Title Page

  • Conducted on

  • Prepared by

  • Location

Time & Temperature

  • Are Timers in use for Sanitizer Solution?

  • Are Timers in use for Cool Down Chicken?

  • Are Timers in use for Filets, Strips, Nuggets, and Grilled Chicken?

  • Temp. of Regular Filet

  • Temp. of Spicy Filet

  • Temp. of Nuggets

  • Temp. of Strips

  • Temp. of Grilled Filet

  • Temp. of Grilled Nuggets

  • Temp. of Colby Jack Cheese in Randell

  • Temp. of American Cheese in Randell

  • Temp. of Pepper Jack Cheese in Randell

  • Temp. of Tomatoes in Randell

Breading Table

  • Temp of Raw Chicken

  • Temp. of Milkwash

Lowboys

  • Temp. of Grilled Wraps

  • Temp. of Fruit Cup

  • Temp. of Southwest Salad

  • Temp. of Market Salad

  • Temp. of Yogurt Parfait

Cooler

  • Temp. of Bulk Superfood

  • Temp. of Tomatoes

  • Time & Date Prepped

  • Temp. of Cooldown Chicken

  • Temp. of Milkwash

  • Date & Time Milkwash Prepped

Cleaning & Sanitation

Sanitation Concentration

  • Is Breading Table Sanitizer at Correct Concentration?

  • Is Boards/Nuggets/Strips Sanitizer at Correct Concentration?

  • Is Prep Table Sanitizer at Correct Concentration?

  • Is Front Counter Sanitizer at Correct Concentration?

  • Is Produce Wash at Correct Concentration?

  • 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).

  • Are Chemicals stored in Proper Location and in Well-Labeled containers?

  • Is Kay5 Solution available?

  • Is Mop Sink Clean and Clear of Clutter?

  • Is Dishwashing Station Clean and Functioning Properly?

  • Is Sugar scoop and bin free of encrusted debris?

  • Are metal pans/trays facing down on dry rack & free of wet nesting?

  • Are Chix towels or yellow spill pads readily Available?

  • Does men's restroom have soap, sanitizer, & paper towels?

  • Does women's restroom have soap, sanitizer, & paper towels?

  • Are floors and drains free of standing water and debris? (Check Drive Thru Area too)

  • Tomato Slicer

  • Lettuce Chopper

Cross-Contamination

  • Are all items in walk-in properly labeled? (Check for Expiration dates)

  • Are All Items in Lowboy properly Labeled?

  • Is all Food being Stored at Least 6 Inches Above Ground?

  • Are scoops (i.e. lemonade, prep table scoop) free from touching the product (i.e. sugar)?

  • Are Food & Drink Restricted to Non-food Areas?

  • Are all personal items (Including Dishwashing apron) stored away from food areas?

  • Are Thermometers (Raw and Regular) readily Available?

  • Are all Team Members in Back-of-House Wearing Proper Hair Restraints?

  • Are Dishes free from Label Residue?

Health & Hygiene

  • Are All Hand washing Facilities Clean and Accessible? (Accessible means that nothing can be in front of, on, or inside- i.e. metal scraper)

  • Are proper handwashing procedures observed (20 seconds, bear claw, after every glove change)?

  • Are employee uniforms clean? (Especially kitchen)

  • Do Handwashing Stations have Soap & Paper Towels?

Pests Overview

  • Is Exterior Garbage Storage Covered and Doors Closed when Not in Use?

  • Is Dumpster Area Free of Debris?

Ice Machine

  • Door Free of Mold

  • Door Sanitized

  • Door Rail Free of Mold

  • Door Rail Sanitized

  • Under Bin Lid Free of Mold

  • Under Bin Lid Sanitized

  • Is Ice Machine Food Safe?

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.