Title Page

  • Conducted on

  • Prepared by

  • Location
  • Conducted By:

  • Add signature

  • Select date

I. PERSONAL HYGIENE - 25 Points

Handwashing Facilities (6 points)

  • QI_1a - Sinks conveniently located and accessible in restrooms, production, dish room and service areas and properly maintained with hot and cold water, approved antibacterial or antimicrobial soap, disposable towels or air dryer and in good working condition.

  • QI_1b - Handwashing sinks used only for handwashing purposes. Food prep sink and pot sink not used for handwashing.

Handwashing Practices (11 points)

  • QI_2a - Hands washed frequently and correctly per standards after using the restroom and/or between handling raw foods of animal origin and ready to eat foods.

  • QI_2b - Hands washed frequently and correctly per standards for all other occasions other than those listed above in QI.2.a

  • QI_2c - Fingernails well-trimmed and clean; no nail polish or artificial fingernails worn. Jewelry and watches on hands and arms (except smooth-surface rings / bands) not worn during production and service. (Exception: medical bracelet, where needed for a medical condition)

  • QI_2d - Hair and beard restraints worn by food-handlers that are designed to effectively keep their hair from contacting exposed food, clean equipment, utensils, linens, and unwrapped single-service and single-use articles.

Employee Health (6 points)

  • QI_3a - Employees and managers who handle, prepare or serve food have no apparent illnesses (vomiting, diarrhea, fever, jaundice, sore throat with fever, infected open wounds or boils, etc.) and cuts, abrasions and burns on hands and exposed arms properly covered (i.e., bandage, finger cot, disposable glove).

  • QI_3b - Evidence employees have acknowledged the Employee Health Foodservice Notifications, Restrictions and Exclusions policy (i.e. evidence may include sign offs, policy available, or poster posted).

Disposable Gloves (2 points)

  • QI_4a - Gloves used when handling ready-to-eat foods without utensils, changed when they are torn, dirty or contaminated, or when changing tasks and removed when leaving the immediate work station. Gloves are not needed when handling raw foods that will be cooked, cleaning or handling trash.

II. TIME AND TEMPATURE CONTROL - 30 points

Thermometers (4 points)

  • QII_1a - Employees and managers have access to and use properly calibrated thermometers.

  • QII_1b - Appropriate thin-tipped thermometers (i.e. digital) available and used for thin foods such as hamburger patties, chicken or fish filets, etc. where applicable.

Cooking Foods (Critical Control Point (CCP)) (5 points)

  • QII_2a - Potentially hazardous foods cooked to correct minimum internal temperature. -- 165ºF / 74ºC for 15 seconds: poultry (solid and ground), stuffed foods (meat, poultry, seafood, pasta, etc.), dishes that include previously cooked potentially hazardous ingredients -- 155ºF / 68ºC for 15 seconds: ground meats (beef, pork, veal, lamb, fish), injected meats, game, pork (steaks & chops), shell eggs hot held for service -- 155ºF / 68ºC for 22 seconds: pork roasts -- 145ºF / 63ºC for 15 seconds: beef, veal, lamb (steaks & chops); seafood, shell eggs for immediate service, pasteurized egg dishes -- 145ºF / 63ºC for 4 minutes: beef, veal, lamb (roasts) -- 140ºF / 60ºC for 15 seconds: commercially processed, ready-to-eat food, heated for the first time & hot-held for service -- 140ºF / 60ºC: fruits & vegetables hot held for service -- 135ºF / 57ºC and hold for 45 minutes: roast beef – Sodexo recipe

Foods during Preparation and Service (9 points)

  • QII_3a - Food thawed under refrigeration, not at room temperature. -- Emergency procedure: under cold running water (70ºF / 21ºC or below) or in microwave, (using a defrost cycle, followed by immediate cooking)

  • QII_3b - Food kept at room temperature during preparation for no more than 40 minutes.

  • QII_3c - CCP: Hot food held / served at 140ºF / 60ºC or above.

  • QII_3d - CCP: Cold food held / served at 40ºF / 4ºC or below.

Cooling Potentially Hazardous Foods (CCP) (6 points)

  • QII_4a - Food prepared for later use or left over after meal period cooled properly (from 140ºF / 60ºC to 70ºF / 21ºC within 2 hours and then to 40ºF / 4ºC within an additional 4 hours). • Placed in shallow containers; for thick (viscous) products no more than 2" - 3" (5 cm - 7.5cm) in pan. • Ice bath method used, where possible. • Stirred to speed cooling (i.e., with ice paddle). • Placed in refrigerator uncovered but protected from contamination for remainder of the cooling process. • Larger pots or pans acceptable when cooling large quantities of liquid products (i.e., soups, sauces).

Reheating Foods (CCP) (3 points)

  • QII_5a - Food reheated rapidly (within 2 hours) to 165ºF / 74ºC or above (does not apply to foods being reheated for immediate consumption). Temperature must register on thermometer for 15 seconds minimum.

Refrigeration Equipment Temperatures (CCP) (3 point)

  • QII_6a - Refrigeration equipment maintained at 40ºF / 4ºC or below.

III. CROSS-CONTAMINATION - 21.5 points

Storing Foods (6 points)

  • QIII_1a - No evidence of contamination from raw foods of an animal origin or environmental sources (i.e. leakage, condensation, debris, glass, etc.)

  • QIII_1b - Proper food storage practices observed in refrigerated storage: • Ready to eat foods (including washed produce) • above unwashed produce • above raw seafood • above raw whole cuts of beef and pork • above raw ground meats • above raw whole and ground poultry

  • QIII_1c - Food stored only in food-grade containers and not used for purposes other than their intended use.

  • QIII_1d - All ready to eat foods (including fruits with edible skins) are displayed properly to prevent contamination in customer service areas (i.e. individually wrapped, lids, containers or sneeze guards and serving utensils available for customers where applicable).

Preparing and Serving Foods (5 points)

  • QIII_2a - Raw foods kept separate from ready-to-eat foods during preparation.

  • QIII_2b - Separate and appropriate utensils used for each food item (during cooking, serving and self-service areas).

  • QIII_2c - Unit observed using the appropriate color cutting board for products being handled: • Red cutting board used for raw foods of animal origin. Red cutting board always cleaned and sanitized between different raw foods (i.e., cutting chicken, then beef). • White cutting board used for ready-to-eat foods • Green cutting board used for washed produce.

  • QIII_2d - Cutting boards in good condition (without cracks, deep grooves and discoloration) and stored vertically and separated for proper draining and quick drying.

Sanitizing Food Contact Surfaces (5.5 points)

  • QIII_3a - All food contact surfaces and utensils (including thermometers, prep knives and stationary parts of slicer, etc.) cleaned and sanitized.

  • QIII_3b - Sanitizing method at correct setting (chemical or mechanical) and concentration in use at proper ppm or hot water at proper temperature.

  • QIII_3c - Wiping cloths used for cleaning up food spills are being properly stored in sanitizer of the correct concentration between uses.

Cleaning Non-Food Contact Surfaces and Pest Control (5 points)

  • QIII_4a - All non-food contact surfaces, under Sodexo responsibility, (including cooking equipment, cold storage units, preparation equipment/ surfaces, service counters, floors, floor mats, baseboards, walls, ceilings and exhaust fans or vents, etc.) clean.

  • QIII_4b - No evidence of insects, rodents, or other pests.

IV. RECORDKEEPING, TRAINING, SELF-INSPECTIONS - 21 points

HACCP Recordkeeping (7.5 points)

  • QIV_1a - All refrigerator equipment in which Potentially Hazardous Foods are stored (including for grab-n-go display cases) and warming cabinet logs completed and accurate. Logs available (hard copy or electronically) for one year. Temperatures checked at least once during stable times, i.e., at opening of the operation.

  • HACCP temperature logs completed and accurate. Keep available for one year (hard copy or electronically): -- Cooking to required temperature

  • HACCP temperature logs completed and accurate. Keep available for one year (hard copy or electronically): -- Holding hot foods

  • HACCP temperature logs completed and accurate. Keep available for one year (hard copy or electronically): -- Holding cold foods

  • HACCP temperature logs completed and accurate. Keep available for one year (hard copy or electronically): -- Cooling foods

  • HACCP temperature logs completed and accurate. Keep available for one year (hard copy or electronically): -- Reheating foods

  • QIV_1c - The Sanitizer Solution log completed where ever sanitizer is dispensed (three compartment sink or chemical feed tower) and available (hard copy or electronically) for one year.

  • QIV_1d - The Receiving log completed and accurate whenever a food delivery is received and available (hard copy or electronically) for one year.

  • QIV_1e - The Dishwashing / Warewashing Machine Temperature Log completed and accurate where applicable and available (hard copy or electronically) for one year.

Manager Certification (5 points)

  • QIV_2a - All managers, dietitians and supervisors certified through Sodexo-approved food safety certification program (Refer to the Sodexo policy: Food Safety Certification Requirements). Managers, dietitians and supervisors without current certification scheduled for training and certified within 90 days of hire or within 90 days of expiration of previous certification. Recertified every three years. Those newly hired to Sodexo complete the Sodexo Food Safety Standards & Resources module per policy.

Frontline Employee Training (6 points)

  • QIV_3a - New employees have completed two step food safety training program per Sodexo policy (Food Safety Training Requirements for Frontline Employees). Per policy, the Introduction to Food Safety – Temporary Labor completed for any temporary staff prior to starting work. Attendance rosters on file

  • QIV_3b - Repeat food safety training for all employees conducted at least annually (per Sodexo policy -- Food Safety Training Requirements for Frontline Employees). Attendance roster on file

Self-Inspection Program (2.5 points)

  • QIV_4a - The SoSafe Food Safety Standards Review completed, including documented corrective action plan for all non-compliant questions including general observation questions, for each month and available for one year.

  • QIV_4b - The Comprehensive Food Safety Self-Inspection completed, including documented corrective action plan for any non-conformances at least annually (available for one year). Also completed within 30 days of opening a new unit and after change of top management in the unit.

V. PURCHASING & RECIEVING SPECIFICATIONS - 2.5 points

Receiving Refrigerated and Frozen Food (1.5 points)

  • QV_1a - Refrigerated and frozen food received at proper temperatures and stored within 1 hour or less of delivery. • Randomly check temperatures of potentially hazardous foods; refrigerated foods received at 40˚F/ 4˚C or below unless specified by regulatory and frozen foods shall be frozen (hard). • May be extended to 2 hours only under extreme conditions - reason must be documented.

Banned Product List (1 point)

  • QV_2a - Unit observes “Banned Products List” requirements and no banned products are used at this facility.

VI. DEMONSTRATION OF KNOWLEDGE (NOT INCLUDED IN POINT TOTAL!!!)

  • QVI_1a - The Person in Charge can describe foods identified as major food allergens and the symptoms that a major food allergen could cause in a sensitive individual who has an allergic reaction. • Follow Up Question: What should an employee do if a customer asks if an offering contains an ingredient that they are allergic to or not? • Follow up Question: What could you do to further inform customers of food allergens in products?

  • QVI_1b - The Person in Charge can state the required temperatures for the following: • Refrigerated storage • Hot holding • Cold holding • Cooling • Reheating

  • QVI_1c - The Person in Charge can state the required food temperatures for safe cooking of: • Poultry (solid and ground), stuffed foods (meat, poultry, seafood, pasta, etc.), dishes that include previously cooked potentially hazardous ingredients • Ground meats (beef, pork, veal, lamb, fish), injected meats, game, pork (steaks & chops), shell eggs hot held for service • Beef, veal, lamb (steaks & chops); seafood, shell eggs for immediate service, pasteurized egg dishes • Commercially processed, ready-to-eat food, heated for the first time & hot-held for service • Fruits & vegetables hot held for service

  • QVI_1d - The Person in Charge can describe the steps in a proper handwashing by a food service employee and its relationship to the prevention of foodborne illness.

  • QVI_1e - The Person in Charge can describe what a critical control point is and why it is important.

  • QVI_1f - The Person in Charge can describe what responsibility the food service employee has if the employee has symptoms or are diagnosed with an illness by a health practitioner that are transmissible through food. • Follow up: The Person in Charge can describe what two of the symptoms and two of the diseases that a food service employee should report are.

GENERAL OBSERVATIONS - FOOD SAFETY & SECURITY (NOT INCLUDED IN POINT TOTAL!!!)

  • QVII_1a - Sodexo Food Security poster (#885) placed in visible back-of-the-house location.

  • QVII_1b - All supplies purchased from Sodexo approved vendors and distributors only.

  • QVII_1c - Access to all loading areas, entrances, and storage, production and service areas restricted to authorized personnel only.

  • QVII_1d - All managers know how to access the Sodexo Food & Facilities Security Guidelines posted on the Sodexo Net Food Safety page (under “Food Security Toolkit”). These guidelines are used to determine unit-specific food security procedures, as applicable, including steps taken to raise employee awareness.

  • QVII_1e - Sodexo Food Allergy back of house poster (#884) displayed for viewing by foodservice employees. Sodexo Food Allergy front of house signage (#884CUST) displayed for viewing by customers.

GENERAL OBSERVATIONS - GOOD RETAIL PRACTICES (NOT INCLUDED IN POINT TOTAL!!!)

Front of the House (Service Areas)

  • QVIII_1a - All packaged foods intended for customer self-service are properly labeled (i.e. ingredients, nutritional information (when applicable), production location, “use by” date).

  • QVIII_1b - All dishes, tableware, silverware stored properly to prevent contamination.

  • QVIII_1c - All dispensers (for silverware, cups, condiments, etc.) clean, sanitized and in good repair.

  • QVIII_1d - All beverage areas (including coffee urns, cold beverage dispensers, etc.) and soft serve / frozen yogurt machines clean, sanitized and in good condition.

  • QVIII_1e - All cash registers and stands clean, neat and uncluttered.

  • QVIII_1f - All tables and chairs, under Sodexo responsibility, in dining areas clean and neat.

  • QVIII_1g - If location is using Time as A Public Health Control (i.e. “Time Only”) appropriate procedures are followed (i.e. written plan, regulatory approval, log, etc.) where applicable.

Back of the House (Production Areas)

  • QVIII_2a - Drains working properly, clean, and free of standing water.

  • QVIII_2b - Employees eating, drinking and personal items stored and/or consumed in a designated area away from food preparation, service and storage.

  • QVIII_2c - All handwashing sinks in restrooms, production area, dish room and service areas have approved handwashing signs posted.

Dishwashing and Warewashing Areas

  • QVIII_3a - Dishwashing machine in good condition, clean interior and exterior, proper wash and rinse temperatures, correct pressure, nozzles clean (with correct spray patterns), pressure gauge provided, thermometers in good condition.

  • QVIII_3b - Method for validating the final rinse of manual stations and the dishwashing cycle (chemical test strips, thermal strips and registering thermometer).

  • QVIII_3c - Pot sink, storage carts and storage shelving clean and in good repair.

  • QVIII_3d - Cleaned equipment and utensils air-dried and properly stored to protect from contamination. Knives stored safely in knife holders or other designated storage space. Dishwashing trays not stored on the floor between uses.

Storage Areas (Dry Storage, Refrigerators, Freezers)

  • QVIII_4a - Date mark ready-to-eat foods with date to be consumed that have been prepared onsite or commercially prepared and opened as well as being held for more than 24 hours.

  • QVIII_4b - Dry storage areas clean, cool, dry, free of empty boxes. All items stored at least 6” above the floor.

  • QVIII_4c - Walk-in and reach-in refrigerators clean. All food stored on shelves or carts, at least 6” above the floor.

  • QVIII_4d - Walk-in freezers clean. All food stored on shelves or carts, at least 6” above the floor.

  • QVIII_4e - Dented or damaged cans and food containers are identified and segregated in designated location so as not to be used in production. Reference 2.1.10 - Food Container Defect Guidelines in the online PQA Manual.

Restrooms, Dressing Rooms, Lockers

  • QVIII_5a - Restrooms clean, free of odors, in good working condition, vented to outside. Toilet room doors kept closed or self-closing. Proper waste receptacles provided; emptied frequently.

  • QVIII_5b - Dressing rooms and lockers clean, neat and orderly; no items stored on floor.

Receiving Areas, Refuse Disposal

  • QVIII_6a - Receiving areas clean, free of empty boxes, debris and trash.

  • QVIII_6b - Refuse storage areas clean, neat, free of odors and pests and easily cleanable.

  • QVIII_6c - Refuse storage containers (dumpsters, compactors, etc.) in good repair, covered.

  • QVIII_6d - Sufficient number of refuse containers available throughout the foodservice facility, in proper condition, not overfilled and emptied when needed.

General Sanitation

  • QVIII_7a - Facility Cleaning Schedule specifying the equipment/ location, designated personnel, and frequency on file.

  • QVIII_7b - Mops, brooms, other cleaning equipment stored properly off the floor when not in immediate use in designated location.

  • QVIII_7c - Mop water disposed of properly. Mop sink used properly.

  • QVIII_7d - Plumbing for all equipment properly working and maintained. All equipment properly drained.

  • QVIII_7e - Back flow devices (i.e. air gap, vacuum breaker, etc.) installed and working properly to prevent back siphonage where necessary. No cross-connections between waste water and potable water lines.

  • QVIII_7f - All areas properly ventilated.

  • QVIII_7g - Shielded safety-type lights in all food production, service, ware washing and storage areas.

  • QVIII_7h - Cleaning system chemicals (i.e. in buckets or spray bottles), while in use, are properly labeled and stored to prevent cross-contamination of food or food contact surfaces.

Pest Control

  • QVIII_8a - Pest Activity Log used for reporting any evidence and location of pests observed, kept on file for 12 months.

  • QVIII_8b - All openings to outside screened or otherwise protected against insects. No openings (holes, open doors, windows, etc.) allowing pests to enter.

  • QVIII_8c - Pest control reports (left after each inspection and / or treatment) kept on file for 12 months. When the client is responsible for pest control, documentation to demonstrate actions taken to obtain reports must be available for review by auditor.

GENERAL OBSERVATIONS - REGULATORY & COMPANY COMPIANCE (NOT INCLUDED IN POINT TOTAL!!!)

Local Food and Sustainability

  • QIX_1a - When the unit has an onsite fruit and/or vegetable garden at the account that is used as a food source for service to customers, documented evidence is available on file that the Sodexo Gardens Food Safety Requirements are followed including the Garden Guideline Weekly Checklist.

Regulatory & Company Compliance

  • QIX_2a - In the past 12 months has the unit had any regulatory inspections that resulted in a closure, fine, hearing, or any repeat critical violations that were not corrected?

  • QIX_2b - Can the unit management team demonstrate that they understand their requirements if a failed regulatory inspection occurs?

  • QIX_2c - Valid food permit or license from the appropriate authority kept on file and available for review by auditor.

  • QIX_2d - Unit employing specialized processing methods requiring regulatory variances (i.e. MAP, ROP, Cook Chill, Sous Vide, Smoking/ Curing for Preservation, etc.) and written approval by regulatory agency on file.

  • QIX_2e - Documented evidence that a Corrective Action Plan was submitted for the previous third party review, where applicable.

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.