RBD Food Safety Inspection Template

• Client / Site

• Date

  Date

• Inspected by

• Location
  Address

• Instructions
  
  1. Conduct a food safety inspection by answering the questions accordingly.
  2. Add Photos and Notes by clicking on the Paperclip icon
  3. To add a Corrective Measure click on the Paperclip icon then "Add Action", provide a description, assign to a member, set priority, and due date
  4. Complete audit by providing digital signature
  5. Share your report by exporting as PDF, Word, Excel or Web Link.

Food Safety – Level 3

• Cross contamination is not observed

  ✔

  ✖

  N/A

• No significant pest activity

  ✔

  ✖

  N/A

• All food must be cooked or heated to the proper internal cooking temperature

  ✔

  ✖

  N/A

• Cold food held <5°C and within documented 4 hour hold time

  ✔

  ✖

  N/A

• Hot food held >60°C and within documented 4 hour hold time

  ✔

  ✖

  N/A

• Temp controlled food using only time for food safety must have documented procedures and be within 4 hour hold time

  ✔

  ✖

  N/A

• Only approved ingredients or food evident

  ✔

  ✖

  N/A

• TM not observed working with symptoms of illness or infection

  ✔

  ✖

  N/A

• Hand washing conducted as required

  ✔

  ✖

  N/A

• Food handling TM with bandage on hand must wear gloves

  ✔

  ✖

  N/A

• Thermometers in use are calibrated

  ✔

  ✖

  N/A

• Restaurant has electric power

  ✔

  ✖

  N/A

• Proper sanitizing in 3 step sink

  ✔

  ✖

  N/A

• Raw protein and other wiping cloths are never mixed

  ✔

  ✖

  N/A

• Water is from an approved source

  ✔

  ✖

  N/A

• Hot water is available in the 3 compartment sink

  ✔

  ✖

  N/A

• Dedicated hand wash sink BOH

  ✔

  ✖

  N/A

• No sewage backup (restaurant or kitchen drains)

  ✔

  ✖

  N/A

• No significant pest activity

  ✔

  ✖

  N/A

• Minimum of one functioning toilet available

  ✔

  ✖

  N/A

• Hot carry over procedures for approved ingredients are followed by the team

  ✔

  ✖

  N/A

Local Standards/Health & Safety – Level 3

• All fire routes and doors are clear and accessible, unlocked and functioning correctly

  ✔

  ✖

  N/A

• No manipulation of company records (training, CCPs etc.)

  ✔

  ✖

  N/A

• Person in charge is fully trained

  ✔

  ✖

  N/A

• Delivery drivers comply with local training and licensing

  ✔

  ✖

  N/A

• ACE audit unable to be completed

  ✔

  ✖

  N/A

Brand Standards – Level 3

• Core menu items are all available at all times

  ✔

  ✖

  N/A

• Fry basket is not full beyond the oil level

  ✔

  ✖

  N/A

• Pizza is not raw or burnt

  ✔

  ✖

  N/A

Sign Off

• Inspected by: (Full Name and Signature)

  Sign