FA Food Safety Evaluation

Restaurant*

Email*

Area Director*

Completed By*

MOD(s)*

Score

1.1.1 Person-in-Charge certified by accredited program (C5)*

PassFail

1.2.4 Food and equipment temperature logs are available and complete (M3)*

PassFail

2.1.1 No sick or symptomatic food handler(s) at work; Manager / PIC has properly restricted food handler when required (C5)*

PassFail

3.1.1 No smoking/vaping, gum, or tobacco in food service area 3.1.2 Proper drinking/eating in food service area (C5)*

PassFail

3.2.2 Proper hair restraints are worn in the food service area (M1)*

PassFail

3.2.3 All staff is wearing clean uniforms and aprons. (M1)*

PassFail

4.1.1 Proper handwashing procedure, 4.1.2 Handwashing at appropriate times, 4.3.1 Hand washing sinks are accessible, usable and used only for hand washing, 4.3.4 Soap and single-use paper towels or high velocity hand drying device available at all hand washing sinks, including restrooms (C5)*

PassFail

4.2.1 When gloves are required, food handlers do not contact ready-to-eat foods with bare hand (C5)*

PassFail

4.4.1 Handwashing reminder sign at all sinks (M1)*

PassFail

6.1.1 Proper use of food hierarchy in storage (C5)*

PassFail

6.1.2 Food stored in packages, covered containers, or wrappings (M3)*

PassFail

6.1.3 Food and food contact items stored in appropriate locations (includes single-use items)(M3)*

PassFail

6.1.5 Cross contamination prevented during food storage and preparation (C5)*

PassFail

6.2.1 Food utensils in use are stored properly (M3)*

PassFail

6.3.1 Utensils/equipment food contact surfaces are in good repair (M3)*

PassFail

6.6.2 Temp of hot water sanitizing at dishwashing machine is 180°F - 194°F/82 - 90°C (160°F (71°C) and above at surface) 6.6.3 Proper concentration of chemical sanitizing at the 3-compartment sink that is set-up for use and sufficient contact time for effective sanitizing 6.6.4 Proper concentration of chemical sanitizing for dishwashing machine (C5)*

PassFail

6.6.5 Stored food contact surfaces/clean-in place food contact equipment properly cleaned and sanitized (C5)*

PassFail

6.7.2 Sanitizer test kits/strips available and not expired (M3)*

PassFail

6.7.3 Equipment/utensils are air-dried before stacking and none observed cloth dried (M3)*

PassFail

6.8.2 Wiping cloths stored properly and are at the proper concentration (per manufacturer specifications); spray bottles at proper concentration (M3)*

PassFail

6.9.1 All non-food contact surfaces are clean, cleanable, and in good repair 6.9.4 All gaskets on refrigeration are clean and in good repair (M1)*

PassFail

6.9.2 Floors, walls, ceiling are cleanable, clean and in good repair (M1)*

PassFail

6.9.3 Ventilation hood systems are clean and in good repair with adequate drip prevention (M1)*

PassFail

6.9.5 All lighting sources are properly shielded or shatter-proof in areas where food, service utensils and equipment are stored or prepared. Lighting is adequate. Light fixtures are clean (M1)*

PassFail

6.9.6 Waste receptacles in the back of house are sufficient availability/capacity. Waste containers are maintained clean and in good repair. (M1)*

PassFail

6.9.9 Dumpster area is regularly cleaned and free of excess debris or unnecessary items; dumpster plug is in place where applicable; dumpster and outdoor garbage container lids are kept closed and are in good repair (M1)*

PassFail

7.3.4 Proper cooling methods are in use. Recently prepared TCS product placed in cold holding service equipment has been properly cooled/chilled to 41F. (M3)*

PassFail

7.4.1 Items in hot holding ≥135°F (C5)*

PassFail

7.5.1 TCS foods held in cold holding ≤ 41°F (C5)*

PassFail

7.6.1 Products are time and date labeled when time in lieu of temperature is used as a control. 7.6.2 No product using Time in lieu of Temperature as a Public Health Control is expired (C5)*

PassFail

7.7.3 No expired Ready-to-eat TCS product present (M3)*

PassFail

7.7.4 Refrigerated, ready-to-eat TCS foods prepared and held for more than 24 hours properly date or day labeled; Commercially prepared TCS food is properly date or day labeled when original packaging is opened if held for more than 24 hours (M3)*

PassFail

7.8.1 Accurate food thermometer present (M3)*

PassFail

7.9.1 TCS foods properly thawed/slacked (M3)*

PassFail

7.10.1 All coolers and freezers have functioning thermometers within reasonable range (M1)*

PassFail

8.2.1 Chemicals properly labeled 8.2.2 Chemicals properly stored (C5)*

PassFail

10.1.1 No critical pest activity is observed (C5)*

PassFail

10.2.1 Pest activity is prevented through proper sealing of outer openings and the elimination of harborage conditions (M1)*

PassFail

11.2.1 Sinks meet water temperature requirements; hot and cold water are available at the facility (M3)*

PassFail

4.4.2 Covered waste container available in restrooms where required (M1)*

PassFail

11.4.1 All plumbing in good repair (M1)*

PassFail

11.5.1 Employee clothing, food, and personal items are properly stored (M1)*

PassFail

Failed Item(s) Recap*

Action Steps taken to resolve Failed Items. (Be Specific)*

Score

Total Points

Points Lost

FA Food Safety Evaluation - Full Audit