Post on 18-Dec-2021
transcript
Facility:Date:Reviewer:
Points Possible
Points Received
9 9
Meal Production records Food Temp Log Culinary Tracking Form
ACP Production Records Equip. Temp Log Meal Count RecordsACP Rosters Food Cooling Log Sanitation Log
4 4K30 Forms Food Allergy FNS In-Service
Civil Rights
1 1
6 6Forms are organized and
accessibleSpecial diet menus printed Forms are kept securely
Forms & JTS Alerts matchSpecial diet menus
followedMenu items are recorded
appropriately
4 4Employees wash hands
between task Hand washing sign posted Trash bin availablePaper towels available
5 5
Sanitizing bins in useDishwasher at correct
tempsDish rags stored dry or in
sanitizerSanitizer within range Max temp thermometer
2 2
Thermometers in all units Within appropriate range5 5
Equipment clean Floor clean
Surfaces cleanDry storage clean &
organizedCold storage clean &
organized4 4
Health permit Health inspection Employee health infoServSafe Certificates
6 6Labeled and dated FIFO observed Within expiration date
Is general cleanliness observed?
FORMS & PAPERWORKAre all forms and paperwork correct, complete and up to date?
Are required in-services complete?
Is HACCP binder available and up to date?
SPECIAL DIETSIs special diet protocol followed appropriately?
OBSERVATIONS - General Safety & SanitationIs hand washing station set up and used appropriately?
Are sanitizing bins, 3-compartment sink, and dishwasher set up appropriately?
Are food storage areas temperature controlled?
Instructions:Enter 1 on line corresponding with a deficiency.Enter 0 on line for items met or not observed.
OBSERVATIONS - FoodIs food stored appropriately?
Is required paperwork posted?
6" from floor, 12" from ceiling
Open foods resealed appropriately
Employee food stored in designated area
1 11 1
4 4Portion size accurate All items served Milk choice given
Recipes followed4 4
Food labeled Dated All items sampledTime recorded
1 1
4 4
Shadow board organizedAll tools shadowed on
board Tools reconciled per policyTools logged correctly
5 5Chemicals stored
appropriately Perpetual chemical logBody fluid cleanup kit
availableMSDS Sheets available Chemicals labeled
5 5Hair restraints worn Uniform worn No false eyelashes
Jewelry policy observed No polished or fake nails
Staffing vacancies: Equipment issues:
Are staff abiding by DJJ Policy 9.3 (i)7
ISSUES
Are leftovers returned to inventory or discarded appropriately?Are frozen foods thawed appropriately?
OBSERVATIONS - Menu
CHEMICAL CONTROL
BEST PRACTICE
FINAL SCORE100%
Is menu followed?
Are sample bags kept correctly?
Is appropriate counting procedure used?
TOOL CONTROLAre tools controlled per policy?
Are chemicals controlled per policy?
STAFF