Title Page

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Covid Check

  • Covid Questions and Temperature Log

  • Picture of Sanitation set up (Bleach diluted bottle, White towel in Sanitizer (Red bucket), Blue towel in soap&Water(Green Bucket)

  • Photo of Restroom Checklist

Exterior walk through

  • Trash Cans & Enclosed Receptacles (Clean & in good repair)

  • Exterior Landscape (Free of Trash, cigarettes, healthy Plants

  • Patio / Patio Tables (Umbrellas Up, tables clean & table slats free of debris, patio free of debris ie. napkins, trash, forks, etc.)

  • Windows clean and streak free

  • Front Door/Exterior Windows Clean (Glass clean of finger prints or smudges)

Interior Walkthrough-FOH

  • Lobby Trash Cans (Cans relined, emptied, surface clean, no odor)

  • Restroom (Cleaned and stocked, no order, trashed changed)

  • High Chairs Clean

  • Tables & Chairs (Cleaned and sanitized, no gum, table set up correct)

  • Display Case (Cleaned and stocked, contains secondary thermometer

  • Beverage / Condiment Station (Cleaned and Stocked including fresh cut lemons)

  • Paper Menus and Chips Stocked

  • POS set up / pens / register paper / cashier checklist

  • Uniforms 100% including all Name Tags and Black Face Masks

  • All employee meals have been rung through POS for current shift?

Interior Walkthrough-BOH

  • Trash Cans (re-lined, emptied, surfaces clean, no odor)<br>

  • Quat Sanitary Bucket (proper ppm 200-400)

  • Sneeze Guard Glass (clean and streak free, proper marketing material in place)

  • Aiolis & Dressings (area cleaned and stocked, back up sauces in place)

  • Breadbox (Proper rotation, stocked and lid close) Timer Set

  • Bread Timers & Cookie Timers (In use & working)

  • To Go Containers, Paper Wrap, (stocked and in proper place)

  • Checklists (AM completed.)

  • Break Chart (in use and communicated)

  • Take a photo of all checklists.

  • Picture of Break Forecast

  • Water levels in soup warmer are filled

  • Soup is Stocked and ready for dinner service.

Produce Specifications

  • Tomatoes (Color is vibrant, fresh, stocked, recipe adherence)

  • Corn Bean Salsa (Color is vibrant, fresh, stocked, recipe adherence)

  • Pickled Products Drained with back up in liquid.

  • Feta Cheese (Color is vibrant, fresh, stocked)

  • Apple Cole slaw ( Stocked, Fresh apples and Proper Measuring Utensil)

  • Lettuce (Color is vibrant, fresh, stocked, recipe adherence)

  • Arugula ( Color vibrant and product is fresh)

  • Cilantro looks fresh and green

  • Nuts (Stocked, Fresh, Clean and proper Spoon)

  • Bacon Bits (Fresh, Stocked, Clean and proper Spoon)

  • Spring Mix (Color is vibrant, fresh, stocked)

  • Chop Salad (Color is vibrant, fresh, stocked)

  • Gourmet Area has fresh avocado, mushroom, cucumber and radishes

Walk-in Cooler

  • Organization (product off the floor, shelves labeled, items in place, Raw product on bottom shelf away from all other products)

  • Cleanliness (floors, walls, doors, shelves, handles)

  • All products labeled accurately / No Expired Products

  • Tuna (On Ice, Correct Specification & Handling/Rotation)

  • Picture of Ahi Tuna on Ice

  • Picture of Tuna Salad double wrapped

Prep Kitchen & Dish Station

  • Dish Area (wash, rinse, sanitize)

  • Quat Sanitizer (PPM 200-400)

  • All Chemical Bottles Properly Labeled

  • Mop Sink ( clean, organized, chemicals in proper place)

  • Organization ( product off floors, shelves labeled, items in place)

  • Cleanliness ( floors, walls, doors, shelves, handles clean)

Temperatures

  • If any temps do not meet target temp do the following steps:
    1) check if equipment is on/plugged in/ or working.
    2) if equipment isn't working contact your district manager.

  • Soups above >165*
  • What actions did you take to correct?

  • Grape Tomatoes <41*
  • What actions did you take to correct?

  • Feta Cheese <41*
  • What actions did you take to correct?

  • Ahi Tuna <41*
  • What actions did you take to correct?

  • Tuna Salad<41*
  • What actions did you take to correct?

  • Apple Coleslaw <41*
  • What actions did you take to correct?

  • Aiolis <41*
  • What actions did you take to correct?

  • Italian Chicken below <41*
  • What actions did you take to correct?

  • BBQ Tri Tip below <41*
  • What actions did you take to correct?

  • Walk in cooler <41*
  • What actions did you take to correct?

  • Hand Sink water >110*
  • What actions did you take to correct?

  • Wash water >110*
  • What actions did you take to correct?

  • Rinse water >120*
  • What actions did you take to correct?

  • Sanitizer water <75*
  • What actions did you take to correct?

  • Signature..

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.