Title Page
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Conducted on
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Prepared by
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Location
Food Safety Verification
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[FS1-US] Is the restaurant infested or does it have signs of active pest infestation? Is the restaurant building , adjoining corral, and any area within 10 feet (3m) from the building (i.e. inside the drive thru lane) clean from animal or insect infestation?
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[FS2-US] Are the internal temperatures of beef patties after cooking at or above 155° F and fresh beef patties at or above 175°F?
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[FS3-US] Are the internal temperatures of raw chicken products after cooking at or above 165°F?
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[FS4-US] Are the internal temperatures of breakfast steak and breakfast sausage after cooking at or above 155°F for sausage made from beef or pork and 165°F for sausage made from poultry
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[FS5-US] Do cooked round eggs have gelled yolks (are not runny)? Are internal temperatures at or above 155°F?
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[FS6-US] Can managers (or staff assigned to complete the checklist) demonstrate they have been trained on properly completing the procedures on the Food Safety Daily Checklist and can take corrective action? Assess through observation, questioning, and demonstration of knowledge (Make sure that training is completed, by the manager knowing and demonstrating food safety checks and corrective actions are done appropriately)
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[FS7-US] Is there warm running water and required supplies at all hand washing sinks? Are hand was sinks easily accessed by employees and only used for hand washing, not preparing food, or storing equipment?
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[FS8-US] Are hands properly washed following hand washing procedures at the appropriate times and is a system in place to ensure hourly hand washing by all employees?
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[FS9-US] Do sanitized towel buckets contain towels and sanitizer solution at the correct concentration checked with a chlorine test trip?
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[FS10-US] Are sanitizer-soaked towels and grill cloths used at food, beverage preparation, and service areas placed into the soiled towel bucket after using and not left sitting out on surfaces?
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[FS11-US] Are all UHC trays, grill utensils, prep table utensils, and utensil holders clean (no build up), washed, and sanitized at least every 4 hours as per approved procedure? do the back sink and soap/sanitizer dispensers or dishwashers function (hot water 110°F or higher) with all required supplies? does the sanitizer solution have the right concentration when checked with an appropriate test strip?
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[FS11-US-01] all soiled raw wares that come into contract with raw proteins (such as fresh beef and raw chicken) are washed and sanitized last (unless and warewasher is used). Soiled blue raw beef trays and lids are kept in blue bus box until cleaned. Back sink is properly sanitized after washing wares that come into contact with raw proteins.
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[FS12-US] Are floors, walls, ceilings, and equipment in good repair (not cracked or damaged) and clean (free of excessive soil, grease, or food debris buildup)? Are floor drains functioning (not clogged)? Are the floors free of standing or puddling water?
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[FS13-US] Are appropriate measures taken to protect water and ice from foreign material, chemicals, and/or bacterial contamination? Are water filters in date and ice machines free from mold or buildup?
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[FS14-US] Are opened packages of food in storage, (including dry storage, refrigerators, and freezers) covered/wrapped, labeled, off the floor and away from walls and stored according to proper procedures? If No, mark what product is not stored properly:
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[FS15-US] Are blue disposable glove procedures or dedicated tongs used to prevent cross-contamination when handling all raw meat or poultry products (including shell eggs) at the grill station and fryer station? Are dedicated utensils used for raw products (e.g. the yellow yolk braking tool is only used to break egg yolks)?
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[FS16-US] Are clear/white disposable gloves worn for food preparation of ready to eat foods at the sandwich prep table and salad prep table, and in all other areas to prevent bare hand contact with any cooked or ready-to-eat foods?
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[FS17-US] are chemicals stored away from food and packaging?
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[FS18-US] is a pest management program and pest prevention steps and behaviors in place and being managed effectively? Is that restaurant properly pest proofed to prevent entry of pests (e.g. gaps under door s are sealed)? Review the most recent pest control report, ensuring all recommendations have been corrected. if the pest management program and pest prevention steps and behaviors are not in place or are not complete, then mark this question as no. Include in the comments specifics on what you observed.
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[FS19-US] Are no-food spill clean-up procedures in place?
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[FS20-US] Are walk-in freezers and any other primary storage freezers operating at 0°F or blow? Are secondary storage freezers keeping all products solidly frozen? If no, check which units are not at proper temperature:
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[FS21-US] Are refrigerated products inside all refrigerated units at or blow 40°F (including shake/sundae reservoir)? If no, check which units do not meet the temperature standard:
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[FS22-US] Are all refrigerated products in code (within primary shelf life)? If no, mark what product is not code:
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[FS23-US] Are secondary shelf lives of all refrigerated products held in refrigerators and at room temperature marked and are the products being used within their secondary shelf lives? If no, mark what product is not in code:
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[FS24-US] Are leftover heated foods discarded (including any shake/sundae mix removed from heat treatment shake/sundae machines)? If no, mark what product:
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[FS25-US] Is the Pyrometer calibrated, working correctly, and is the probe clean?
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[FS26-US] Is the internal temperature of Filet-O-Fish portions after cooking at or above 150°F
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[FS27-US] Are all food, food packaging, equipment (including utensils), and cleaning chemicals from approved sources?
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[FS28-US] Do managers understand employee illness symptoms and reportable illness cause for when an employee cannon be working? Do managers also understand when an employee can return to work after illness?
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[FS29-US] Are all managers (including shift managers) trained and currently certified in food safety through ServSafe (or an equivalent and accredited food safety training course)? Are all employees trained and verified on food safety and sanitation per McDonald's current training program in accordance with local regulations
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[FS30-US] Are at least the last 60 days or correctly completed Food Safety Daily Checklists verification available? (For digital Food Safety please reference the Food Safety Guide)
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[FS31-US] When reviewing the most recent health department inspection report, have all food safety violations noted by the health department been corrected or a plan in place to correct issues?
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[FS32-US] Are nut containing McFlurry Mix-ins kept in the orange container with lid and a dedicated scoop?