Title Page

  • Store Name and Number

  • Store Representative

  • Audited By

  • Date and Time completed on

  • Please see attached guide for clarifications on each compliance check

First Impressions

  • Ask the PiC (Person in Charge) about any maintenance requests placed regarding refrigeration or the dish machine. Note these and any other relevant info below.

  • Request the below documentation from the PiC and inform them they have 45 mins to gather the following;

SECTION 1: Behaviours

  • CRITICAL: Partners do not work while ill; Bandages are used properly

  • CRITICAL: Food is not touched with bare hands; Single use gloves are used properly

  • CRITICAL: Hands are washed at appropriate times

  • CRITICAL: Proper handwashing procedures are followed

  • MAJOR: Hand Sinks are accessible, stocked, and used properly

  • MAJOR: Fingernails, hair and jewelry to standard

  • MAJOR: Partners can demonstrate Food Safety knowledge

  • MAJOR: Partners food and beverages are stored properly

  • MAJOR: Partners follow eating, drinking and smoking standards

  • MINOR: Partner uniforms are clean

  • MINOR: Partner personal items stored properly

  • MINOR: Health Department reports and permits are available

  • MINOR: Food Safety signage is present

SECTION 2: Temperature Control [TCS]

  • CRITICAL: Adequate Refrigeration for TCS Foods

  • CRITICAL: Cold Food Held at Proper Temperature

  • CRITICAL: Proper Thawing/Slacking Procedures in Place for TCS Foods

  • MAJOR: Refrigeration Units Within Required Temperature

  • MAJOR: Product Thermometer [Probe] Present and Working Properly

  • MAJOR: Temperature Logs Completed

  • MINOR: Frozen Product Held Solidly Frozen

  • MINOR: Thermometers Present and Working Properly

  • MINOR: Gaskets in Good Repair

  • MINOR: Refrigeration Ventilation Maintained

SECTION 3: Pest Prevention

  • CRITICAL: No Critical Fruit Fly Activity Observed

  • CRITICAL: No Critical House Fly Activity Observed

  • CRITICAL: No Critical Rodent Activity Observed

  • CRITICAL: No Critical Cockroach Activity Observed

  • CRITICAL: No Critical Ant Activity Observed

  • MAJOR: No Major Fruit Fly Activity Observed

  • MAJOR: No Major House Fly Activity Observed

  • MAJOR: No Major Ant Activity Observed

  • MAJOR: Pest Entry Prevented

  • MAJOR: Pest Control Devices Placed Properly, If Present

  • MINOR: No Minor Ant Activity Observed

  • MINOR: Pest Harborage Prevented

  • MINOR: Floors, Walls, Ceilings Clean and Cleanable

  • MINOR: Pest Reports on File

  • MINOR: Mop Area Maintained

  • MINOR: Plumbing Maintained

SECTION 4: Contamination

  • CRITICAL: No Biohazard Event Present

  • CRITICAL: No Sewage Backup Present

  • CRITICAL: No Water Service Interruption

  • CRITICAL: Fire/Flood/Other Natural Disaster

  • CRITICAL: Partner Restroom Available

  • CRITICAL: Proper Conditions/Procedures for Warewashing

  • CRITICAL: Sanitizer Present, at Required Concentration

  • CRITICAL: Contamination of Food Not Observed

  • CRITICAL: No Food From Unapproved Sources

  • CRITICAL: TCS Product Within Quality Use-By Date

  • MAJOR: Equipment Drain Lines Have Backflow Protection

  • MAJOR: Food Items Stored Protected

  • MAJOR: Food Contact Items Stored Protected

  • MAJOR: In-Use Food Contact Items Approved, Clean and Cleanable

  • MAJOR: In Use Food Contact Items Washed/Rinsed and Sanitized as Required

  • MAJOR: Food Packages in Good Condition/Damaged Products Segregated

  • MAJOR: Prepped, Ready-To-Eat or Refrigerated Foods Properly Labeled

  • MAJOR: TCS Product Within Quality Use-By Date

  • MAJOR: Ice Stored Protected

  • MAJOR: Ice Equipment Maintained Clean

  • MAJOR: Ice Equipment in Good Repair

  • MAJOR: Chemicals Properly Labeled & Stored

  • MAJOR: Dishwashing Machine/Three Compartment Sink Used/Set Up Properly

  • MAJOR: Proper Wiping Cloth Storage/Procedure

  • MAJOR: Contamination of Food Not Observed

  • MINOR: Equipment/Utensils/Smallwares Air-Dried Before Stacking

  • MINOR: Approved Scouring Pads in Use

  • MINOR: Non-TCS Foods Not Expired

  • MINOR: Refrigeration Units Clean and Cleanable

  • MINOR: Sinks and Dish Area Maintained Clean

  • MINOR: Cabinetry/Counter Tops Maintained Clean

  • MINOR: Other Equipment Clean and Cleanable

  • MINOR: Condiment Bar Maintained Clean

  • MINOR: Lighting Maintained and Properly Shielded

  • MINOR: Restrooms Clean and Cleanable

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.