Title Page

  • Site conducted

  • Conducted on

  • Conducted by

Visit Details

  • Restaurant - 44K020/54

  • Length of Visit

  • Restaurant Address
  • MOD

  • Position

  • Visit Type

Exterior

  • The Restaurant exterior is clean and well maintained to brand standard?

Guest Area

  • Guest area is clean and well maintained and to brand standard?

  • Front of house self-serve beverage & condiment station is stocked, clean and<br>well maintained to brand standard?

  • Restrooms are clean, maintained and stocked to brand standard?

Product

  • Marination process is to Brand Standard?

  • Breading station and process is to Brand Standard?

  • Frying procedures are to brand standard in all fryer types?

Cooked Chicken Quality ***ASSESS ONLY 3 PRODUCTS***

  • Original Recipe Chicken

  • Fillets

  • Mini Fillets

  • Zingers

  • Hot Wings

Fries Quality

  • Fries are to standard?

Availability

  • Products are available when ordered?

  • Original Recipe Chicken

  • Fillets

  • Mini Fillets

  • Zingers

  • Hot Wings

Accuracy

  • All restaurant employees are 100% Trained?

  • Team members provide a memorable customer experience?

  • Orders are accurately packed, presented, dispatched within brand standards?

Back Of House

  • Emergency fire equipment and exits comply with local legislation and<br>brand standard?

  • Health & Safety standards comply with local legislation and brand<br>standard?

Equipment

  • Required equipment is approved in place and functioning properly?

  • Fryers (Pots/Cookers/Vats) are certified and operated to brand standard?

Food Safety Hygiene

  • Brand/BU Employee Health Standard is posted visibly for team members?

  • Team member must not be observed working with symptoms of illness<br>or infection?

  • Significant - Hand washing procedures followed?

  • Secondary - Hand washing procedures followed?

  • Significant - Hand washing sinks accessible, clean, functioning, in good<br>repair, used only for hand washing, and includes posted hand washing signs?

  • Secondary - Hand washing sinks accessible, clean, functioning, in good<br>repair, used only for hand washing, and includes posted hand washing signs?

  • How many handwash sinks are BOH? (Kitchen only, not including<br>toilet rooms)?

Proper Temperature Or Time Management

  • Thermometers in use are calibrated?

  • Cold holding and storage equipment temperature meets standard?

  • Hot holding and storage equipment temperature meets standard?

  • Cold Temperature Controlled for Safety (TCS) Foods must be held ≤<br>5°C?

  • Hot Temperature Controlled for Safety (TCS) Foods must be held ≥<br>63°C?

  • Time Controlled for Safety (TCS) Foods using only time for food safety<br>must have documented procedures and be within time?

  • Frozen foods are thawed correctly?

  • Cooling procedures are properly followed?

  • Foods must be cooked or heated to the proper internal food safe<br>temperature?

Control Expiration Dates & Shelf-Life

  • Significant - Ingredients and products are correctly labeled with an<br>expiration date and are not expired?

  • Secondary - Ingredients and products are correctly labeled with an<br>expiration date and are not expired?

  • Significant - Spoiled foods or ingredients are not in use and not for sale?

  • Secondary - Spoiled foods or ingredients are not in use and not for sale?

Prevent Contamination

  • Food and packaging are properly stored and in good condition;<br>damaged or donated products are segregated; team member food/medication<br>segregated?

  • Utensils, smallwares, and food contact surfaces are properly<br>cleaned, stored, air-dried, in good repair, and held properly when in us?

  • Significant - Cross contamination or conditions that could lead to cross<br>contamination must not be present?

  • Secondary - Cross contamination or conditions that could lead to<br>cross contamination must not be present?

  • Team members meet grooming and personal hygiene standards and practices?

  • Significant - Single-use disposable food handling gloves and blue or<br>brightly colored (non-flesh colored) bandages are available in the restaurant<br>and used correctly?

  • Secondary - Single-use disposable food handling gloves and blue or<br>brightly colored (non-flesh colored) bandages are available in the restaurant<br>and used correctly?

  • Significant - Dish washing process set up and followed correctly, proper<br>sanitizer concentration and test strips available?

  • Secondary - Dish washing process set up and followed correctly, proper<br>sanitizer concentration and test strips available?

  • Equipment is properly cleaned and free of excess debris, buildup?

  • Significant - Wiping cloths used and stored properly in a sanitizer<br>bucket with correct concentration?

  • Cleaning supplies (e.g., mops, mop bucket, etc.) must be available and<br>stored clean?

  • Restaurant BOH floors, walls, ceiling, vents/exhaust hoods, and<br>shelving are clean?

  • Lighting sources are properly shielded or have shatter proof bulbs in<br>areas where food, service utensils and equipment are stored or prepared?

  • Back flow is prevented at the sink sprayer and all other hoses?

  • Is there a dedicated cold storage (walk-in, reach-in refrigeration;<br>not a freezer) for raw animal foods?

Prevent Pest Entry, Harborage & Activity

  • Current and Approved Brand/BU Weekly Pest Walks must be<br>completed and retained?

  • Pest control devices evident and installed, maintained properly; service<br>is evident and by an approved Pest Management Professional Vendor?

  • Pest activity is prevented through elimination of harborage and pest<br>points of entry? (Including outside storage sheds and landscaping)

  • Restaurant BOH floors, walls, ceiling, vents/exhaust hoods, and<br>shelving are in good repair?

  • Significant - Pest Infestation or Activity not present? (Food Safety<br>Emergency)

  • Secondary - Pest Infestation or Activity not present?

Restaurant Basics

  • The most recent health department inspection report is available, and<br>evidence is available that corrective actions against any Health Authority<br>critical non-conformances has been completed?

  • As required by the Brand/BU or by regulation, at least 1 manager must<br>have locally acceptable food handler certificate on file?

  • Team Member food safety training records meets Brand/BU standards?

  • Current and Approved Brand/BU Food Safety Checklists must be<br>completed and retained?

  • Only approved ingredients or food evident?

  • Only approved equipment and smallwares in use?

  • Gaskets on refrigeration/freezer units, ice machines, hot holding<br>units, or any other equipment that has gaskets are clean and in good repair?

  • Trash receptacles are of sufficient availability, capacity, cleaned, and<br>maintained properly?

  • Three-compartment sink, prep sink, dishwasher or PowerSoak sink is<br>functioning properly?

  • Approved chemicals are properly labeled and stored, and handled<br>correctly?

  • Restaurant has electric power or an alternate power source available<br>for use? (Imminent Health Hazard)

  • Significant - Hot water ≥49°C is available in the kitchen as<br>measured at any sink providing hot water other than a handwash sink?<br>(Imminent Health Hazard, Food Safety Emergency)

  • Secondary - Hot water is between 43°C and 48°C

  • Minimum of one functioning toilet available in the facility for team<br>member use? (Imminent Health Hazard)

  • Significant - Drains not clogged and functioning properly? (Imminent<br>Health Hazard)

  • Secondary - Drains not clogged and functioning properly?

  • Water is from an approved source?

Growth Drivers

  • There is an automated product forecasting system?

  • There is an automated labour forecasting, scheduling & deployment<br>system?

  • If the restaurant does their own delivery, is there a DELIVERY<br>MANAGEMENT SYSTEM in place?

  • The restaurant has an automated Kitchen Management System?

  • Number of Kiosks in restaurant?

  • All Kiosks are available and functional?

  • All aggregator or own delivery tablets are functioning correctly and<br>accepting orders?

  • The restaurant and the team are prepped and ready for sales?

  • The restaurant has KDS screens in the necessary positions?

  • The restaurant is meeting the required speed standard for Drive Thru?

  • Drive Thru Restaurants have a digital timer that is fully functional?

  • Drive Thru Restaurants digital timer measures the following speed<br>attributes?

Signatures

  • Inspector

  • MOD

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.