Title Page
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Conducted on
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Prepared by
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Location
Time & Temperature
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Are Timers in use for Sanitizer Solution?
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Are Timers in use for Cool Down Chicken?
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Are Timers in use for Filets, Strips, Nuggets, and Grilled Chicken?
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Temp. of Regular Filet
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Temp. of Spicy Filet
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Temp. of Nuggets
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Temp. of Strips
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Temp. of Grilled Filet
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Temp. of Grilled Nuggets
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Temp. of Colby Jack Cheese in Randell
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Temp. of American Cheese in Randell
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Temp. of Pepper Jack Cheese in Randell
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Temp. of Tomatoes in Randell
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Breading Table
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Temp of Raw Chicken
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Temp. of Milkwash
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Lowboys
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Temp. of Grilled Wraps
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Temp. of Fruit Cup
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Temp. of Southwest Salad
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Temp. of Market Salad
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Temp. of Yogurt Parfait
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Cooler
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Temp. of Bulk Superfood
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Temp. of Tomatoes
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Time & Date Prepped
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Temp. of Cooldown Chicken
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Temp. of Milkwash
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Date & Time Milkwash Prepped
Cleaning & Sanitation
Sanitation Concentration
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Is Breading Table Sanitizer at Correct Concentration?
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Is Boards/Nuggets/Strips Sanitizer at Correct Concentration?
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Is Prep Table Sanitizer at Correct Concentration?
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Is Front Counter Sanitizer at Correct Concentration?
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Is Produce Wash at Correct Concentration?
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Are Food-Contact Surfaces Properly Cleaned and Sanitized? (Only mark "yes" if they have been cleaned with multi-surface cleaner and wiped down with sanitizer wipes within the past four hours).
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Are Chemicals stored in Proper Location and in Well-Labeled containers?
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Is Kay5 Solution available?
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Is Mop Sink Clean and Clear of Clutter?
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Is Dishwashing Station Clean and Functioning Properly?
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Is Sugar scoop and bin free of encrusted debris?
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Are metal pans/trays facing down on dry rack & free of wet nesting?
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Are Chix towels or yellow spill pads readily Available?
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Does men's restroom have soap, sanitizer, & paper towels?
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Does women's restroom have soap, sanitizer, & paper towels?
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Are floors and drains free of standing water and debris? (Check Drive Thru Area too)
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Tomato Slicer
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Lettuce Chopper
Cross-Contamination
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Are all items in walk-in properly labeled? (Check for Expiration dates)
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Are All Items in Lowboy properly Labeled?
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Is all Food being Stored at Least 6 Inches Above Ground?
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Are scoops (i.e. lemonade, prep table scoop) free from touching the product (i.e. sugar)?
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Are Food & Drink Restricted to Non-food Areas?
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Are all personal items (Including Dishwashing apron) stored away from food areas?
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Are Thermometers (Raw and Regular) readily Available?
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Are all Team Members in Back-of-House Wearing Proper Hair Restraints?
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Are Dishes free from Label Residue?
Health & Hygiene
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Are All Hand washing Facilities Clean and Accessible? (Accessible means that nothing can be in front of, on, or inside- i.e. metal scraper)
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Are proper handwashing procedures observed (20 seconds, bear claw, after every glove change)?
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Are employee uniforms clean? (Especially kitchen)
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Do Handwashing Stations have Soap & Paper Towels?
Pests Overview
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Is Exterior Garbage Storage Covered and Doors Closed when Not in Use?
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Is Dumpster Area Free of Debris?
Ice Machine
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Door Free of Mold
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Door Sanitized
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Door Rail Free of Mold
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Door Rail Sanitized
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Under Bin Lid Free of Mold
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Under Bin Lid Sanitized
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Is Ice Machine Food Safe?