Home Kitchen Inspection Self-Assessment Form

Countertops clean and sanitized Sink clean and clear of dishes Floors clean and free of debris Appliance surfaces clean

Refrigerator is organized and clean Food items are properly covered/stored Expired food items are discarded Dry goods stored in sealed containers

Waste bins covered and not overflowing Proper waste separation (recycling, compost, landfill)

Equipment/utensils clean and well-maintained Utensils stored properly Knives and sharp items stored safely

Handwash station available Hands washed before food handling Hair restraint used as needed

No visible signs of pests No open entry points for pests