

  N/A

• Ceiling is free of water damage and chipped paint/paint repair color matches

  Yes

  No

  N/A

PIC Only - Complete as needed (Daily, Weekly, Monthly)

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

  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 and not expired

  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, recycling, or compost

  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 and locatable.

  Yes

  No

  N/A

• Expires:

  Date

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

  Yes

  No

  N/A

• All partners have valid food worker cards if required

  Yes

  No

  N/A

• All partners serving alcohol have appropriate alcohol training completed and current

  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) Order at signage@starbucks.com

  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

• Select date

  Date

• Alcohol signage d posted as required

  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

• Smallwares 2 hour timer is in place and running

  Yes

  No

  N/A

• Partner food/beverage is not stored on shelving next to dry goods, clean

  Yes

  No

  N/A

• 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

  Yes

  No

  N/A

• smallwares, and/or clean linens on metro shelving, BOH prep station 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 knowledgeable of proper dishwashing procedures-Wash, Rinse, Sanitize, then Air Dry

  Yes

  No

  N/A

• Recycling

• Identify which bins are used for recycling and/or compost behind the bar where applicable

  Yes

  No

  N/A

• Identify where recycling and/or compost should be placed for pick-up outside of the store or building where applicable

  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 shifts 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

• Partners not wearing watches, wearing plain band only (reference partner dress code on 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

Sign off

• Name and Signature of Assesssor

  Sign