Académique Documents
Professionnel Documents
Culture Documents
Contract Oversight
Location: _Fremont Fresh and Natural__
Instructions: Circle level of compliance
Date_12/10/15
Legend: Compliant = No problems noted; Isolated = 1 incident; Pattern = 2-3 incidents; Widespread = 4 or more incidents or critical incident.
No
Indicator
A. Cafeteria Personnel
1. Manager or designee food safety
certification current and posted
2. All employees wearing badges, hair
restrained, and neat appearance
3. Sample one employee file documentation complete and current
4. No evidence of personal food or
belongings in work area
5. Current inspection report posted or
availability of report signage posted
6. No evidence of skin lesions, and/or
infections observed
7. Health screening process in place and all
staff have current health screening
A. Cafeteria Personnel Total Points (35)
Compliant
Isolated
Pattern
Widespread
-5
-5
-5
-5
-5
-5
-5
-5
-13
-5
5
5
3
3
1
1
-5
-13
-5
Problem
35
Revised 8/12
Page 1 of 6
Date_12/10/15
Legend: Compliant = No problems noted; Isolated = 1 incident; Pattern = 2-3 incidents; Widespread = 4 or more incidents or critical incident.
Indicator
7. Cold storage: raw meat or raw eggs below
other food, stored food labeled and dated,
no outdated items
8. Cold storage temperatures are recorded
at least 1x daily and follow up is documented
when out of range.
Refrigeration at 41F or below
Freezer at 0F or below
Internal thermometers
9. Cold storage is clean: racks, walls, floors,
vents, door gaskets, no air gaps, no ice, no
staff food
B. Storage Total Points (45)
Compliant
5
Isolated
3
Pattern
1
Widespread
-13
-13
-5
-5
-5
-5
-13
-5
Problem
45
C. Food Handling
1. Manager/Chef & staff have (and use)
thermometers; calibrated and sanitized
2. No evidence of improper thawing, i.e. not
at room temperature
3. Cooking temperatures are posted and
followed
4. Hot food is held at 140 or above;
Steam table pans with adequate moisture;
evidence of documentation
5. No evidence of improper cooling*, check
cooling logs
6. Salad bar temps are documented; Follow
up documented when out of range
7. Salad bar well maintained: crocks appear
full, sneeze guard clean, free of spills, ice
bed covers exterior of crocks
Revised 8/12
5
5
-13
3
-5
Page 2 of 6
Date_12/10/15
Legend: Compliant = No problems noted; Isolated = 1 incident; Pattern = 2-3 incidents; Widespread = 4 or more incidents or critical incident.
Indicator
Compliant
Isolated
Pattern
Widespread
Problem
Revised 8/12
-5
-5
-5
Page 3 of 6
Date_12/10/15
Legend: Compliant = No problems noted; Isolated = 1 incident; Pattern = 2-3 incidents; Widespread = 4 or more incidents or critical incident.
Indicator
4. Labeled buckets of fresh sanitizer with rag
available in production areas
5. Preparation equipment is clean, free of
grease, grime, rust, intact and sanitized
appropriately, can opener blade intact.
6. Dispensing machines are cleaned and
sanitized on a regular basis per manufacturer
recommendations, e.g. yogurt, cappuccino,
smoothie, etc.)
7. Display refrigerators and freezers are
clean, sanitized, free of ice or leaks, glass
clean, shelves clean, interior and exterior
8. Serving areas, counters, walls, etc. are
clean and well organized, free of paper signs,
tape, etc. Products are well stocked
9. Sufficient air drying of pots, pans, dishes
and utensils; Storage organized, no cracks,
chips, rust, etc
10. Ice is stored in sanitary method.
Evidence of cleaning schedule according to
manufacturer recommendations
11. Scoops are not stored in bins (food and
ice)
D. Appearance & Sanit. Total Points (55)
Compliant
5
Isolated
3
Pattern
1
Widespread
-5
-13
-5
-5
-5
-5
-5
-5
5
5
3
3
1
1
-5
-13
-5
-5
Problem
55
E. Dish Room/Chemicals/Hazards
1. Chemicals stored away from food
2. Dish machine temperatures recorded and
follow up documented when out of range.
Test wash and rinse temperatures
3. Dish machine-internal: free of lime, spray
arms not clogged
4. Three Comp Sink: Staff demonstrate
Revised 8/12
Page 4 of 6
Date_12/10/15
Legend: Compliant = No problems noted; Isolated = 1 incident; Pattern = 2-3 incidents; Widespread = 4 or more incidents or critical incident.
Indicator
proper method, sanitizer or pH paper in use,
explain; Documentation of proper pH and
temperature; Evidence of appropriate
commercial chemicals
5. Current MSDSs in binder in kitchen or
nearby
6. Floors, walls, vents and ceiling clean, no
holes, rust, buckets, etc.
7. Janitors closet clean, organized. Mop
bucket with fresh water and clean mop not
stored in bucket
8. Hallways clear of obstructions
9. All garbage cans and garbage trucks are
clean, interior, exterior, lids, wheels and/or
dollies
E. Dish Room Total Points (45)
A. Personnel
B. Storage of Food and Supplies
C. Food Handling
D. Appearance & Sanitation
E. Dish
Room/Chemicals/Hazards
Total Points Scored
Overall Performance
Threshold = 95%
Revised 8/12
Compliant
Isolated
Pattern
Widespread
-5
-5
-5
-5
-13
Problem
41
SCORE
35
45
61
55
41
237
Total Score x 100
Total Possible 245
Score = 96.7 %
Page 5 of 6
Date_12/10/15
Legend: Compliant = No problems noted; Isolated = 1 incident; Pattern = 2-3 incidents; Widespread = 4 or more incidents or critical incident.
Corrective Action
Document hot line food temperatures every day prior to the beginning
of service.
Document dish washer temperatures every day, by the end of the day.
Date of
Anticipated
Completion
12/11/15
12/11/15
Revised 8/12
Page 6 of 6