Title Page

  • Site conducted

  • Audit Title

  • Site

  • Conducted on

  • Prepared by

  • Location
  • Instructions:
    -------------------------------------
    1. Answer "Yes", "No", "N/A" for the questions below.
    2. Add photos and notes by clicking on the paperclip icon.
    3. To add a Corrective Action click on the paperclip icon then "Add Action", provide a description, assign to a member, set priority and due date.
    4. Complete audit by providing digital signature.
    5. Share your report by exporting as PDF, Word, Excel or Web Link.

DINING ROOM

  • Hospitality Station Standard Met

  • Dining tables spaced appropriately

  • Sugar Caddies, S&P, Stocked

  • Tables Level & do not Wobble

  • Flowers Fresh w/clean water

  • Table Linens Clean & Wrinkle Free

  • Menus Clean & Accurate

  • Table Bases Dust Free

  • Chairs Clean & Free from scuffs

  • Baseboards/Walls Free from scuffs

  • Sitting Areas/Couches Free from Clutter

  • TV set to to appropirate channel

  • Music appropriate level

  • Control of Service Demonstrated

  • Steps of Service followed

  • Tables "pre-bussed"

  • Dining Room Re-set promptly

  • Dining Floors well maintained

  • Service areas organized and sanitized

  • Linens stored properly

  • Survey Box Observed

  • Window Blinds at 45 degree upward slant

  • Thermostat regulated to comfortable temp

  • Floorplan & Sidework assignments utilized

  • Menu posted in designated area

  • Resident Meal Log accurate

  • Room Service process in place

  • Walkers stored safely/not trip hazard

UNIFORMS, APPEARANCE & HYGIENE

  • Hair neat and restrained properly

  • Hair nets or hats observed in kitchen

  • Facial hair neat and trimmed

  • Jewelry kept to simple earring, ring, watch

  • Nails clean and trimmed short

  • Proper shoes worn

  • Correct uniform observed

  • Uniforms clean and presses

  • Name tags observed

  • Proper handwashing and use of gloves

  • Bandages used properly

  • Eating, drinking, smoking, gum chewing

  • Appropriate action when coughing/sneeze

  • Soap and Paper towels stocked

  • Handwashing signs posted at each sink

SAFETY, SANITATION & CLEANLINESS

  • ServSafe Certificates Posted on Wall

  • Health Dept. Grade & Permit Posted

  • Proper handwashing & Use of gloves

  • Sani Solution at work statoins

  • Cutting Boards stored properly

  • Air drying observed

  • BMG Temp logs utilized & up to date

  • Overhead lights & Ceiling Tiles dust free

  • Cooler gaskets & handles free from mold

  • Ice machine filter up to date

  • Ice machine free from mold

  • Proper storage of ice scoop

  • Proper transport of ice observed

  • System in Place to transport food to rooms and remote areas safely

  • Food deliveries put away promptly

  • Food labeled and dated

  • Food stored 6 inches from floor

  • Food covered

  • Raw meat and eggs below RTE foods

  • Raw foods prepared away from RTE foods

  • Pasteurized Eggs used where required

  • Non-necessary staff restricted from kitchen

  • Eye washing station observed

  • First Aid kit observed

  • Thermometors present/calibrated

  • Chemicals stored in secure area

  • Coolers at 40 or below, freezer at 0 or below, cooked food held at 140 or above

  • Hot water observed at hand sink

  • Knives and blades washed seperately

  • Dish and mop chemicals stocked

  • Scoops not stored in flour bins

  • Floor Drains clean

  • Pipes to sink & dish area clean/leak free

  • Floors free from water and trip hazards

  • Food covered, labeled & dated

  • Food Prep Sink Clean to sight & touch

  • 3 Sink set up: scrape→wash→rinse→ sanitize→air dry

  • 3 sink dish water free from grease/food

  • Sanitizer solution at proper dillution

  • Garbage Cans/lids clean

  • Dumpster/Loading Dock Area Clean

  • Brooms and Mops easy to access/in good order

  • No Rodent droppings found

  • Slicer Cleaned properly

  • Can opener clean & sanitized

  • Stove top clean/burner light/unobstructed

  • Griddle clean throughout service

  • Fryer oil clean, fryer free from build up

  • Hood vents cleaned

  • Documentation of hood cleaning

  • Equipment, walls, floors free from grease

  • Cooler Vents/Fans free from dust

  • Hold Holding Units are clean

  • Drawers and Racks are clean

  • Work surfaces clean to sight and touch

  • Coffee, Tea and Juice Machines Cleaned

  • Beverage area clean & Organized

  • Sick employees not present

  • Serving trays clean

  • Beverage pitchers free from stains

  • Clean Serving wares free from food/grease

  • Employee Restroom Clean & Stocked

  • Chlorine or Multi Quat Test Strips present

  • Dish Machine De-limed/no film/build up

  • Dish machine drains clear of food/trash

OPERATIONS, FOOD QUALITY & SERVICE

  • Kitchen on time with preparation of food

  • Food delivered to residents promptly

  • Dietary restrictions followed

  • Sugar Free Dessert (besides ice cream) avail

  • Soup of the Day available

  • Servers able to describe daily feature(s)

  • Non-dining dept. Driector assignements

  • Team members demonstrate training

  • Inventory Levels maintained properly

  • Menus followed/any changes approved

  • Culinary Council held monthly

  • "Taste Of" events held monthly

  • Quarterly Events held

  • Chef's features reflect thoughtful planning

  • Spend Down/Invoices Maintained

  • Food presentation in restaturant quality

  • Room service is delivered promptly

  • Employee Meals are prepared promptly

  • kitchen remains clean through service

  • Servers remain present in dining room

  • Dining Room is reset promptly

Completion

  • Completed by:

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.