Title Page

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

  • Date

  • Ward/Department

Cleanliness & Facility Suitability

  • The floor is free of dust, grit, litter, marks, water or other liquids?

  • Inaccessible areas (edges, corners, behind furniture) are free of dust, grit, litter, marks, water or other liquids?

  • There is no evidence of infestation or animals in the kitchen?

  • Fly screens are in place where required?

  • Cleaning materials used in the kitchen are identifiable (e.g. colour coded) and stored separately & away from food?

  • Specific hand wash facilities & PPE (green aprons) are available?

  • Fixtures and fittings are in a good state of repair? (e.g. cupboards, surfaces, shelves and drawers - including inside)

  • Fixtures and fittings are clean & free from dust, stains and debris?

  • Appliances are in a good state of repair? (including fridges, toasters, microwaves etc.)

  • Appliances are clean & free from dust, stains and debris?

  • Walls & ceilings are in a good state of repair, free from chips, marks and staining?

  • Kitchen trolleys are clean & in a good state of repair?

  • Ice machines are clean, mains supplied and on pre-planned cleaning and maintenance program?

  • There is a satisfactory system for cleaning crockery i.e. return to main kitchen or maintained dishwasher?

  • Hot water boilers are clean and on pre-planned cleaning and maintenance program?

  • Disposable paper roll is available for drying equipment and surfaces?

  • Waste bins are clean and in a good state of repair (including being foot operated)

  • Vents & Grilles are clean & on a PPM?

Storage & Supply Management

  • The kitchen surfaces are kept clutter free to enable effective cleaning?

  • Patient and staff food in fridge is labelled with name & use by date?

  • There are no inappropriate items stored in the kitchen? (clinical supplies, linen etc)

  • There are no inappropriate items stored in fridges? (medication, specimens etc.)

  • Bread is stored in a clean bread bin & bin is sealed?

  • Scoop for ice machine is stored in designated lidded container?

  • Patient and staff food stored in kitchen (including in cupboards) is kept separate?

  • Food items in kitchen are stored appropriately? (e.g. in fridge, cupboard or designated storage)

  • There is no evidence of overstock within the kitchen? (including bread, cereals etc.)

  • All items (including cleaning supplies) are stored off the floor?

Policy & Documentation

  • There is clear signage indicating access policy to kitchen? (e.g. STAFF ONLY signage)

  • There is a thermometer in the fridge & regular temperature recordings are evident?

  • There are no 'unexplained' gaps in temperature readings? (e.g. records indicate when ward is closed)

  • Are there any open estates requisitions in relation to this kitchen?

  • Is there evidence that all food handling staff have undertaken food hygiene training appropriate to their role? (Nurses & HCA's are required to have watched 'Bacteria Bites')

  • Records are kept of out of date food thrown away?

  • Menu folder (including allergen & nutritional information) is available in kitchen?

  • All electrical items have been PAT tested & are within date?

  • All signage in kitchen is laminated?

  • Information is displayed in the kitchen regarding: Allergens & Availability of food from switchboard out of hours?

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.