Title Page

  • Site

  • Conducted on

  • Name of manager:

  • Prepared by

BREAKFAST

Breakfast Basics:

  • What is the planned breakfast menu for the day of Review?

  • What is the Breakfast serving method?

  • What is the Breakfast Serving Time?

  • Can you easily find the Breakfast food production record(s) in the food prep area?

  • Are the food production records completed prior to meal service? (except recording leftovers)

Breakfast in the Classroom - Counting & Claiming

  • Does Manager have BIC folders for each classroom with a 5 - Day backup manual meal roster included?

  • List classrooms visited. Visit 25% of the Total BIC classrooms.

  • What is the method of recording meals in the classroom(s)?

  • How are teachers distributing meals?

  • If other, describe method?

  • Are the teachers verifying that reimbursable meals have been selected before recording the meal?

Breakfast in the Classroom - Counting & Claiming: BIC Rosters

  • Review the BIC rosters for the following: Labeled with Name of Teacher, Classroom Number, Folder Number, Correct Month, Correct Dates, Current School Year?

  • Review the 25% of the returned folders and should not be the same as the classrooms visited. Check the BIC rosters: Did the teacher properly mark the number of reimbursable meals issued (one mark per each)?

  • Did the manager complete the Child Nutrition Services section on the BIC roster?

  • Did teacher and manager sign the roster at the end of the week?

  • Review the BIC Daily Participation worksheet: Did the manager enter the correct counts off the rosters to the spreadsheet?

  • Review the BIC Daily Participation worksheet to check that the folder number and teacher names are in the same sequence as on the BIC rosters. Is the information the same?

Breakfast in the Classroom - Counting & Claiming: Mosaic POS

  • Is the teacher able to access Mosaic - Serving in the Classroom?

  • Are teachers providing a reimbursable meal before recording the meal on Mosaic?

  • Is Manager verifying classroom counts using the Serving in the Classroom Report?

Breakfast in the Classroom - Meal Components & Quantities

  • Of the classrooms visited, were all the required meal components available to the participating students?

  • Was at least two of the required varieties of fluid milk available?

  • If milk substitutions are made, are they allowable?

  • Do portion sizes meet the minimum amounts per meal pattern requirements and planned menu for the day of review?

Breakfast Thru the Line - Counting & Claiming

  • What is the medium of exchange at the POS?

  • Ask the cashier if they know what is a reimbursable meal when selected by student during breakfast, Does cashier know?

  • Is there a Reimbursable Meal Sign on each line?

Breakfast Thru the Line - Meal Components & Quantities

  • Were all required meal components available on every reimbursable meal service line to all participating students at all times during service?

  • Was at least two of the required varieties of fluid milk available?

  • If milk substitutions are made, are they allowable?

  • Do portion sizes meet the minimum amounts per meal pattern requirements and planned menu for the day of review?

  • BREAKFAST OBSERVATIONS

LUNCH

Lunch Basics

  • What is the Lunch Serving Times for all grades?

  • What is the planned Lunch menu for the day of Review?

  • What is the Lunch serving method?

  • Is there a Reimbursable Meal Sign on each line?

  • What grades are served at this school?

  • Can you easily find the food production record(s) in the food prep area?

  • Indicate the which food production record is being used?

  • Is the manager using the correct one for the site?

Lunch Thru the Line: Counting & Claiming

  • Is there a trained back-up cashier other than the manager?

  • Ask the cashier if they know when a reimbursable meals has been selected by student. Does the cashier know?

  • What is the medium of exchange at the POS?

  • Are purchased snacks rung up under the student's account?

  • When are cashiers entering a la carte sales in the POS?

  • Does each register have a current (no more than 30 days) Master Roster?

  • Is the Meal Roster to record meals not served in the cafeteria (satellites, ISS, etc) used by the manager?

  • Review the CEP Edit Check Report or the Over-claim Edit Check Report for the month. If there are any edit check exceeds did the manager obtain the necessary support documents?

Lunch Thru the Line: Meal Components & Quantities:

"Day of Review"

  • Has the school complied with the planned menu for the day of review?

  • Review the food production record(s) for the "Day of Review" Are the food production records completed prior to meal service? (except for the recording of leftovers)

  • Does the FPR indicate the temperatures recorded for the day?

  • Does the FPR indicate the quantity prepared in the correct format (case ct, #10 cans, lbs)?

  • Are the menu revisions approved substitutions?

  • Do menu substitutions/revisions have an explanation?

  • For the substitutions/revisions made, are the meal components identified (M/A oz ez, Grain Oz eq, Fruit cup, Veg cup, Milk cup)?

  • Are recipes attached?

  • Are Special Diet FPR attached?

  • Did the manager indicate whether offer vs serve or straight tray?

  • Are the food production records filed neatly by month by meal service?

  • Were all required meal components available on every reimbursable meal service line to all participating students during the entire meal service?

  • Was fluid milk available in at least the two required varieties throughout the serving period on all meal service lines?

  • Do portion sizes meet the minimum amounts per meal pattern requirements and planned menu for the day of review for the grade group at this school?

  • Are the minimum daily requirements of grains/breads, meat/meat alternate, milk, fruits, and vegetables met for the age/grade group being served?

  • Is Offer vs. Serve being implemented properly?

  • Are there any competitive foods available in any food service areas during any of the meal periods ?

  • LUNCH OBSERVATIONS

"REVIEW PREVIOUS WEEK"

  • REVIEW THE LUNCH FOOD PRODUCTION RECORDS FOR THE PREVIOUS WEEK.

  • Review 5 days and check that FPR are filled out completed with all required information. Record the dates reviewed.

  • Did the school comply with the planned menu for the review period?

  • Does the FPR indicate the temperatures recorded for the day?

  • Does the FPR indicate the quantity prepared for the required ingredients?

  • Does the FPR indicate the quantity prepared in the correct format (case ct, #10 cans, lbs.)?

  • Do production records for the review period indicate the required quantities of food were available? Select two days to do calculations.

  • Did the manage indicate whether offer vs serve or straight tray?

  • Are the meals served for both students and adults recorded on the food production record?

  • Are the menu revisions approved substitutions?

  • Do menu substitutions/revisions have an explanation?

  • For the substitutions/revisions made, are the meal components identified (M/A oz ez, Grain Oz eq, Fruit cup, Veg cup, Milk cup?

  • Are recipes attached?

  • Are Special Diet FPR attached?

FAMILY STYLE DINING: Counting & Claiming

  • Is teacher verifying that a reimbursable meal is selected by students?

  • If teacher is using Mosaic in the classroom, did teacher record only reimbursable meals?

  • Did manager provide a 5 - day classroom roster in case of computer failure?

  • Is manager verifying count at the end of Lunch by reviewing or printing Serving int eh Classroom report?

FAMILY STYLE DINING: Meal Components & Quantities

  • Does the teacher have the required serving spoons to ensure the correct portion sizes are provided to the students?

  • Were all the required meal components provided to the students?

  • Is the teacher returning leftover food in the pans to the cafeteria in the cambro?

  • FAMILY STYLE DINING OBSERVATIONS:

FRESH FRUIT & VEGETABLE PROGRAM: FFVP

  • Is the FFVP offered during the school day, but outside the meal service times of the NSLP?

  • What time was FFVP service ?

  • Is the FFVP widely publicized within the school?

  • Are gloves sent to the classroom for distribution of the item ?

  • Are teachers who are in the classroom with students during the FFVP meal service the only adults provided with fresh fruits and vegetables?

  • FFVP OBSERVATIONS:

General Areas

  • Are Manager's FS Certification up to date and posted?

  • Expiration Date:

  • Are Food Handlers Certifications up to date and posted?

  • Has the serving site posted its most recent health inspection in a visible location ?

  • What is the date of the previous health inspection?

  • If previous findings, what were the findings?

  • Have previous health inspection findings been addressed and corrected ?

  • Is the Food Establishment Permit posted in a public area ?

  • Is the USDA "And Justice for All" poster displayed in a prominent location and visible to recipients of benefits? (For BIC, poster should be at entrance of building)

  • Is there a Civil Right Complaint form easily accessible to cashier?

  • Is free potable water available to all students for lunch? (in each location where lunches are served during the meal service)

  • Are records filed and labeled as required by Record Retention Procedure?

  • GENERAL AREA OBSERVATIONS:

HACCP

  • Does the manager know how to access the HACCP Plan and Standard Operating Procedures (SOP) on SharePoint?

  • Does the manager complete the HACCP Manager Self-Inspection and submit through Google Forms?

  • Does the manager submit the monthly staff development through Google Forms?

  • Are food products stored properly? (dented cans, opened product labeling, expired items)

  • Ice Machine clean and free of mold?

  • Review each of the required HACCP Logs.

  • Daily Food Panty log completed?

  • Daily Thermometer Calibration Log completed?

  • Daily Refrigerator, Freezer and Milk Cooler Log completed?

  • Daily Holding Temperature Log completed? (Transport sites)

  • Dish machine log being completed weekly with test strip provided?

  • Daily Sanitizing Log - 3 Compartment Sink and Sanitize Buckets completed?

  • Milk and Juice Recycling Temperature Log completed?

  • HACCP OBSERVATIONS:

Finance

  • Does School not have any overages or shortages for previous week?

  • Does campus show A la Carte sales ? (Review 5 previous days)?

  • Was explanation given for overage or shortages of 5 dollars ?

  • Cash for change the correct amount?

  • Cash for Change paperwork being completed daily?

  • FINANCE OBSERVATIONS:

  • SIGNATURES
  • Manager's Signature:

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.