Information
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SAFE AD Assessment
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Audit Title
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Assessment Type:
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Type of Restaurant
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Restaurant Name:
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Restaurant #:
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Address:
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Date:
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Auditor Sign Here:
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Revised March 2013
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INSTRUCTIONS: Conduct the assessment in the zoned format by evaluating and answering the following questions in each of the designated restaurant zones below. Once a violation is marked as non-compliant in one zone it cannot be marked again in subsequent zones but additional notes can be taken to explain in which zones the violation was found.
BEHAVIORS: 3.0, 4.0, 5.0, 6.0, 10.0, 24.0
OUTSIDE: 21.0, 23.0
FOH & BAR: 7.0, 11.0, 17.0, 18.0, 21.0, 23.0
COLD STORAGE: 9.0, 15.0, 17.0, 18.0, 22.0
DISH & MOP: 7.0, 11.0, 21.0, 23.0
DRY STORAGE: 9.0, 11.0, 12.0, 18.0, 21.0, 23.0
LINE: 7.0, 11.0, 13.0, 14.0, 16.0, 17.0, 18.0, 23.0
PREP & EXPO: 7.0, 11.0, 13.0, 14.0, 15.0, 18.0, 20.0, 23.0
ADMIN: 1.0, 2.0, 19.0, -
1.0 Manager and Team Member Certification / Regulatory Code Compliance<br>Check for manager certification, team member food handler cards, health inspections, permits and health code.
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CHECK ALL THAT APPLY
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A certified food protection Manager is not present during all hours of operation
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Certification, wallet card, or other document not current (within 5 years)
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Certification does not conform to local regulatory standards and / or CFP requirements (, Thomson Prometric, National Registry, or CIEH certification cards)
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Team Members / Managers do not have food handler cards when required by the local regulatory authority or within the timeframe specified by the local regulatory authority
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Inspections not on file
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Inspections not posted (where required by law)
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Health Department and Operating Permits not available for review during the assessment
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Local health code not available for review during the assessment
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Permit is expired by more than 30 days
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SAFE Manual not available for Non- Us locations where no code is available
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2.0 Employee Reporting & Exclusion: Randomly choose five team members (managers included) and verify that an Employee Health Condition form is on file and properly completed for each team member / manager.
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CHECK ALL THAT APPLY
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Manager not aware or knowledgeable of the Employee Reporting & Exclusion Policy
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Manager not able to answer the scripted question with all 5 key symptoms and / or scenarios that require action to be taken
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3.0 Gum / Tobacco Chewing, Smoking or Improper Eating: Verify that gum chewing, tobacco usage, improper drinking or eating and smoking are not occurring.
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CHECK ALL THAT APPLY
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Gum chewing inside of restaurant
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Tobacco chewing inside of restaurant
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Improper drinking in food service area
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Improper eating in food service area
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Smoking or evidence of smoking in food service area
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4.0 No Sick / Symptomatic Team Members / Managers at Work: Verify that no employees are working with symptoms of cold / flu, diarrhea, vomiting, jaundice or any communicable or infectious disease.
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CHECK ALL THAT APPLY
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Sick/symptomatic Team Members/Managers working in restaurant
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5.0 Correct Hand Washing Practices Followed: Spend several minutes observing team members, and verify that they are washing hands immediately after engaging in activity that contaminated the hands.
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CHECK ALL THAT APPLY
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Not washing hands after engaging in an activity that contaminates the hands
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Not washing hands after using the toilet facility
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Not washing hands before returning to food prep after change in duties
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Only using hand sanitizer to wash hands
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Not using soap while washing hands
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Not washing hands after coughing / sneezing into hands, then returning to food prep
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Wiping hands on sanitizing towel in place of handwashing
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Drying hands on a cloth, common towel, or clothes
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Not washing hands after touching face, hair, body, or other people
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Not washing hands after handling garbage, handling dirty dishes, or cleaning / bussing tables
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Not washing hands when switching between raw and ready to eat foods
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Not washing hands before putting on gloves
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Improper hand washing procedures
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5.1.A INFORMATIONAL ONLY: What are the 5 steps of proper hand washing?
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Answer should include all of the following: Use hot water, apply soap, lather for 20 seconds, rinse, dry with paper towels
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6.0 Disposable Gloves Properly Used: If required by the local regulatory authority, ensure that gloves are used when handling foods. Ensure that gloves are put on only after washing hands and that they are worn over bandages and cut-gloves.
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CHECK ALL THAT APPLY
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Not used during food prep activities when required (local code requirements)
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Not used during menu item assembly when required (local code requiments)
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Hands washed with gloves on
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Gloves removed from hands and then re-used
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Gloves not used over bandages (including finger cots), casts, or finger cuts(except bartenders and servers not preparing or handling food, who only need to wear blued bandages over wounds)
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Gloves not worn over cloth cutting gloves
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Glove variance not available when required by local regulatory authority
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7.0 Hand Washing Sink Stocked, Functioning, and Properly Used: Verify that all sinks dispense water capable of reaching 100 F - 120 F. Verify that sinks have towels, a "hand washing only"sticker, antibacterial soap and a trash can.
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CHECK ALL THAT APPLY
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Hand washing sink obstructed from Team Member use
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No single-use paper towels available at every sink
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A hands-free dispenser is not being utilized
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Air dryer being used instead of single-use paper towels
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Continuus feed cloth instead of single-use paper towels
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No trashcan available (in sight)
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Trashcan is blocked or otherwise not accessible
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Trashcan is full and not emptied
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No signs available or not adjacent to sinks
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Signs not legible
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Not using the Brinker approved "Handwashing Only" sign
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Handwashing sinks used for purposes other than handwashing
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Items in Handwashing sink (food particles, towels, utensils, etc.)
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Only cold water at any single sink, including toilet facilities (less than 100F)
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Only hot water at any single sink, including toilet facilities
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Hot water temperature exceeds 120F (49C) and must be reduced
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No running water at a hand washing sink, including toilet facilities
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Non-anti-bacterial soap being used
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Soap dispenser empty
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Soap dispenser not functioning
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Bar soap being used instead of liquid/foam soap
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No stocked glove dispenser located at each BOH hand washing sink
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8.0 (International Only) Food Items Are Purchased From Approved Sources: Using the APL list, select 5 items and verify that those items are approved products.
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9.0 Acceptable Receiving Practices Followed: Verify that received product is being checked for damage and/or temperature abuse. Cold product must immediately be placed in refrigeration.
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CHECK ALL THAT APPLY
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Damaged product accepted
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Refrigerated product not stored immediately
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Receiving observed without temperatures being taken on cold items
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10.0 Cross Contamination Not Observed: Spend several minutes observing team members / processes and verify that cross contamination is not occurring with food or food-contact surfaces.
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CHECK ALL THAT APPLY
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Using prep sink for food preparation without first cleaning and sanitizing the sink
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Small wares, containers, and lids not washed and sanitized before using after touching unsanitary surface
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Using unclean utensils to open bags of product
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Food prep at hand sink (including rinsing of equipment/small wares &dumping contents of food containers)
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Food prep at un-sanitized sanitizing compartment of the 3-part sink in the restaurant with no prep sink
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Cross-contamination as a result of improperly using ice bags for cold holding
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Washed/prepared produce placed back into original container
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Storing food in container previously used to store chemicals
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Food containers used to store chemicals
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Foreign objects stored in ice to be used as food
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Cleaned and sanitized food-contact items stored on the floor
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Thermometer used without sanitizing first
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11.0 Food Contact Surfaces Cleaned And Sanitzed: Verify that 3-comp sinks and dish machines are sanitizing properly. Verify that all dishware and equipment are free of debris (no evidence of food particles, grease, or other debris).
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CHECK ALL THAT APPLY
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CLEANLINESS VIOLATIONS (COOKWARE / UTENSILS / CUT GLOVES- 6 OR MORE OF 20 RANDOM ITEMS OBSERVED IN ANY ONE AREA)
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(Dishes) Dishes not in use found to be dirty and unsanitary, evidence of food particles, grease or other debris
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(Dishes) Clean dishes stored in an unclean area such as a soiled wall, dirty shelf or rack, or in a dirty storage bin
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(Dishes) Clean dishes are stored with other dishes that are not clean and sanitary
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(Dishes) Glassware stored clean with residue/ debris/ lipstick
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(Cookware) Cookware not in use found to be dirty and unsanitary, evidence of food particles, grease or other debris
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(Cookware) Clean cookware is stored in an unclean area such as a soiled wall or on a dirty shelf or rack, or in a dirty storage bin
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(Cookware) Clean cookware is stored with others dishes that are not clean and sanitary
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(Cookware) Cutting boards stored clean with food debris present
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(Cookware) Cutting boards not stored upright
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(Utensils) Utensils not in use found to be dirty and unsanitary, evidence of food particles, grease or other debris
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(Utensils) Clean utensils stored in an unclean area such as a soiled wall, dirty shelf or rack, or in a dirty storage bin
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(Utensils) Clean utensils are stored with other dishes that are not clean and sanitary
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(Utensils) Knife rack(s) with food debris present
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(Cut Gloves) Soiled cut gloves in use
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(Cut Gloves) Cut gloves not washed, rinsed, and sanitized by dish machine
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SANITIZING VIOLATIONS
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Oasis 144 too high (reads 300 ppm or more on the test strip)
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Oasis 146 too high (reads > 400 ppm)
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Chlorine too high (> 200 ppm)
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Oasis 144 too low (reads 100 ppm or less on the test strip)
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Oasis 146 too low (reads <150 ppm)
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Chlorine too low (<50 ppm)
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Proper test strips not available in the restaurant
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Heat temperature too low on glass washer (less than 160 F (71 C) at surface of cleaned utensil)
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Lollipop thermometers not available for high temperature dish machines
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High temperature dish machine sanitizing temperature < 160 F (71 C)
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CLEANLINESS VIOLATIONS - EQUIPMENT (2 OR MORE OBSERVED IN ANY ONE AREA)
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(Equipment) Clean equipment stored in an unclean area such as a soiled wall or on a dirty shelf or rack, or in a dirty storage bin
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(Equipment) Clean equipment is stored with other dishes that are not clean and sanitary
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(Equipment) Soda nozzles with mold/buildup and beer tap equipment
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(Equipment) Can openers with buildup
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(Equipment) Slicers/dicers stored clean with food particles or debris present
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(Equipment) Food shelving in poor condition or food debris present
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(Equipment) Equipment not in use found to be dirty and unsanitary, evidence of food particles, grease or other debris (equipment)
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(Equipment) Ice machine has mold buildup, rust, off odor, or dirty gaskets
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12.0 Proper Disposition of Unsafe Food ( Dented Cans): Check to see if there are any dented / swollen cans stored with other usable cans.
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CHECK ALL THAT APPLY
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Dented/ rusted/ swollen cans in storage
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13.0 All Products Meet Minimum Internal Cooking Temperatures: Using the restaurant's calibrated thermometer, verify that proteins are cooked according to the cooking chart temperatures in Section 13.0 of the SAFE manual.
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CHECK ALL THAT APPLY
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Products do not meet minimum maternal cooking temperatures given in the temp chart in the manual
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Team members are not knowledgeable of the minimum internal cooking temperature requirements
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14.0 TCS / PHF Products Reheat to 165 F (74 C) within 2 Hours: Using the Restaurant's Calibrated Thermometer, verify that TCS / PHF items are properly reheated prior to placing the product on the hot line.
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CHECK ALL THAT APPLY
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TCS/PHF product not reheated to 165F (74C) within 2 hours
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Team Members are not knowledgeable of reheating standards
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TCS/PHF foods cooked/ reheated in hot holding units
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15.0 Cooling Method In Use Effectively Cools Product to 41 F (5 C) or Lower / Proper Cooling Method: Verify that proper cooling procedures are being used, temperatures are within range, and that cooling logs are properly completed.
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CHECK ALL THAT APPLY
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Two stage cooling method not in use
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Product not at proper temperature at either the first or second stage of the Two Stage cooling method
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Team Member not knowledgeable of cooling cooling method in use and proper cooling procedures
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Product being cooled on a sheet pan greater than 2" (5cm) deep
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Left over product not reduced to small quantities at end of night
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Batches of product not split to shallow mounts for cooling or not cut into smaller pieces
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Ice bath method not used for products greater than 2" (5cm) deep
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No cooling log is present
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Cooling log is not being used for all products at least once a month
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Some information is missing such as date, time process started, temperature checks, corrective action, etc.
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A master list of all items that require cooling is not available
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Cooling log not kept on file for 90 days
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3 or more of 10 randomly selected items have missing or incomplete information
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16.0 TCS / PHF Products Meet Hot Holding lnternal Temperature Requirements of 135 F (57 C): Using the restaurant's calibrated thermometer, verify that TCS / PHF items held hot are at or above 135 F (57 C).
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CHECK ALL THAT APPLY
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Minimum hot holding temperature for all ingredients is not greater than or equal to 135F (57C)
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17.0 TCS / PHF Products Meet Cold Holding lnternal Temperature Requirements of 41 F (5 C) or Lower: Using the restaurant's calibrated thermometer, verify that TCS / PHF items held cold are at or below 41 F (5 C).
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CHECK ALL THAT APPLY
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Product temperature greater than 41 F (5C) because unit is not functioning properly
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Product temperature greater than 41 F (5C) because the unit was overloaded
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Product temperature greater than 41 F (5C) because the individual containers were overfilled
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Prepped product at temp greater than 41 F (5 C), and label shows that product we prepped more than four hours earlier
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Received product at temp higher than 41 F (5 C), and documentation shows that product was delivered more than 4 hours earlier
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Prepped product at temp higher than 41 F (5 C) and label does not state prep time
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18.0 Labeling of Food Products Meets Standards & No RTE TCS / PHF Products are Expired: Verify that all food products are labeled according to Section 18.0 Standards. Also verify that no RTE PHFs are expired.
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CHECK ALL THAT APPLY
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Manufactured TCS/PHF products in storage are expired per the label
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Prepared TCS/PHF products in storage are more than 7 days past the prepped date
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Obviously expired/ spoiled products observed
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Dairy products more than three days past the "Sell By" date
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Product not labeled according to the requirements (6 or more labels are incomplete or missing in one area/zone)
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19.0 Manager Knowledgable of Consumer Advisory: Quiz the MOD to verify that they know where the consumer advisory is located and what is its purpose.
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CHECK ALL THAT APPLY
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Manager not knowledgeable abut consumer advisory
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20.0 Produce Wash Using Ecolab's Victory System (or other approved system) Prior to Use: Verify that the dispenser is functioning and not empty. Ensure that team members are not skipping the wash step entirely, and that proper contact time is being achieved.
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CHECK ALL THAT APPLY
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Not using Ecolab's Victory system or another Brinker approved produce wash
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Victory system or Brinkeer-approved produce wash not dispensing
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Ecolab Victory system or another Brinker-approved produce wash not present in restaurant
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Not using Victory system properly ( rinsing product for less than 30 sec or submerging for less than 1 minute)
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Observed Victory wash being diluted with water
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21.0 Cleaning Chemicals Properly Labeled and Stored: Verify that all chemical containers, spray bottles, and team member medications are labeled legibly. Verify that chemicals are properly sealed, stored away from direct sunlight, stored below food, and kept at least 3 feet (1 meter) away from heat. Verify no lawn chemicals are present.
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CHECK ALL THAT APPLY
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Spray bottles not labeled
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Chemicals not labeled
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Chemicals stored above food and/ or food contact surfaces
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Spray bottles assembled, empty, missing label
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Labels not legible
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Chemicals labeled incorrectly
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Chemicals not properly sealed
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Chemicals not stored below all other food items and food contact materials
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Chemicals stored in direct sunlight
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Liquid soap and hand sanitizer dispensers mounted in other locations (other than the handwashing sink)
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Chemicals are stored within 3 feet (appro 1 meter) of sources of heat or flame
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Lawn chemicals present
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22.0 Question reserved for future use
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23.0 No Pest Activity is Evident in the Facility: Using the Critical Pest Chart in Section 23.0, verify that there is no pest activity in the building. Also verify that no pesticides are being stored at the restaurant. Verify that all outer/exterior/delivery doors are not propped open or have gaps 0.25" (63.5 mm) or larger.
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CHECK ALL THAT APPLY
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Rodent (1 or more live or dead rodents observed)(Excluding those caught inside of PCO approved traps)
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Flies (3 flies in 3 or more areas)
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Roaches (2 live or dead roach sightings)
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Other insects (Any obvious substantial activity of pests other than roaches, rodents or flies)
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Pesticides present
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Lawn chemicals present
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Outer/Exterior door(s) propped open
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Gaps greater than or equal to 0.25" (6.35mm) present around outer/exterior door(s) to allow for pest entry
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24.0 Hair Restraints Worn as Required & Team Member Clothing Clean to Prevent Contamination: Verify that team member clothing is in good condition, hair restraints are worn where required, and outer garments (aprons) are not brought into the toilet facility.
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CHECK ALL THAT APPLY
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Team Member clothing is not clean or in good condition
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Team Member aprons are excessively dirty with potential to cross contaminate
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Hair restraints not worn when required by regulatory
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No outer protective garment (apron, cutting glove,vinyl gloves, etc...) brought into the toilet facility
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