Title Page

  • Site conducted

  • Conducted on

  • Prepared by

  • Location

Procedure

  • Is the FM working grill only using the blue poly glove procedure correctly? Handling RTE foods without the poly glove and all RAW food with the poly glove.

  • MUT - Do all products on the line have a current / proper label? ( Not re-labeling the line every few hours )

  • Are all hot held timers used properly, and product discard at the end of the time?

Hand Wash Sinks

  • Stocked with paper towels, soap, & hand sanitizer?

  • Hot water temperature 100 or higher within 45 seconds?

  • Double hand-wash poster at each sink in BOH?

  • Sink is CLEAN and not used for anything other than washing hands? (no drinks pored out, gravy or tea whisks left in the sink, towels, etc.)

  • Did you observe a FM completing hand-wash correctly?

  • Did you observe a FM completing a hand wash after hands had become contaminated and at least every hour if they have not left their station.

Coolers and Freezers

What is the temperature and Gasket condition of:

  • Walk-In Cooler, ambient temperature at or below 41 degrees

  • Walk-In Freezer ambient temperature at or below 20 degrees

  • M/S under MUT cooler, ambient temperature at or below 41 degrees

  • M/S Grill Reach-In Cooler, ambient temperature at or below 41 degrees

  • M/S Extra Cooler, ambient temperature at or below 41 degrees

  • D/T Under MUT Cooler, ambient temperature at or below 41 degrees

  • D/T Grill Reach-In cooler, ambient temperature at or below 41 degrees

  • D/T Extra Cooler, ambient temperature at or below 41 degrees

  • Under Fry Station Freezer, ambient temperature at or below 20 degrees

  • Fry Station Reach-In Freezer, ambient temperature at or below 20 degrees

  • Front Counter Reach-In Cooler, ambient temperature at or below 41 degrees

  • Super Cooler, ambient temperature at or below 32 degrees

Dish Wash Sink

  • Are sanitizers strips available, open (unwrapped), and not expired?

  • Food Contact surfaces clean and free of debris? Lettuce Chopper/Tomato Slicer/Onion Dicer

Pest Control

  • Pests not present in establishment? 10 or less flies in the kitchen area, 20 or less in the Dining room and Restrooms.

Ice Machine/Bins

Are Ice Machines and Bins in clean condition (no eveidence of mold or mildew)

  • BOH Ice machine

  • Front Drink station ( soda nozzles, ice dispenser, and ice bin )

  • D/T & Bubble Drink station ( soda nozzles, ice dispenser, and ice bin )

Orange Guide Book

  • FOOD SAFETY CHECKLIST being completed shift/daily as called out in OGB? check last 7 days)

Criticals

  • Imminent Health Hazards? (Sewer backing up inside or outside building)

  • Time and Temperature Controls? (Proper labels/time, temperature of all cold held products at or below 41 degrees)

  • Contamination Prevention? (All products in Coolers stored properly)

  • Equipment & Utensils cleaning and Sanitizing

  • Personal Hygiene and Food Handling ( No persons present, presenting a symptom of a food borne illness)

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.