Cleanliness & Food Safety Assurance Checklist (STREET LEVEL)

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Your Name

Store Manager's name

Your Supervisor's name

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Your email

Supervisor's email address

Additional email address

Date

Format: dd.mm.yyyy

Front of House

	Good	Poor
1. Store looks bright & clean from a distance (No burnt out light bulbs)	Good	Poor
2. No handwritten sign and no unauthorized menu items	Good	Poor
3. Dining Area,Tables ,Chairs,Floors, Windows, Glass, Doors & Patio (if applicable) are cleaned	Good	Poor
4. No grease on Japanese window & Sarku Japan sign	Good	Poor
5. POS register is free from grease and grime	Good	Poor
6. POS register should be cleaned	Good	Poor
7. All marketing materials are posted at the recommended area (crystal panel & windows clings)	Good	Poor
8. Tables, chairs, floor, pop-machine, condiment counters are cleaned after peak hours	Good	Poor
9. Display cooler is full & well lit	Good	Poor
10. Garbage bins checked and emptied regularly	Good	Poor
11. Wiping cloths properly used and stored	Good	Poor
12. Garbage Bins are not overflowing	Good	Poor
13. Space between counter and griddle is clean	Good	Poor
14. Back counter is clean and organized	Good	Poor
15. No grease accumulated on hood interior & filter	Good	Poor
16. All walls ,baseboard & ceilings are cleaned	Good	Poor
17. Seats and garbage bins are put up 1-2 times a week for deep cleaning	Good	Poor
18. Restroom is checked regularly. Toilet paper & soap dispenser restocked. Restroom Log Sheet is initialed by staff	Good	Poor

Front of House Comments:

Back of House

	Good	Poor
1. All food items stored 10 inches above the floor	Good	Poor
2. No cracks, holes or loose tiles on walls & corners	Good	Poor
3. Hood, filters and cooking area are cleaned	Good	Poor
4. Rice cookers, fryers & stove top are cleaned & free of food debris	Good	Poor
5. Soiled linen should be stored in linen bag	Good	Poor
6. Chemical items are stored separate from food items	Good	Poor
7. Do not use any chemicals near food items	Good	Poor
8. Keep small parts, smallwares, loose materials in clear plastic containers with lid	Good	Poor
9. Do not leave boxes in dining room area	Good	Poor
10. Store portable thermometer at the back wall of the cooler	Good	Poor
11. Cooler storage complied with Food Safety Standard	Good	Poor
12. No ice build up inside the cooler	Good	Poor
13. Check cooler door closes well & door rubber seal is in good condition	Good	Poor
14. Check to make sure frozen food items are not defrosted	Good	Poor
15. Deliveries are stored properly immediately	Good	Poor
16. Ensure no food items are placed on the floor	Good	Poor
17. Manager station is clean & organized. Keep all paperworks & binders in clear plastic containers with lid	Good	Poor

Back of House Comments: