| Date | Inspector | ||
|---|---|---|---|
| Location | Time |
| Item | Yes | No | Remarks |
|---|---|---|---|
| Floors, walls, and ceilings are clean and free from debris | |||
| Food preparation surfaces are sanitized and dry | |||
| Storage areas organized and items off the floor | |||
| Refrigerators and freezers are clean and at correct temperature | |||
| Food properly labeled and dated | |||
| No signs of pests or contamination | |||
| Waste bins covered and emptied regularly | |||
| Utensils and equipment are sanitized and properly stored | |||
| Hand washing facilities supplied and operational |
| Signature | Date |
|---|