Title Page
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Service Kitchen
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Date & Time
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Prepared by
Food Storage
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Food is kept at least 6" off the ground
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Food is stored in a clean dry place that is not exposed to contamination
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Containers are labeled with the food name and delivery date
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Food is stored using the FEFO method (First Expired First Out)
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Food-contact surfaces are clean and sanitized
Freezer and Refrigerator Maintenance
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Freezer Thermometer is present and accurate
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Freezer Temperature is holding at 0˚F or below
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Refrigerator Thermometer is present and accurate
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Refrigerator Temperature is at 40˚F or below
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Freezer and Refrigerators are clean
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Food items are correctly identified and date marked
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Food is stored using the FEFO method (First Expired First Out)
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Freezer Temperature Check Item 1
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Freezer Temperature Check Item 2
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Refrigerator Temperature Check Item 1
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Refrigerator Temperature Check Item 2
Food Preparation
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Food is protected from cross contamination (Covered)
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Frozen food is properly thawed in the refrigerator or under running water
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Staff have clean hands, disposable gloves, and or utensils when handling food
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Rice is held at 140˚F or higher
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Cheese sauce is held at 140˚F or higher
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Food preparation area, shelves and cabinets are clean and sanitized
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Prep Line Refrigerator Temperature Check Item 1
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Prep Line Refrigerator Temperature Check Item 2
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Prep Line Refrigerator Temperature Check Item 3
Sanitation
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Washing station is set and in compliance (Wash-Rinse-Sanitize) Sanitizer at 200ppm
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Smallware/utensils are properly cleaned and sanitized between uses
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Utensils are properly air dried after washing
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Water source is safe at 85˚F
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Hand soap and hand washing sign available
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Cleaning equipment available and stored correctly
Employee Hygiene
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Employees are wearing clean uniforms and hairnets
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Employees wash hands regularly and correctly
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Cuts and bandages are covered
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Jewelry and nail polish policies are followed
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No eating in the kitchen policy
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Personal items are stored away from food preparation areas
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Personal food items are clearly identified and kept in designated areas
Pest and Checmical Controls
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No presence or breading of insects / rodents / pests
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Outer openings protected from insects /rodents / pests
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Garbage and refuge is properly disposed off
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All chemicals and labeled and identified
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All chemicals are properly stored and away from food
Safety and Miscellaneus (reporting purposes only)
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Fire extinguishers equipment
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All exits are not block or locked
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Electrical wiring / outlets in good repair
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Curent License is properly displayed
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Serv Safe Certifications are current and properly displayed
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Bathrooms are in working order and accessible
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Lockers and break area is available for staff
HACCP Logs
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Refrigerator Temperature Log Unti 1
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Refrigerator Temperature Log Unit 2
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Refrigerator Temperature Log Unit 3
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Freezer Temperature Log
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Chemical Disinfection Log
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Cheese Sauce Temperature Log
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Rice Temperature Log
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Thermometer Calibration Log
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Receiving Log
Notes
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Notes
