Title Page

  • Prepared by

  • Store Name / #

  • Menaul 220
  • Candelaria 1424
  • Lomas 2570

CRITICAL FOOD SAFETY

  • Is the restaurant free of a pest infestation and/or signs of an active pest infestation in the restaurant building, adjoining corral and any area within 10 feet of the building?

  • Inside the restaurant has visisble infestation

  • ⃝ Inside the restaurant has visible infestation

  • ⃝ Inside the restaurant shows signs of infestation

  • ⃝ Outside the restaurant has visible infestation

  • ⃝ Outside the restaurant shows signs of infestation

  • ⃝ Un-trapped live rodent(s)

  • ⃝ Live cockroach(es)

  • ⃝ Rodent droppings

  • ⃝ Other

  • Are the internal temperatures of beef patties after cooking at or above 155°F?

  • ⃝ Temperature settings and cooking timers are not set correctly

  • ⃝ Maximum run size exceeded

  • ⃝ Patties not laid and removed in the proper sequence

  • ⃝ Release sheets are not in good condition or not tightly placed on platen

  • ⃝ Release sheets are not squeegeed between every run and wiped off with a grill cloth at least four times per hour

  • ⃝ Patties not solidly frozen or shows signs of thawing

  • ⃝ Grill is not in good repair

  • ⃝ Other

  • FS3-US Are the internal temperatures of chicken products after cooking at or above 165°F?

  • ⃝ Temperature settings and cooking timers are not set correctly

  • ⃝ Maximum run size exceeded

  • ⃝ Proper fryer baskets not being used or are overfilled

  • ⃝ Oil levels in fryers are not correct

  • ⃝ Portions not solidly frozen or shows signs of thawing

  • ⃝ Fryer is not in good repair

  • ⃝ Other

  • FS4-US Are the internal temperatures of Filet-O-Fish portions after cooking are at or above 150°F?

  • ⃝ Temperature settings and cooking timers are not set correctly

  • ⃝ Maximum run size exceeded

  • ⃝ Proper fryer baskets not being used or are overfilled

  • ⃝ Oil levels in fryers are not correct

  • ⃝ Portions not solidly frozen or shows signs of thawing

  • ⃝ Fryer is not in good repair

  • ⃝ Other

  • FS5-US Are the internal temperatures of breakfast steak and breakfast sausage after cooking at or above 155°F?

  • ⃝ Temperature settings and cooking timers are not set correctly

  • ⃝ Maximum run size exceeded

  • ⃝ Patties not laid and removed in the proper sequence

  • ⃝ Release sheets are not in good condition or not tightly placed on platen

  • ⃝ Release sheets are not squeegeed between every run and wiped off with a grill cloth at least four times every hour

  • ⃝ Patties not solidly frozen or shows signs of thawing

  • ⃝ Grill is not in good repair

  • ⃝ Other

  • FS6-US Are the internal temperatures of round eggs after cooking at or above 155°F?

  • ⃝ Temperature settings and cooking timers are not set correctly

  • ⃝ Eggs not laid and removed in the proper sequence

  • ⃝ Egg ring not positioned properly on the grill surface or egg cooker not level on the floor

  • ⃝ Improper amount of water is poured into the center of the egg ring or timer is not started immediately after pouring water

  • ⃝ Egg ring or egg cooker is not in good repair

  • ⃝ Grill is not in good repair

  • ⃝ Other

  • FS7-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?

  • ⃝ Pyrometer is not being properly placed in the center of the patties

  • ⃝ Not all the 4:1 patties cooked are checked

  • ⃝ The manager does not know the correct minimum cooking temperature requirement

  • ⃝ The manager does not take proper corrective action when a product is undercooked

  • ⃝ Other

Scored Food Safety

  • FS8-US Are all Time- Temperature Control for Safety (TCS) refrigerated products in code (within primary shelf life)? If no, mark what product is not in code.

  • ⃝ Fresh beef

  • Produce

  • ⃝ Cheese / Eggs / Dairy

  • ⃝ Canadian bacon

  • ⃝ Apple Slices

  • ⃝ Milk

  • ⃝ Shake / Sundae mix

  • ⃝ Other

  • FS9_US Handwashing sinks: Is there warm running water and required supplies at all handwashing sinks?

  • ⃝ Hand washing sink knobs/automatic tap not working well

  • ⃝ Soap dispenser empty / not working

  • ⃝ No warm running water of at least 100˚F

  • ⃝ No paper towel/working hand dryer

  • ⃝ Hand washing sink/tap obstructed and not accessible

  • ⃝ Hand washing sink used for other purposes

  • ⃝ Other

  • FS10-US Handwashing procedure: Are hands properly washed at the required times following hand washing procedures? Is there a system in place to ensure hourly hand washing by all employees?

  • ⃝ Hands not washed on hourly basis

  • ⃝ Hand washing clock / timer not working / not in use / system not in place

  • ⃝ Hand washing activity not monitored

  • ⃝ Hands not washed after using restroom / taking a break

  • ⃝ Hands not washed after handling raw products and working on other station, e.g., prep table

  • ⃝ Hands not washed after tasks (i.e. handling waste, cell phone usage, touching face, hair, picking items off floor, etc)

  • ⃝ Proper hand washing procedure not followed

  • ⃝ Other

  • FS11-US Sanitized towel/cloth buckets: Do sanitized towel buckets contain towels and chlorine sanitizer solution at the correct concentration checked with a chlorine test strip?

  • ⃝ Fresh bucket with sanitized towels not prepared

  • ⃝ Buckets not labeled correctly

  • ⃝ No towels in fresh bucket

  • ⃝ Bucket is soiled

  • ⃝ Sanitizer level is less than 50 ppm

  • ⃝ Test strips not available / damaged / expired / not in usable condition

  • ⃝ Other

  • FS12-US Sanitizer-soaked towels/cloths: Are sanitizer-soaked towels

  • ⃝ Grill towels left out on kitchen surfaces

  • ⃝ Cloth towels left out on kitchen surfaces

  • ⃝ Cloth towels left out on beverage/service areas

  • ⃝ Soiled towels mixed with fresh towels in the clean towel bucket

  • ⃝ Other

  • FS13-US Utensils sanitizing: Are all in-use UHC trays, grill utensils, prep table utensils, and utensils 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 in the wash bin/sink)

  • ⃝ UHC trays, utensils, and utensil holders have excessive grease or build-up

  • ⃝ Items are not being cleaned and sanitized every 4 hours

  • ⃝ Back sink dispenser/ware washer not operating properly

  • ⃝ Sanitizer solution not at the correct concentration

  • ⃝ Water at back sink is not 110˚F or hotter

  • ⃝ Test strips not available or damaged / expired / not in usable condition

  • ⃝ Other

  • FS13-US-01 All soiled raw wares that came into contact with fresh beef are washed and sanitized last (unless a 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 came into contact with raw proteins

  • ⃝ Raw ware equipment not cleaned last

  • ⃝ Raw ware equipment not washed separately

  • ⃝ Soiled raw beef tray(s) / lid(s) are not stored in blue bus box

  • ⃝ Back sink / Powersoak sink not cleaned after washing raw ware equipment

  • ⃝ Raw ware equipment is soaking in Powersoak sink

  • ⃝ Other

  • FS14-US State of cleanliness: Is the restaurant (all areas) in a good state of cleanliness. In all areas, the floors/walls/ceiling and equipment do not have excessive soil, grease or food debris build up? Are the floors free of standing or puddling water?

  • ⃝ Excessive build up of dirt/grease/mold on floors/walls/ceiling

  • ⃝ Excessive build up of dirt/grease/mold on equipment

  • ⃝ Standing/puddling water on the floor

  • ⃝ Other

  • FS15-US State of Repair: <br>Is the restaurant (all areas), the floors/walls/ceilings, and equipment functioning properly and in a good state of repair (not cracked or damaged)? The freezers should not have excessive buildup of ice.

  • ⃝ Floors/drains/walls/ceiling not in good repair (e.g. broken/missing tiles)

  • ⃝ In-use food contact equipment/utensils/trays cracked or damaged

  • ⃝ Grease traps in use not functioning properly

  • ⃝ Ice build up in freezer

  • ⃝ Other

  • FS16-US Water and ice: <br>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 build up?

  • ⃝ Water filter(s) not dated (if not serviced by Coke)

  • ⃝ Water filter(s) bypassed

  • ⃝ Ice transfer bucket or ice scoop not clean

  • ⃝ Ice scoop not stored in holder

  • ⃝ Water / ice not protected from possible contamination

  • ⃝ Ice machine, bin, or ice chute has visible mold or build up

  • ⃝ Other

  • FS17-US Food product opened: <br>Are opened packages of food in storage, (including dry storage, refrigerators, and freezers) covered/wrapped, off the floor and away from the walls and stored according to proper procedures? If not, mark what product is not stored properly.

  • ⃝ Frozen beef

  • ⃝ Fresh beef

  • ⃝ Frozen chicken

  • ⃝ Fish

  • ⃝ Breakfast meats

  • ⃝ Potato products

  • ⃝ Produce / Salad ingredients

  • ⃝ Cheese / Eggs / Dairy

  • ⃝ Raw products are not stored separately from ready-to-eat foods

  • ⃝ Packages of food stored touching the wall/floor

  • ⃝ Packages of food are not covered/wrapped

  • ⃝ Other

  • FS18-US Raw food product handling: Are blue disposable glove procedures or dedicated tongs use 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 product (yolk breaking tool is only used to break egg yolks)?

  • ⃝ Gloves not discarded when removed/are being reused

  • ⃝ Double set of gloves being worn

  • ⃝ Proper blue glove procedures for use/removal are not being followed

  • ⃝ Yellow yolk breaking tool not available

  • ⃝ Yellow yolk breaking tool used for items other than raw eggs

  • ⃝ Yellow yolk breaking tool is improperly stored in contact with food or utensils used for cooking food

  • ⃝ Utensils other than yellow yolk breaking tool used to break raw egg yolks

  • ⃝ Dedicated tongs are used for anything other than handling raw protein products

  • ⃝ Bare hands used with raw product at grill / fryer

  • ⃝ Other

  • FS19-US Ready-to-eat food product handling: Are clear/white disposable gloves worn for food preparation of ready-to-eat foods at the sandwich prep table and salad prep table to prevent bare hand contact with any cooked or ready-to-eat foods?

  • ⃝ Gloves not worn when preparing sandwiches, salads, or burritos

  • ⃝ Gloves not replaced when damaged / contaminated

  • ⃝ Gloves not discarded when removed or being reused

  • ⃝ Gloves not changed if they become contaminated

  • ⃝ Clear gloves are used for handling raw products

  • ⃝ Double set of gloves being worn

  • ⃝ Other

  • FS19-US-01 Good hygienic practices: Are proper personal hygiene procedures being followed?

  • ⃝ Crew hair/beard restraint/cover not used properly

  • ⃝ Manager hair/beard restraint/cover not used properly, where applicable

  • ⃝ Uniforms and/or apron has excessive encrusted buildup

  • ⃝ Excessive jewelry on hands and wrists (more than a smooth ring/wedding band)

  • ⃝ Finger nails are not trimmed, filed and maintained so the edges and surfaces are cleanable and not rough

  • ⃝ False nails, dirty fingernails or nail polish and not wearing intact disposable gloves

  • ⃝ Employees consuming food and/or beverages in food prep areas

  • ⃝ Employees consuming food and/or beverages in service areas

  • ⃝ Other

  • Chemical management:

  • FS20-US Chemical management: Are chemicals stored away from food and packaging?

  • ⃝ Chemical spray bottles / containers stored in the kitchen

  • ⃝ Chemical spray bottles / containers stored in the service area

  • ⃝ Chemicals are stored in dry storage near to food and packaging

  • ⃝ Chemicals stored in food containers

  • ⃝ Chemicals improperly used (ex. spraying around open food or packaging)

  • ⃝ Other

  • FS21-US Pest management: Is a pest management program and pest prevention steps and behaviors in place and being managed effectively? Is the restaurant properly pest proofed to prevent entry of pest (e.g. gaps under doors are sealed)?

  • ⃝ Pest management program is not in place

  • ⃝ Pest management program is not working effectively

  • ⃝ Restaurant is not pest proofed

  • ⃝ Drive-thru window is not closed when not in active use (and there are no cars in the Drive-thru)

  • ⃝ Report is older than 60 days or no pest service report is available for review

  • ⃝ Most recent pest control report recommendations not corrected or there is no action plan to correct

  • ⃝ Dead cockroach(es)

  • ⃝ Trapped rodent(s)

  • ⃝ Trailing ant activity in one area

  • ⃝ High large fly activity greater than 5 in one area

  • ⃝ Other

  • FS22-US Are non-food spill clean-up procedures are in place?

  • ⃝ 3N1 cleaner / disinfectant not available

  • ⃝ Staff not trained in the use of the non-food spill procedures

  • ⃝ Non-food spill procedures not available

  • ⃝ Non-food spill procedures not followed

  • ⃝ Other

  • FS23-US Frozen products: Are walk-in freezers and any other primary storage freezers operating at 0*F or below? Are the secondary storage freezers keeping all products solidly frozen? If no, check which units are not a proper temperature:

  • ⃝ Walk-in freezer or other primary storage freezer is above 0°F and the unit is not in defrost

  • ⃝ Walk-in freezer or other primary storage freezer is above 10°F even if the unit is in defrost

  • ⃝ Product is not solidly frozen in two-door reach-in freezer

  • ⃝ Product is not solidly frozen in grill side reach-in freezer

  • ⃝ Product is not solidly frozen in wall-mounted freezer

  • ⃝ Product is not solidly frozen in any other unlisted secondary/reach-in freezer

  • FS24-US Refrigerated products: Are refrigerated products inside all refrigerated units at or below 40*F (including shake/sundae reservoir)? If no, note which units do not meet temperature standar:

  • ⃝ Walk-in refrigerator

  • ⃝ Prep Table refrigerator

  • ⃝ Pass-through prep line refrigerator

  • ⃝ Two-drawer grill side refrigerator

  • ⃝ Service area refrigerator

  • ⃝ Shake / Sundae Machine

  • Blended Ice Machine

  • ⃝ Any other unlisted secondary/reach-in refrigerator

  • ⃝ Produce held at the prep table or chilled rail

  • ⃝ Cheese / Eggs / Dairy

  • ⃝ Canadian bacon

  • ⃝ Apple slices/butter pats at room temperature or chill pans

  • ⃝ Product held in refrigerators are not properly marked

  • ⃝ Product held in refrigerators not within proper secondary shelf life

  • ⃝ Other

  • FS26-US Leftover heated foods: Are leftover heated foods discarded ( including any shake/sundae mix removed from heat treatment shake/sundae machines)? If no, mark what product:

  • ⃝ Shake / Sundae mix

  • ⃝ Sauces / Soups / Gravies

  • ⃝ Food donation products not stored in freezer

  • ⃝ Other

  • FS26-US-01 Hot holding units: Are heated food in a hot holding unit at or above 140*F ? If no, select which product(s), which type of hot holding unit(s) ( UHC, Marinator, Extended hot cabinet, etc.), and if the products are being without a timing mechanism.

  • ⃝ Products held without a timing mechanism

  • ⃝ Breakfast meats

  • ⃝ Egg products

  • ⃝ Beef patties

  • ⃝ Fried chicken products

  • ⃝ Fried fish products

  • ⃝ Hot cakes

  • ⃝ Marinator

  • ⃝ Extended Hot Holding Cabinet

  • ⃝ Other (e.g., sausage gravy, limited time offer (LTO) protein products and/or sauces)

  • FS27-US Pyrometer Is the Pyrometer calibrated, working correctly, and is the probe clean?

  • ⃝ Probe not complete/missing

  • ⃝ Pyrometer not in calibration

  • ⃝ Pyrometer / probes damaged

  • ⃝ Probe has excessive, encrusted food residue

  • ⃝ Other

  • FS28-US Sourcing: Are all food, food packaging, equipment (including utensils), and cleaning chemicals from approved sources?

  • ⃝ Food not from approved sources

  • ⃝ Packaging not from approved sources

  • ⃝ Equipment not from approved sources

  • ⃝ Cleaning chemicals not from approved sources

  • ⃝ Other

  • FS29-US Employee health: Do Managers understand employee illness symptoms and reportable illness causes for when an employee cannot be working? Do managers also understand when an employee can return to work after illness?

  • ⃝ Manager does not know what symptoms (at a minimum, vomiting, diarrhea and jaundice) would result in employees not being allowed to work

  • ⃝ Manager does not know the procedures to follow when presented with an ill employee

  • ⃝ Manager does not know when an ill employee would be allowed to return to work

  • ⃝ Manager does not know the reportable illness causes

  • ⃝ Employee(s) are observed exhibiting any of the reportable illness symptoms

  • ⃝ Other

  • FS30-US Staff training: 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 McDonalds current training program?

  • ⃝ Certification date is not current

  • ⃝ Certification for managers not issued by ServSafe or equivalent/accredited organization

  • ⃝ Certification records for all managers not available for review during the visit

  • ⃝ Employee training tracking document not available for review during the visit

  • ⃝ Not all employees have been trained and verified

  • ⃝ Other

Food Safety Checklists:

  • FS31-US Food Safety Checklist: Are at least the last 60 days of correctly completed Food Safety Daily Checklist available? Are the last two correctly completed Monthly Food Safety Procedure Verifications available? ( For Digital Food Safety please reference the Food Safety Guide)

  • ⃝ 3 or more missing required sections or days within the 14 days record review

  • ⃝ 12 or more missing required sections or days within the 60 days record spot check

  • ⃝ Daily Food Safety Book (records) not available

  • ⃝ Last two completed Monthly Food Safety Procedure Verifications are not available

  • ⃝ Digital Food Safety less than 80% completion for the last 60 days of Food Safety Daily Checklists

  • ⃝ Other

  • FS32-US Health Department Inspections: When reviewing the most recent health department inspection report, have all critical food safety violations noted by the health department been corrected or a plan in place to correct the issues?

  • ⃝ Health department inspection report not available

  • ⃝ Critical violations noted by Health Department have not been corrected

  • ⃝ Plan not in place to correct issues

  • ⃝ Other

Allergen management:

  • FS33-US Allergen Management: Are nut containing McFlurry mix-ins kept in the orange container with the lid and a dedicated scoop?

  • ⃝ Orange container not utilized for nut containing mix-ins

  • ⃝ Dedicated scoop not utilized or available

  • ⃝ Nut-free mix-ins kept in the orange container

  • ⃝ Other

TOTAL FOOD SAFETY POINTS ACHIEVED 100

  • If the overall score is below 80%, the visit results in not meeting standards and a follow-up is required between 30 - 90 days. Food

  • Safety Review Guide is available for this section

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