Information

  • Location
  • Conducted on

  • Prepared by

  • Partners

  • Prepared by

Food Safety

FOOD SAFETY

  • Food and Single Use Item Protection and Storage

  • In-use smallwares/equipment food contact surfaces, approved, clean and in good repair

  • Non-Potentially Hazardous Foods within code date

  • Potentially Hazardous Foods within code date

  • Food approved and name labeled properly

  • Food items stored properly

  • Food contact items properly stored

  • Partners do not contact ready-to-eat foods or food contact surfaces with bare hands

  • Partner food labeled, stored properly, and no eating/drinking in food storage/prep areas

  • Ice and ice utensils protected in Bar/CBS area and/or BoH area

  • Hygiene

  • Proper handwashing taking place at appropriate times

  • Hand sinks are accessible and used properly

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

  • Partners uniforms maintained clean/hair properly restrained (per jurisdictional requirements)

  • Partner not working while ill

  • Partner non-food personal belongings stored separately from food storage areas and not left overnight

  • Wiping Cloth Usage and Sanitization

  • Sanitizer present/strength at proper concentration/proper test strips available

  • In-use wiping cloths properly stored

  • Approved scouring pad in use

  • Beverage/Food Preparation

  • Steaming thermometers in use/calibrated correctly

  • Thermocouple present and properly working

  • Steamed milk ≥150°F(65.5°C) and is not resteamed

  • Potentially hazardous food(PHF) is not stored at room temperature

  • Refrigeration and Cold Storage

  • Refrigerated PHF ≤41°F (4°C)

  • Refrigeration units ≤41°F (4°C)

  • Hanging thermometer/temp readout present where required

  • Condiment bar carafes ≤41°F (4°C)

  • Refrigeration ventilation maintained

  • Chemical Storage and Usage

  • Only approved chemicals present

  • Chemicals properly labeled/stored

  • Permits and Certifications

  • Permit/Food service license to operate available as required by jurisdiction

  • Partner food safety training adequate as required

  • Proper documentation/signage available

  • Temperature logs complete in Duty Roster

  • Dishwashing

  • Dishwashing sink compartments labeled and followed properly

  • Correct amount of detergent for each mechanical dishwasher load

  • Dishmachine rinse water is properly maintained for sanitizing dishes

  • Hot water available in store

Cleanliness

CLEANLINESS

  • Trash Handling

  • Trash in store disposed of as needed

  • Pest Control

  • No evidence of rodents

  • No evidence of flying insects

  • No evidence of cockroaches

  • No evidence of ants

  • Cleanliness of facility

  • BoH area floors/drains maintained clean

  • BoH area walls/ceilings maintained clean/lights functioning

  • BoH equipment maintained and clean

  • Mop area maintained and clean

  • BoH dish area/hand sink/storage areas maintained and clean

  • Restrooms/Toilet floors/walls/ceiling maintained/lights functioning

  • Restrooms/Toilet fixtures maintained

  • Customer area floors maintained

  • Customer area walls/ceilings maintained and lights functioning

  • Condiment bar maintained

  • Customer area furnishings maintained

  • Exterior area maintained

  • Bar area/Food Station/CBS floors maintained clean

  • Bar area/Food Station/CBS walls and ceiling maintained clean/lights functioning

  • Bar/Brewing area equipment maintained clean

  • CBS equipment maintained clean

  • Food Station equipment maintained and clean

  • Pastry and Refrigerated Display Case maintained clean

  • FoH Dish area/hand sink/storage areas maintained clean

  • Customer area furnishings maintained in good repair

  • Bar/CBS/Food Station counters maintained clean

Facilities

FACILITIES

  • Restrooms floors/walls/ceilings in good repair (which restroom)

  • Restrooms fixtures in good repair

  • Floor in good repair in FoH

  • Walls in good repair in FoH

  • Ceiling in good repair in FoH

  • Cabinetry/shelving in customer area in good repair

  • Condiment bar in good repair

  • Heavy, High, or Hazardous cleaning service items meet standards

  • Awnings/soffit/drive thru equipment in good repair

  • Building entrances maintained in good repair and rodent proof

  • Sink/Dipper well/ice bin/drain pan sealed to counter

  • Counter tops in good repair

  • Cabinetry in the bar area in good repair

  • Floors in good repair in BoH

  • Walls in good repair in BoH

  • Ceiling in good repair in BoH

  • Ice machine in good repair

  • Refrigeration in good repair (indicate which refrigerator)

  • Flex drain hose not placed in sewer pipe

  • Plumbing in good repair

  • No sewage back up in facility

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Signature

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  • Reviewed by DM:

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.