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Food Premises Self Inspection Checklist
Section 1: Food
1. 1. Is food purchased from an approved source (licensed by the country, state, or federal government)?
Yes
No
N/A
2. 2. Is food inspected and found to be free from contamination, adulteration, and spoilage?
Yes
No
N/A
3. 3. Are unpackaged foods which have been served or returned from the dining area discarded?
Yes
No
N/A
4. 4. Are all foods stored a minimum of 6” off the floor?
Yes
No
N/A
5. 5. Are restrooms not used for the storage of food, equipment, or supplies?
Yes
No
N/A
6. 6. Are all paper products stored in a manner so as to protect them from contamination?
Yes
No
N/A
7. 7. Are food and food-related products being protected from dirt, unnecessary handling, overhead leakage, and other forms of contamination?
Yes
No
N/A
8. 8. Do all food storage containers have tight-fitting lids and are properly labeled?
Yes
No
N/A
9. 9. Are foods dispensed in the self-serve area in an approved manner?
Yes
No
N/A
10. 10. Is the use of sulfites restricted?
Yes
No
N/A
11. 11. Are food products labeled in an approved manner?
Yes
No
N/A
12. 12. Are food products with an alcohol content exceeding .5% properly labeled?
Yes
No
N/A
Section 2: Temperature Control
1. 1. Are potentially hazardous foods maintained below 4oF or above 135oF at all times?
Yes
No
N/A
2. 2. Is a thermometer, accurate to + or -2oF, provided either as an integral part of the refrigerator and freezer (dial outside), or is located inside each unit at its warmest point?
Yes
No
N/A
3. 3. Are thermometers readily visible?
Yes
No
N/A
4. 4. Is an accurate metal probe thermometer, suitable for measuring food temperatures, readily available and used to check food temperatures daily?
Yes
No
N/A
5. 5. Are food products thawed in one of the following methods only: a) in refrigeration units, b) under cold running, potable water of sufficient velocity to flush loose food particles, c) in a microwave oven, d) as part of the cooking process?
Yes
No
N/A
6. 6. Is frozen food maintained in a frozen state?
Yes
No
N/A
7. 7. Are thawed food items not refrozen? Cooked or processed foods may be refrozen.
Yes
No
N/A
Section 3: Personnel
1. 1. On or before January 1, 2000, did each food facility have an owner or employee who successfully passed an approved and accredited food safety certification examination?
Yes
No
N/A
2. 2. Have all employees handling food or utensils obtained their Food Worker's Certification?
Yes
No
N/A
3. 3. Do employees wash their hands with soap and warm water for the following reasons: a) before starting work b) immediately after using the bathroom c) any time needed to prevent food contamination?
Yes
No
N/A
4. 4. Do employees handling food or utensils have no open sores?
Yes
No
N/A
5. 5. Are employees wearing clean outer garments?
Yes
No
N/A
6. 6. Are tongs or other implements used for serving food products?
Yes
No
N/A
7. 7. Is the hair of employees properly confined?
Yes
No
N/A
8. 8. Do employees not smoke or use tobacco inside the facility?
Yes
No
N/A
9. 9. Are clothing and personal effects stored away from food products in a proper manner?
Yes
No
N/A
Section 4: Water And Sewage
1. 1. Are all sinks fully operable with hot and cold water at each faucet?
Yes
No
N/A
2. 2. Do all sinks drain properly? Are floor drains and floor sinks in good working order?
Yes
No
N/A
3. 3. Is the plumbing in good repair?
Yes
No
N/A
Section 5: Equipment
1. 1. Is all equipment (i.e. stoves, grills, refrigerators, tables, sinks, etc.) clean and well maintained?
Yes
No
N/A
2. 2. Has inoperable equipment been repaired or replaced (removed from the facility)?
Yes
No
N/A
3. 3. Is equipment NSF (National Sanitation Foundation) or equivalent?
Yes
No
N/A
4. 4. Has any equipment been replaced, moved, or added without prior approval from the local environmental health department?
Yes
No
N/A
Section 6: Utensils
1. 1. Are multiservice utensils being washed by one of the following means only: a) hand washing in a three-compartment sink (wash, rinse, sanitize), b) chemical sanitizing (dish machine) conforming to NSF standards, c) dishwasher rinse water reaches at least 180O F for 30 seconds?
Yes
No
N/A
2. 2. Are testing materials to adequately test sanitizing methods readily available?
Yes
No
N/A
3. 3. Are all utensils clean and well-maintained?
Yes
No
N/A
4. 4. Have damaged or unapproved utensils been repaired or replaced?
Yes
No
N/A
5. 5. Are utensils properly protected during storage?
Yes
No
N/A
6. 6. Ventilation is provided in each restroom and is in proper working order.
Yes
No
N/A
Section 7: Floors / Walls / Ceilings
1. 1. Are floors clean, well-maintained, and in good repair?
Yes
No
N/A
2. 2. Are walls, ceilings, and windows clean, well-maintained, and in good repair?
Yes
No
N/A
Section 8: Toilet/ Dressing Room / Handwashing Sinks
1. 1. Are toilet facilities clean, well-maintained, and in good working order?
Yes
No
N/A
2. 2. Do self‐closing doors in the toilet and dressing rooms work properly?
Yes
No
N/A
3. 3. Are single-service soap and towel dispensers above all handwash sinks operable and full?
Yes
No
N/A
4. 4. Are toilet tissue dispensers full?
Yes
No
N/A
5. 5. Are legible handwashing signs properly posted?
Yes
No
N/A
6. 6. Is ventilation provided in each restroom and in proper working order?
Yes
No
N/A
Section 9: Light And Ventilation
1. 1. Is adequate lighting and ventilation provided throughout the facility?
Yes
No
N/A
2. 2. Are exhaust ventilation filters clean and well-maintained?
Yes
No
N/A
3. 3. Do light fixtures have approved safety covers?
Yes
No
N/A
Section 10: Pest Control
1. 1. Is the facility free from insect and rodent infestations?
Yes
No
N/A
2. 2. Are live animals, birds, or fowl not located in the facility?
Yes
No
N/A
3. 3. Do outside doors and screen doors self‐close, and are closures in working order?
Yes
No
N/A
4. 4. Are air curtains operating properly?
Yes
No
N/A
Section 11: Refuse
1. 1. Are trash containers lined with disposable plastic bags at all times?
Yes
No
N/A
2. 2. Are plastic bags tied before placing in refuse containers?
Yes
No
N/A
3. 3. Are outside trash bin lids closed?
Yes
No
N/A
4. 4. Is the outside premise and refuse areas clean and well-maintained?
Yes
No
N/A
Section 12: Operation
1. 1. Are hazardous substances (examples: chemicals, cleaning supplies, etc.) properly labeled and stored away from food products?
Yes
No
N/A
2. 2. Are there no living quarters within the facility?
Yes
No
N/A
3. 3. Are no smoking and first aid signs (choking) properly posted?
Yes
No
N/A
4. 4. Are cleaning equipment and soiled linens properly stored?
Yes
No
N/A
5. 5. Are returned, damaged, or unlabeled food products properly stored?
Yes
No
N/A
6. 6. Does the facility have a current Environmental Health Permit to operate?
Yes
No
N/A