Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Exterior

Exterior

  • Building

  • Building Clean/Undamaged

  • Front/Back Doors Illuminated Properly

  • Paint looks fresh, no chips

  • Windows Clean and Ledges Empty and mullions wiped

  • Security door has peep hole or security window

  • Door glass and frames clean

  • Emergency numbers, alarm system info displayed on window

  • Outside storage properly secured with substantial locks

  • No access to building by dumpster, ladder, trash cans, etc.

  • Roof drains to ground properly

  • Roof top and equipment well maintained

Canopies

  • Clean

  • Undamaged

  • Canopy beam lights working

  • Height Clearance signs available

Menu Housings

  • Speakers operational and audible

  • Menu tops clean

  • Menu lights and Showcase Lights Operational

  • Menus clean, including interior

  • Menu frames in good condition (no cracks, scratches, etc)

  • Menu showcase clean and supported

  • Menu background in good condition (no light showing through)

  • Poles - none damaged/plates missing

  • Poles painted, no rust and clean

  • POP cards and banners current

  • POP cards in good condition

  • POP materials professionally printed, no handwritten signs on menus

  • Tray holders in good condition

Signs, Lighting, Playground

  • Pole/Monument Sign Undamaged

  • Pole/Monument Fully Lit

  • EMC fully operational and displaying current message

  • Marquee message current and legible

  • Entrance sign undamaged and fully lit

  • Exit sign undamaged and fully lit

  • Building sign undamaged and fully lit

  • Parking lot well lit

  • Parking lot illuminated at dusk

  • Back door light illuminated at dusk

  • Exterior telephone wire enclosed in conduit

Stalls and Lot

  • Concrete/Asphalt Undamaged

  • Landscaped areas free of litter

  • Free from stains (grease, oil, gum, etc)

  • Dumpster Area free from litter/trash

  • Dumpster area free from stains/lids closed

  • Storage Building organized

  • Underground access covers in place and secure

Landscape

  • Free from weeds

  • No dead grass/plants are neatly trimmed<br>

  • Surrounding area free of litter

  • Dumpster fence in good condition

  • Bushes, shrubs trimmed to prevent hiding

  • Interior view clean and organized

Enter exterior comments below

Interior

Interior (Equipment)

Refrigeration

Walk-In Freezer

  • Temp -10 to +10

  • Clean and organized

  • Shelving clean (rust free)

  • Food stored off the floor

  • Cases spaced for proper ventilation

  • All opened food covered/resealed

  • No ice build up on floor

  • Food properly dated/rotated

  • Evaporator fan clean and not frozen

  • Lights work and explosion guard intact

  • Accurate interior thermometer

  • Gaskets in good condition, no mold

  • No evidence of cross-contamintation

Walk-In Cooler

  • Temp +34 to 40

  • Clean and organized

  • Shelving clean and free of mold, rust

  • Food stored off the floor

  • Cases spaced for proper ventilation

  • Opened/Thawed food stored properly

  • All thawed food stored to prevent cross-contamination

  • Food properly dated/rotated

  • Evaporator fan clean/not frozen

  • Lights working/explosion guard intact

  • Accurate interior thermometer

  • Gasket in good condition, no mold

  • Meat products on lower shelves

  • No evidence of cross-contamination

Reach-In Cooler/Freezer

  • Cooler Temp +34 to 40

  • Freezer temp -10 to +10

  • Both clean and organized

  • No mildew, mold, odor or rust

  • All food covered

  • Evaporator fan clean and not frozen

  • Accurate interior thermometer

  • Gaskets in good condition, no mold

  • No evidence of cross-contamination

Self serve

  • Temp +34 to 40

  • Clean and organized

  • No mold, mildew, rust or odor

  • Evaporator fan clean and not frozen

  • Ice machine functioning<br>

Grill Freezer

  • Temp -10 to +10

  • Clean and organized

  • No mildew, mold, rust or odor

  • All food covered

  • Evaporator fan clean and not frozen

  • Accurate interior thermometer

  • Gaskets in good condition, no mold

Grill

  • Hood and filters cleaned daily

  • Exhaust operational

  • Clamshell Grill Top and bottom temps correct<br>

  • Quick disconnect gas line and chain restraint in use

  • Gas and electrical cut-off devices installed

  • Grill clean, no grease buildup on grill stand or behind grill

  • Bun table in good working order

  • Bun toaster in good working order

  • Grill calibrated/Clamshell Grill Cook Temp Correct

  • Waste bucket in use

Front and Back Fried products

  • Hood and filters cleaned daily

  • Exhaust operational

  • Fryers temp setting calibrated

  • Shortening quality good

  • Salt/bag heating elements operational

  • Lids on pans when not in use

  • Steamer clean in and out, operating correctly

  • Cook times of products verified

  • Fryers filtered twice daily, filter powder used appropriately

  • Quick disconnect gas line and chain restraint in use

Fountain and Misc

  • Dispensed soda at 32 to 40

  • All heads clean, no corrosion

  • Sodas properly carbonated

  • Ice machine bin clean, no corrosion

  • Front ice bins clean, no corrosion or mold

  • All mixers clean and operational

  • Shake machine fully operational/clean

  • Interior/Exterior of Machine Cleaned

  • Softserve machine fully operational and clean<br>

  • Interior/Exterior of machine clean

  • Grill certification current<br>

  • Coffee maker clean and water temp +195

  • Ice tea dispensers and spigots clean

  • Can opener clean and operational

  • Accurate interior thermometer

Enter interior equipment comments below

Interior (Factility)

Interior (Facility)

Floors and Baseboards

  • Clean and undamaged

  • No missing tile, mortar or concrete

  • No standing water

  • Drain covers all intact and clean

Walls

  • Clean and undamaged

  • All opening properly covered

Ceiling

  • Tiles clean

  • No missing tiles

  • All opening properly covered

  • Vents clean (no signs of rust or mold)

  • All lighting operational and properly covered

Restrooms

  • Fully functional

  • Clean and odor free w/ tissue on rollers

  • Trash can clean w/ self closing lid

  • Lighting operational and covered (light shield is clean)

  • Hand washing signs posted

  • No cracks or chips in any fixtures

Dry Storage

  • Neat and organized

  • Stored items free from dust and debris

  • Undershelving clean and dry

  • All storage off floor

  • Paper stored apart from food

  • Chemicals labeled and stored away from food

  • Ice bin area dry, no spills

  • Water hose in good condition and stored properly

Back Door

  • Emergency Exit equipped w/ panic bar, door swings outward

  • Exit alarm functional and engaged

  • Inner door equipped w/scope peep hole or window

  • Inner door not open after dusk

  • Exit signage in working condition

  • Never propped open or unattended

Freezer/Cooler Doors

  • Hardware permitting exit from freezer/cooler operational

  • Freezer door heater operational

  • If equipped w hasp locks, permits exit from interior

MIsc

  • 3 comp sink w wash/rinse/sanitize (Sinks are properly labeled)

  • Hand sinks have hot water, soap, paper towels/dryer

  • Sanitizer buckets in appropriate areas

  • Sanitizer at proper strength and temp

  • Dust pans, mops, brooms clean and stored properly

  • Fire suppression system date valid (Please note date)

  • Portable extinguishers charged (Please note date)

  • First aid kit properly stocked, colored band-aids available

  • Bloodborne pathogen kit available and complete

  • Safety cutting gloves

  • Heat resistant gloves, apron

  • CO2 detector functioning<br>

  • Co2 tank and helium secured with chain or strap

  • Electrical boxes properly labeled

  • Doors and aisles clear of trash and debris

  • No evidence of bugs/rodents

  • Safe properly locked and anchored

  • Security cameras properly aimed and focused

  • Security DVR on and recording

  • Employees wearing proper footwear

Enter interior facility comments below

Service

Service

Speaker Attendant

  • Speaker Response time less <10 seconds?

  • Ask ask tell used

  • Response friendly and courteous w name in greeting?

  • Response clear and understandable?

  • Order repeated

  • Cost given

  • Suggestive selling done

Front cashiers

  • Complete clean and neat uniform with nametag (Long sleeve black shirt may be worn under crew shirt)

  • Hands and nails clean

  • Wearing a friendly smile

  • Hair pulled back

  • Make up acceptable

  • Jewelry within food safety standard

  • Not chewing gum

  • Telling guests about how to complete voice survey

  • Smile and make eye contact

  • Greet the guest and introduce yourself

  • Ask ask tell used

  • Give the total and receipt pagers in use

  • Offer ketchup - ask how many

  • Thank the guest

  • Look for trash on lot

Order

  • Service time <3:30? (Please note delivery time for 3 orders)

  • DT Service Time <2:00 from end of order taking to leaving with food

  • Order accurate

  • Food hot, fresh, cooked properly

  • Bun fresh, toasted (or steamed)

  • Toppings fresh, quality and portioned correctly

  • Side orders hot, crisp, fresh and salted

  • Side order properly portioned

  • Drink only 1/2 full of ice (except for tea)

  • Drink filled to 1/4 in from top, no spillage

  • Received correct amount of napkins

  • Meal packaged neatly and presentable

  • Sandwich flat in bag

  • Drink fresh, no off taste

Image

  • No horseplay

  • No unsanitary behavior

  • Complaints handled appropriately

Enter service comments below

Operations

Operations

Grill

  • Completes mandatory food safety daily

  • Approved holding times observed

  • 60 days of accurate complete food safety checklist available for review

  • Grill timer in place and operational

  • Yellow spatula used for chicken, eggs, burrito mix

  • Salt/Pepper Mix used appropriately

  • Proper product placement observed

  • Verify internal temp of meat

  • Proper tong storage

  • No cross-contamination

  • Bacon properly cooked and sized

  • Towel stored in sanitizer buckets

  • Sense of urgency noted

  • Grease bucket maintained

Prep table

  • Proper bun coverage

  • Holding unit working and timer in use

  • Special order tickets used as required

  • Products and pans rotated, old product not mixed with new

  • Buns fresh, caramelized and hot

  • Not getting too far ahead on toasted buns

  • Toasted buns not placed on unheated cutting board

  • Bun Table sanitized at least every 2 hours

  • Towel stored in sanitizer bucket

  • Sliced cheese stocked in unit

  • All produce fresh and crisp

  • Sense of urgency noted

Fountain

  • Ice scoop in use

  • Drinks 1/2 full of ice (except tea)

  • No drips left on cups

  • Lids marked when appropriate

  • Sense of urgency noted

  • Towel used for wiping cups kept in sanitizer when not in use, and periodically dipped in sanitizer during use

  • Ice bucket labeled "ice only" and stored off floor

  • Ice scoop held in ice caddy

Ice Cream

  • Scale used properly

  • Shakes mixed properly

  • Ice cream overrun correct

  • Shake machine overrun correct

  • Ice cream recipes correct

  • Towel stored in sanitizer buckets

  • Sense of urgency noted

Misc Op Items

  • Active and inactive trash cans used properly

  • Only NSF equipment used

  • Only NSF equipment and utensils used

  • Only approved chemicals in Drive-In

  • List unapproved chemicals found

  • Enter operations comments below

Administrative

Administration

  • Office area neat and organized

  • Access to Operations Manual on Partner Net

  • Crisis hotline posted and accessible

  • All-in-one poster current

  • All required state posters current

  • Non-harassment poster current

  • All required licenses displayed

  • Pest control contract and license on hand

  • Change fund matches balance sheet Safe Audit

  • Mgr cancels and cash paid outs available for review

  • Labor schedule posted timely - scheduler used as required

  • PC Printer, Scanner operational

  • E-Learning Up to Date

  • E-Learning training documentation available

  • Managers and Assistants Servsafe certified

  • All managers have met annual e-learning requirements

  • All employees in proper uniform

  • Mgmt professionally dressed/groomed

  • All employee personal hygiene (hair, hands, etc) acceptable

Enter administration comments blow

Action Plan

Action Plan

  • Supervisor

  • Partner

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.