FDA Procedures for Standardization and Certification
of Retail Food Inspection/Training Officers

Annex 2-3

2000; minor revisions 2003

Report Marking Instructions

FDA STANDARDIZATION INSPECTION REPORT

Candidate's Form / Standard's Form

[ 5° C (41° F) and 7° C (45° F) combination:______]

FOODBORNE ILLNESS INTERVENTIONS AND RISK FACTORS

STATUS

1.

DEMONSTRATION OF KNOWLEDGE

IN/ OUT

This item should be marked IN or OUT of compliance, with notes made concerning the reason it is marked OUT of compliance. The person in charge has three options for demonstrating knowledge. Inability to meet at least ONE of those options constitutes OUT of compliance.

Three options for demonstration of knowledge are allowed by the Code. Compliance with any ONE of the following options is sufficient for a finding of "IN COMPLIANCE" with this item:

1. Certification by an ACCREDITED PROGRAM (see NOTE 2 below)

2. Operation of the facility in compliance with the Code. The effectiveness of the person in charge in protecting the health of the consumer is evidenced by the person's ability to apply the required knowledge to the establishment's operations by designing and implementing procedures that ensure continued compliance with the Code. For the purposes of this Procedure, compliance with the Code means there are no critical items in violation, or if there are critical items violated, the PIC demonstrates knowledge by immediately taking action or making arrangements to correct the violation. The emphasis has to be made on the PIC having knowledge. For example, a critical item that is violated because the landlord failed to make a repair should not be marked against the PIC if he/she demonstrates knowledge of the violation and has made efforts to have it repaired. It is still a FC violation, but not a failure of demo of knowledge. The Candidate must determine that a critical item violation is due to lack of knowledge, not lack of willingness.

3. Correct responses to the inspector's questions regarding public health practices and principles. The candidate should assess this item by asking open-ended questions that would evaluate the PIC's knowledge in the areas enumerated in Section 2-102.11, paragraphs A through O. Questions can be asked during the initial interview, menu review, or throughout the inspection exercise as appropriate. The Candidate should ask a sufficient number of questions to enable him/her to make an informed decision concerning the PIC's knowledge of the Code requirements and public health principles. The dialogue should be extensive enough to reveal whether or not that person is enabled by a clear understanding of the Code and its public health principles to follow sound food safety practices and to produce foods that are safe, wholesome, unadulterated, and accurately represented.

NOTE 1: "Incorrect" responses to questions regarding public health practices and principles (except for Subparagraphs 2-102.11 ( C ) (2) and(3) in and of themselves, are not sufficient for marking other items on this inspection form OUT. For instance, if the PIC does not know the Food Code requirements for cooling, yet no actual out of compliance observations are made with regard to cooling during the inspection, OUT cannot be marked for item 5.4.

N.A.

Do Not Mark This Item N.A.

N.O.

Do Not Mark This Item N.O.

NOTE 2: The Conference for Food Protection has developed Standards for Accreditation of Food Protection Manager Certification Programs. These Standards were developed in response to the need for valid, reliable and legally defensible criteria upon which to base the assessment of Food Protection Manager Certification Programs. During the 2002 Conference meeting, the Assembly of State Delegates unanimously approved the establishment of an accreditation process for Food Protection Manager Certification Programs. The American National Standards Institute (ANSI) has been selected to administer and manage the accreditation program. The Accreditation process will be in place beginning January, 2003.

The FDA is currently working with a Conference for Food Protection (CFP) committee (comprised of stakeholder representatives) in the development and implementation of the ANSI-CFP accreditation program for Food Protection Managers Certification. In the interim, the Conference, in conjunction with the Buros Institute has implemented a CFP Test Recognition process for food protection manager certification exams that meet standards for reliability, validity, and legal defensibility.

For the purposes of this Procedure, during the interim period before the implementation of the ANSI accreditation process that is based on the "Standards for Accreditation of Food Protection Managers," all tests listed by the Buros Institute and recognized by the CFP are acceptable as meeting the requirement for demonstration of knowledge. The listed tests are found on the internet at <http://www.unl.edu/buros/>

2.

EMPLOYEE HEALTH

A.

Management awareness and policy re: handling employee health situations*

NOTE 3: One may rely solely on discussions with management to determine the compliance status of this item.

This item may be marked IN or OUT of compliance. To be IN compliance, the person-in-charge must:

1. Be aware of the Food Code provision that employees or applicants who have received a conditional offer of employment are required to report certain symptoms or diagnosed illnesses to the person-in-charge, AND
2. Convey knowledge of an employee health policy OR have access to an employee health policy (not necessarily written) stating what actions are necessary following a report that an employee has a certain symptom or diagnosed illness.

The policy must reflect the current Food Code provisions. Verbal communication of the employee health policy must be specific to the types of illnesses and symptoms that require reporting. Nonspecific statements such as, "sick or ill employees are not allowed to work," are not acceptable as meeting this requirement.

If OUT of compliance, make appropriate notes on reason(s) for noncompliance.

N.A.

Do Not Mark This Item N.A.

N.O.

Do Not Mark This Item N.O.

B.

Visible or known symptoms / or known diagnoses dealt with according to the Food Code*

This item must be marked IN or OUT of compliance. To be IN compliance, Item 2A must be determined to be IN compliance AND the Candidate determines during the inspection that no employees are ill or are experiencing symptoms that require reporting by the employee or action by the person-in-charge.

If OUT of compliance make notes as to why it is marked OUT of compliance.

N.A.

Do Not Mark This Item N.A.

N.O.

Do Not Mark This Item N.O.

3.

CONSUMER ADVISORY*

IN/ OUT

This item should be marked IN or OUT of compliance, with notes made concerning the reason it is marked OUT of compliance.

N.A.

This item may be marked N.A. such as in the circumstance where a food establishment does not serve a ready-to-eat food that necessitates an advisory, i.e., an animal food that is raw, undercooked, or not otherwise processed to eliminate pathogens.

N.O.

Do Not Mark This Item N.O.

4.

FOOD FROM APPROVED SOURCE

A.

All food from regulated food processing plants / no home prepared or canned foods*

This item should be marked IN or OUT of compliance, with notes made concerning the reason it is marked OUT of compliance.

N.A.

Do Not Mark This Item N.A.

N.O.

Do Not Mark This Item N.O.

B.

All shellfish from NSSP listed sources / no recreationally caught shellfish received or sold*

This item should be marked IN or OUT of compliance, with notes made concerning the reason it is marked OUT of compliance.

N.A.

This item may be marked N.A. if shellstock are not used in the establishment.

N.O.

This item may be marked N.O. also if shellstock are sold periodically in the establishment but are not being sold at the time of the inspection and you are unable to determine prior compliance through tags, invoices or purchase records.

C.

Game and wild mushrooms approved by regulatory authority*

This item should be marked IN or OUT of compliance with notes made concerning the reason it is marked OUT of compliance.

N.A.

This item may be marked N.A. such as when no game or wild mushrooms are offered at the establishment.

N.O.

This item may be marked N.O. when wild game or mushrooms are sold periodically in the establishment but are not being sold at the time of the inspection and you are unable to determine prior compliance through invoices or purchase records.

D.

Food received at proper temperatures / protected from contamination during transportation and receiving / safe and unadulterated food*

This item may be marked IN or OUT of compliance on any one of the listed items.

If the food is safe and unadulterated, but you are not able to check any temperatures of food during receiving or are not able to determine the condition of foods transported, mark the item IN compliance with an explanation on the lines below as to what the IN represents.

If one or all of the listed items are OUT of compliance, make appropriate notes as to why the item is marked out of compliance.

N.A.

Do Not Mark This Item N.A.

N.O.

Do Not Mark This Item N.O.

E.

Shellstock tags retained for 90 days from the date the container is emptied*

This item may be marked IN or OUT of compliance, with notes made concerning the reason it is marked OUT of compliance.

N.A.

This item may be marked N.A. such as when shellstock are not used in the establishment.

N.O.

4.

FOOD FROM APPROVED SOURCE

F.

Written documentation of parasite destruction maintained for fish products for 90 days

This item may be marked IN or OUT of compliance with notes made concerning the reason if it is marked OUT of compliance

N.A.

This item may be marked N.A. such as when raw, raw-marinated, or partially cooked fish (excluding tuna species listed in the Code) are not used in the establishment.

N.O.

5.

TIME / TEMPERATURE CONTROLS

NOTE 4: Cooking temperatures must be taken to make a determination of compliance or noncompliance. Do not rely upon discussions with managers or cooks to make a determination of compliance or noncompliance. If one food item is found out of temperature the item must be marked as OUT of compliance. If one food item is found out of cook temperature the item must be marked as OUT of compliance. If a food is cooked below the required Code temperature but the facility has an approved Consumer Advisory or an approved Variance with HACCP plan for that food item as provided for in paragraph 3.-401.11 (D), mark the item IN compliance, record the temperature and make a note regarding the reason for its IN compliance status.

5.1

Inadequate Cook - Raw Animal Foods*

A.

Raw eggs broken on request and prepared for immediate service cooked to 630 C(1450 F) for 15 seconds. Raw eggs broken, but not prepared for immediate service, cooked to 680 C<(1550 F) for 15 seconds

This item should be marked IN or OUT of compliance, with notes made concerning the reason it is marked OUT of compliance.

N.A.

This item may be marked N.A. such as when raw eggs are not used in the establishment, including raw eggs not used in recipes.

N.O.

This item may be marked N.O. such as when raw eggs are used in the establishment, but you are unable to determine the cooking temperature.

B.

Comminuted fish, meat, game animals cooked to 680 C (1550 F) for 15 seconds.

IN/OUT

This item should be marked IN or OUT of compliance, with notes made concerning the reason it is marked OUT of compliance.

N.A.

This item may be marked N.A. if comminuted meats are not cooked in the establishment.

N.O.

This item may be marked N.O. if one or more types of meat are cooked, but you are unable to determine the cooking temperature of any of them.

C.

Pork roasts and beef roasts, including formed roasts, are cooked to 540 C (1300 F) for 112 minutes or as chart specified and according to oven parameters per chart

This item may be marked IN or OUT of compliance for one or all of the types of meat, with notes made concerning the reason it is marked OUT of compliance.

N.A.

This item may be marked N.A. such as when roasts or formed roasts are not cooked in the establishment.

N.O.

This item may be marked N.O. such as when one or more of these meat items are cooked, but you are unable to determine the cooking temperature for any of them.

D.

Ratites and injected meats cooked to 680 C (1550 F) for 15 seconds

This item may be marked IN or OUT of compliance for one or all of the foods listed, with notes made concerning the reason it is marked OUT of compliance.

N.A.

This item may be marked N.A. such as when NONE of the listed foods are cooked in the establishment.

N.O.

This item may be marked N.O. such as when one or more of the listed foods are cooked in the establishment, but you are unable to determine the cooking temperature for any of them.

E.

Poultry; stuffed fish/meat/pasta/poultry/ratites; or stuffing containing fish, meat, poultry or ratites cooked to 740 C (1650 F) for 15 seconds

This item may be marked IN or OUT of compliance for one or all of the types of poultry/ meat/ratites or stuffed items, with notes made concerning the reason it is OUT of compliance.

N.A.

This item may be marked N.A. such as when poultry / meat / ratites or stuffed items are not cooked in the establishment.

N.O.

This item may be marked N.O. such as when one or more items are cooked, but you are unable to determine the cooking temperature for any of them.

F.

Wild game animals cooked to 740 C (1650 F) for 15 seconds

This item should be marked IN or OUT of compliance, with notes made concerning the reason it is marked OUT of compliance.

N.A.

This item may be marked N.A. such as when wild game animals are not cooked in the establishment.

N.O.

This item may be marked N.O such as when wild game animals are cooked, but you are unable to determine the cooking temperature for any of them.

G.

Whole-muscle, intact beef steaks cooked to surface temperature of 630 C (1450 F) on top and bottom. Meat surfaces are a cooked color

This item should be marked IN or OUT of compliance, with notes made concerning the reason it is marked OUT of compliance.

N.A.

This item may be marked N.A. such as when whole-muscle, intact beef steaks are not cooked in the establishment, or undercooked steaks are not offered.

N.O.

This item may be marked N.O. such as when whole-muscle, intact beef steaks are cooked in the establishment, but you are unable to determine the cooking temperature.

H.

Raw animal foods rotated, stirred, covered, and heated to 740 C (1650 F) in microwave. Food stands covered for 2 minutes after cooking

This item should be marked IN or OUT of compliance, with notes made concerning the reason it is marked OUT of compliance.

N.A.

This item may be marked N.A. such as when raw animal foods are not cooked in a microwave.

N.O.

This item may be marked N.O. such as when raw animal foods are cooked in a microwave but you are unable to determine the cooking temperatures for any of them

I.

All other raw animal foods cooked to 630 C (1450 F) for 15 seconds

This item may be marked IN or OUT of compliance, with notes made concerning the reason if it is marked OUT of compliance.

N.A.

This item may be marked N.A. such as when other PHF foods not listed above are not cooked in the establishment.

N.O.

This item may be marked N.O. such as when you are unable to determine the cooking temperature of any food. The inspection should be arranged at an optimum time for measuring at least one cooked item.

5.2

Reheating for Hot Holding

NOTE 5: Do not depend solely on discussions with management or cooks to determine the compliance status of reheat methods or target temperatures. Supplied information may be used to support or augment your direct observations.

A.

PHF are rapidly reheated to 740 C (1650 F) for 15 seconds for hot holding

This item should be marked IN or OUT of compliance, with notes made concerning the reason it is marked OUT of compliance.

N.A.

This item may be marked N.A. such as when foods are not held over for a second service. Explanatory notes should be made if this item is marked N.A.

N.O.

This item may be marked N.O. such as when foods are held over for a second service, but you are unable to check the reheating procedure.

B.

Food reheated to 740 C (1650 F) or higher in a microwave for hot holding

This item should be marked IN or OUT of compliance, with notes made concerning the reason it is marked OUT of compliance.

N.A.

This item may be marked N.A. such as when foods are not reheated in a microwave in the establishment

N.O.

This item may be marked N.O. such as when foods are reheated in a microwave but you were unable to make a determination of compliance.

C.

Commercially processed RTE reheated to 600 C (1400 F) or above for hot holding

This item should be marked IN or OUT of compliance, with notes made concerning the reason it is marked OUT of compliance.

N.A.

This item may be marked N.A. such as when commercially processed ready-to-eat foods are not reheated for hot holding in the establishment.

N.O.

This item may be marked N.O. such as when commercially processed ready-to-eat foods are reheated for hot holding in the establishment, but you were unable to determine the reheat temperature.

D.

Remaining unsliced portions of roasts are reheated for hot holding using minimum oven parameters

This item should be marked IN or OUT of compliance, with notes made concerning the reason it is marked OUT of compliance.

N.A.

This item may be marked N.A. such as when remaining unsliced portions of roasts are not used or reheated in the establishment.

N.O.

This item may be marked N.O. such as when remaining unsliced portions of roasts are reheated for hot holding in the establishment, but you were unable to determine the reheat temperature.

5.3

Treating Juice

When packaged in a food establishment, juice is treated under a HACCP Plan to reduce pathogens or labeled as specified in the Food Code.

NOTE 6: Please note that the following items address 5° C (41° F) as well as 7° C (45° F). If you have a temperature that meets the 5° C (41° F) temperature requirement, it should also be noted to be in compliance for the 7° C (45° F) item. If you have a temperature that meets the 7° C (45° F) requirement, it may or may not be in compliance with the 5° C (41° F) temperature requirement. Please write in this section of the report form all the temperatures you take of the products, no matter if they are IN compliance or OUT of compliance. Remember if one product is out of temperature the item is marked OUT of compliance.

NOTE 7: Do not depend solely on discussions with management or food employee to determine the compliance status of cooling methods or target temperatures. Supplied information may be used to support or augment your direct observations

A.

Cooked PHF cooled from 600 C (1400 F) to 210 C (700 F) within 2 hours and from 600 C (1400 F) to 70 C/50 C (450 F/410 F) or below within 6 hours

This item should be marked IN or OUT of compliance, with notes made concerning the reason it is marked OUT of compliance.

N.A.

This item may be marked N.A. such as when the establishment is a cook-serve establishment type, or does not cool or heat food.

N.O.

This item may be marked N.O. such as when the establishment does cool PHF for a second service, but you were unable to determine the temperature and times.

B.

PHF (from ambient temperature ingredient)cooled to 70 C/50 C (450 F/410 F) or below within 4 hours

This item should be marked IN or OUT of compliance, with notes made concerning the reason it is marked OUT of compliance.

N.A.

This item may be marked N.A. such as when no PHF are prepared from ambient temperature ingredient.

N.O.

This item may be marked N.O. such as when these foods are prepared, but you were unable to determine the temperature.

C.

Foods (milk, shellfish) received at a temperature according to Law are cooled to 70 C/ 50 C (450 F/ 410 F) within 4 hours.

This item should be marked IN or OUT of compliance, with notes made concerning the reason it is marked OUT of compliance.

NOTE 8: If raw shell eggs are immediately placed under refrigeration capable of keeping foods at 50 C (410 F) or 70 C (450 F), satisfactory compliance is achieved. Federal regulations require that raw shell eggs be transported and stored at 45 F or lower ambient air temperatures - cooling time does not apply to this item.

NOTE 9: If one product is found out of temperature the item is marked out of compliance.

N.A.

This item may be marked N.A. such as when the establishment does not receive shellstock, milk, or other products that have a transport temperature above 5 0 C (410 F).

N.O.

This item may be marked N.O. such as when the establishment does receive shellstock, milk, or other products that have a transport temperature above 50 C (410 F), but you were unable to determine if these products were cooled down as described above.

5.5

PHF Cold & Hot Holding*

NOTE 10: The CANDIDATE should rely only on actual observations to mark section 5.5 of the inspection form.

A.

PHF is maintained at 70 C/ 50 C (450 F/ 410 F) or below, except during preparation, cooking, cooling, or when time is used as a public health control. (For raw shell eggs see 5.5 D.)

This item should be marked IN or OUT of compliance, with notes made concerning the reason it is marked OUT of compliance.

N.A.

Do Not Mark This Item N.A.

N.O.

Do Not Mark This Item N.O.

B.

PHF is maintained at 600 C (1400 F) or above, except during preparation, cooking, or cooling or when time is used as a public health control

This item should be marked IN or OUT of compliance, with notes made concerning the reason it is marked OUT of compliance.

N.A.

This item may only be marked N.A. such as when there is no PHF hot holding in the establishment.

N.O.

This item should be marked N.O. such as when you are unable to determine compliance. Inspections should be conducted during a time when hot holding temperatures can be taken.

C.

Roasts are held at a temperature of 540 C (1300 F) or above

This item should be marked IN or OUT of compliance, with notes made concerning the reason it is marked OUT of compliance.

N.A.

This item may only be marked N.A. if roast is not a menu item.

N.O.

This item should be marked N.O. such as when you are unable to determine compliance. Inspections should be conducted during a time when hot holding temperatures can be taken.

5.6

Date Marking & Discarding*

A.

Date marking for RTE, PHF prepared on-site and opened commercial container held for more than 24 hours

This item should be marked IN or OUT of compliance, with notes made concerning the reason it is marked OUT of compliance.

N.A.

This item may only be marked N.A. such as when there is no RTE, PHF prepared-on-premises, or opened commercial container held for more than 24 hours

N.O.

This item should be marked N.O. such as when there is RTE, PHF either prepared-on-premises, or an opened commercial container and you are unable to determine compliance. Do not depend solely on information from managers or cooks.

B.

DISCARDING of RTE, PHF prepared on-site/ opened commercial container held at < 5° C (41° F) for < 7 days or > 5° C - 7° C (41° F-45° F) for < 4 days; is not date marked; or is incorrectly date marked.

This item should be marked IN such as when foods are all within date marked time limits or food is observed being discarded within date marked time limits or OUT of compliance, such as when date marked food exceeds the time limit or date-marking is not done, with notes made concerning the reason it is marked OUT of compliance.

N.A.

This item may only be marked N.A. such as when there is no RTE, PHF prepared-on-premises, or opened commercial container held for more than 24 hours

N.O.

This item should be marked N.O. when RTE, PHF is prepared-on-premises, or opened commercial container is held beyond the 7-day or 4-day time limits listed above and you are unable to determine compliance.

5.7

Time*

When only time is used as the public health control, food is cooked and served within 4 hours

IN/ OUT

This item should be marked IN or OUT of compliance, with notes made concerning the reason it is marked OUT of compliance.

N.A.

This item may only be marked N.A. such as when time is not used as the only public health control.

N.O.

This item should be marked N.O. such as when time is used as the public health control but the time-controlled process is not in operation during the inspection and you are unable to determine compliance.

6.

FOOD & FOOD PREPARATION FOR HIGHLY SUSCEPTIBLE POPULATIONS*

NOTE 11: The PIC should be questioned regarding whether or not certain foods are offered for sale or certain practices occur in the establishment to mark Section 6 of the inspection form. One may rely solely on discussions with managers or food employees to determine the compliance status of these items.

A.

Only treated/pasteurized juice/juice beverage is served. Packages containing juice/beverage containing juice with a warning label (21 CFR, Section 101.17(g)) not served

This item should be marked IN or OUT of compliance, with notes made concerning the reason it is marked OUT of compliance.

N.A.

This item may be marked N.A. if no highly susceptible population is served or if juice is not served.

N.O.

Do Not Mark this Item N.O.

B.

Use pasteurized eggs in recipes if eggs are undercooked; and if eggs are combined unless: cooked to order & immediately served; used immediately before baking and thoroughly cooked; or a HACCP plan controls Salmonella Enteritidis

N.A.

This item may be marked N.A. if no highly susceptible population is served or if eggs are not served.

N.O.

Do Not Mark this item N.O.

C.

Raw or partially cooked animal food, and raw seed sprouts not served

This item should be marked IN or OUT of compliance, with notes made concerning the reason it is marked OUT of compliance.

N.A.

This item may be marked N.A. if no highly susceptible population is served.

N.O.

Do Not Mark this item N.O.

D.

Unopened food package not re-served

This item should be marked IN or OUT of compliance, with notes made concerning the reason it is marked OUT of compliance.

N.A.

This item may be marked N.A. if no highly susceptible population is served.

N.O.

Do Not Mark this item N.O.

7.

PROTECTION FROM CONTAMINATION* - CRITICAL ITEMS

A.

Separating raw animal foods from raw RTE food and separating raw animal foods from cooked RTE food

This item may be marked IN or OUT of compliance, with notes made concerning the reason if it is marked OUT of compliance.

N.A.

This item may only be marked N.A. such as when there is only a vegetarian menu or only commercially precooked animal foods are used.

N.O.

This item is marked N.O. when raw animal foods are used or served seasonally and you are unable to determine compliance.

B.

Raw animal foods separated from each other during storage, preparation, holding, and display

This item may be marked IN or OUT of compliance, with notes made concerning the reason if it is marked OUT of compliance.

N.A.

This Item may be marked N.A. such as when there are no raw animal foods used, or only one raw animal species is used.

N.O.

This item is marked N.O. when raw animal foods are used or served seasonally and you are unable to determine compliance.

C.

Food protected from contamination - critical items

This item should be marked IN or OUT of compliance, with notes made concerning the reason it is marked OUT of compliance.

N.A.

Do Not Mark This Item N.A.

N.O.

Do Not Mark This Item N.O.

D.

After being served or sold to a consumer, food is not re-served

This item should be marked IN or OUT of compliance, with notes made concerning the reason it is marked OUT of compliance. The actual observation of the disposition of unwrapped/unprotected, served food being returned to the kitchen must be made.

N.A.

Do Not Mark This Item N.A.

N.O.

Do Not Mark This Item N.O.

E.

Discarding or reconditioning unsafe, adulterated or contaminated food

In order to mark this item OUT, a finding must be made that food is unsafe, adulterated, not honestly presented, from an unapproved source, or RTE food is contaminated by employees. If a finding is not made, mark this item IN compliance. This item should be marked IN or OUT of compliance, with notes made concerning the reason it is marked OUT of compliance.

N.A.

Do Not Mark This Item N.A.

N.O.

Do Not Mark This Item N.O.

8.

FOOD-CONTACT SURFACES

NOTE 12: This item will require some judgement to be used when marking it IN or OUT of compliance. It should be marked OUT of compliance if observations are made that support a pattern of noncompliance with this item. One dirty utensil, food-contact surface, or one sanitizer container without sanitizer would not necessarily support an OUT of compliance mark. You must provide notes concerning the reason it is marked OUT of compliance.

Food-contact surfaces and utensils are clean to sight and touch and sanitized before use*

This item should be marked IN or OUT of compliance, with notes made concerning the reason it is marked OUT of compliance.

N.A.

Do Not Mark This Item N.A.

N.O.

Do Not Mark This Item N.O.

9.

PROPER, ADEQUATE HANDWASHING

NOTE 13: You must be in the establishment long enough to make an observation for all sections of Personnel. One should rely only on actual observations to mark Section 9 of the inspection form.

Hands clean and properly washed*

This item may be marked IN or OUT of compliance, with notes made concerning the reason it is marked OUT of compliance. This item must be marked OUT of compliance if one person is observed with dirty hands or with hands that have not been properly washed.

N.A.

Do Not Mark This Item N.A.

N.O.

This item may be marked N.O. for retail operations only in the RARE case where an observation can not be made because no food workers are present to observe.

10.

GOOD HYGIENIC PRACTICES*

NOTE 14: One should rely only on actual observations to mark Section 10 of the inspection form.

Food employees eat, drink, and use tobacco only in designated areas / do not use a utensil more than once to taste food that is sold or served / do not handle or care for animals present. Food employees experiencing persistent sneezing, coughing, or runny nose do not work with exposed food, clean equipment, utensils, linens, unwrapped single-service or single-use articles*

This item may be marked IN or OUT of compliance, with notes made concerning the reason if it is marked OUT of compliance. This item must be marked OUT of compliance if one person is observed to be out of compliance with this item.

N.A.

Do Not Mark This Item N.A.

N.O.

This item may be marked N.O. for retail operations only in the case where no food workers are present.

11.

PREVENTION OF CONTAMINATION FROM HANDS*

NOTE 15: One should rely only on actual observations to mark Section 11 of the inspection form.

Exposed, RTE food not touched by bare hands

This item may be marked IN or OUT of compliance, with notes made concerning the reason it is marked OUT of compliance. This item must be marked OUT of compliance if one person is observed to be out of compliance with this item.

N.A.

This item may be marked N.A. for facilities that do not prepare ready-to-eat foods

N.O.

This item may be marked N.O. for retail operations that prepare ready-to-eat foods only in the case where no food workers are present.

12.

HANDWASH FACILITIES

A.

Handwash facilities conveniently located and accessible for employees*

This item may be marked IN or OUT of compliance, with notes made concerning the reason it is marked OUT of compliance.

N.A.

Do Not Mark This Item N.A.

N.O.

Do Not Mark This Item N.O.

B.

Handwash facilities supplied with hand cleanser / sanitary towels / hand drying devices/signage

This item may be marked IN or OUT of compliance, with notes made concerning the reason it is marked OUT of compliance.

N.A.

Do Not Mark This Item N.A.

N.O.

Do Not Mark This Item N.O.

13.

CHEMICAL

A.

Use of Additives

If additives are used, this item is marked IN compliance if only approved food or color additives are used and used properly, or if sulfites are on the premises, and they are not applied to fresh fruits/vegetables for raw consumption. This item is marked OUT of compliance if unapproved additives are found on premises, or approved additives are improperly used, such as if sulfites are applied to fresh fruits or vegetables.

N.A.

This item may be marked N.A. if the food establishment does not use any (approved or unapproved) additives or sulfites on the premises.

N.O.

Do Not Mark This Item N.O.

B.

Poisonous or toxic materials, chemicals, lubricants, pesticides, medicines, first aid supplies*, and other personal care items properly identified, stored, and used

This item may be marked IN or OUT of compliance, with notes made concerning the reason it is marked OUT of compliance. It may be marked OUT of compliance for improper storage or use of any one of the listed items.

N.A.

Do Not Mark This Item N.A.

N.O.

Do Not Mark This Item N.O.

C.

Poisonous or toxic materials held for retail sale properly stored*

This item may be marked IN or OUT of compliance, with notes made concerning the reason it is marked OUT of compliance. It may be marked OUT of compliance for improper storage of any one of the items.

N.A.

This item may be marked N.A. if the establishment does not hold poisonous or toxic materials for retail sale.

N.O.

Do Not Mark This Item N.O.

14.

CONFORMANCE WITH APPROVED/REQUIRED PROCEDURES*

IN/ OUT

This item may be marked IN or OUT of compliance, with notes made concerning the reason it is marked OUT of compliance

N.A.

This item may be marked N.A. if the establishment is not required by the regulatory authority to have a variance or HACCP procedure.

N.O.

Do Not Mark This Item N.O.

GOOD RETAIL PRACTICES

STATUS

PERSONNEL

15.

PERSONNEL CLEANLINESS (FINGERNAILS, JEWELRY, OUTER CLOTHING, HAIR RESTRAINTS)

IN/ OUT

This item may be marked IN or OUT of compliance, with notes made concerning the reason it is marked OUT of compliance. It may be marked OUT of compliance for improper storage or use of any one of the items.

N.A.

Do Not Mark This Item N.A. unless the establishment has no employees, uses only prepackaged food, or is strictly a vending operation.

N.O.

Do Not Mark This Item N.O.

FOOD & FOOD PROTECTION

16.

FOOD SOURCE*, ORIGINAL CONTAINER, PROPERLY LABELED, CONDITION, USED*, HONESTLY PRESENTED*, SEGREGATED DISTRESSED PRODUCTS

IN/ OUT

This item may be marked IN or OUT of compliance, with notes made concerning the reason it is marked OUT of compliance.

N.A.

Do Not Mark This Item N.A.

N.O.

Do Not Mark This Item N.O.

17.

PLANT FOOD COOKING FOR HOT HOLDING

IN/ OUT

This item may be marked IN or OUT of compliance, with notes made concerning the reason it is marked OUT of compliance.

N.A.

This item may be marked N.A. if vegetables and fruits are not cooked for hot holding in the establishment.

N.O.

This item may be marked N.O. when plant foods are cooked for hot holding, but are not available for observation during the inspection.

18.

PROTECTION FROM CONTAMINATION - NONCRITICAL ITEMS

IN/ OUT

This item should be marked IN or OUT of compliance, with notes made concerning the reason it is marked OUT of compliance.

N.A.

Do Not Mark This Item N.A.

N.O.

Do Not Mark This Item N.O.

FOOD & FOOD PROTECTION

19.

FACILITIES / COOLING METHODS/EQUIPMENT TO CONTROL PRODUCT TEMPERATURE

IN/ OUT

This item should be marked IN or OUT of compliance, with notes made concerning the reason it is marked OUT of compliance. Intent is to determine that adequate hot/cold holding, and heating/cooling equipment and procedures are in place. Do not mark equipment repair items here.

N.A.

Do Not Mark This Item N.A.

N.O.

Do Not Mark This Item N.O.

20.

PHF PROPERLY THAWED

IN/ OUT

This item should be marked IN or OUT of compliance, with notes made concerning the reason it is marked OUT of compliance.

N.A.

This item may be marked N.A. if PHF are not thawed.

N.O.

This item may be marked N.O. if food is thawed, but thawing was not observed during the inspection.

21.

DISPENSING OF FOOD / UTENSILS PROPERLY STORED

IN/ OUT

This item may be marked IN or OUT of compliance on any one of the listed items. If one of the items is OUT of compliance, make notes concerning the reason it is marked OUT of compliance.

N.A.

Do Not Mark This Item N.A.

N.O.

Do Not Mark This Item N.O.

FOOD EQUIPMENT

22.

THERMOMETERS PROVIDED AND CONSPICUOUS

IN/ OUT

This item should be marked IN or OUT of compliance, with notes made concerning the reason it is marked OUT of compliance.

N.A.

Do Not Mark This Item N.A.

N.O.

Do Not Mark This Item N.O.

23.

FOOD- AND NONFOOD-CONTACT SURFACES: DESIGNED / CONSTRUCTED*, MAINTAINED, INSTALLED, LOCATED, OPERATED, CLEANABLE*

IN/ OUT

This item should be marked IN or OUT of compliance, with notes made concerning the reason it is marked OUT of compliance. Include refrigeration/cooking/holding equipment that does not maintain temperature or other food/nonfood surfaces or equipment that is not maintained/operated.

N.A.

Do Not Mark This Item N.A.

N.O.

Do Not Mark This Item N.O.

FOOD EQUIPMENT

24.

WAREWASHING FACILITY: DESIGNED, CONSTRUCTED, INSTALLED, LOCATED, OPERATED, CLEANABLE, USED

(Accurate thermometers, chemical test kits provided, gauge cock)

IN/ OUT

This item should be marked IN or OUT of compliance, with notes made concerning the reason it is marked OUT of compliance.

N.A.

Do Not Mark This Item N.A.

N.O.

Do Not Mark This Item N.O.

25.

WIPING CLOTHS, LINENS, NAPKINS, GLOVES, SPONGES: PROPERLY USED, STORED

IN/ OUT

This item should be marked IN or OUT of compliance, with notes made concerning the reason it is marked OUT of compliance.

N.A.

Do Not Mark This Item N.A.

N.O.

Do Not Mark This Item N.O.

26.

STORAGE, HANDLING OF CLEAN EQUIPMENT, UTENSILS

IN/ OUT

This item should be marked IN or OUT of compliance, with notes made concerning the reason it is marked OUT of compliance.

N.A.

Do Not Mark This Item N.A.

N.O.

Do Not Mark This Item N.O.

27.

SINGLE-SERVICE / SINGLE-USE ARTICLES: STORAGE, DISPENSING, USE, NO REUSE.

IN/ OUT

This item should be marked IN or OUT of compliance, with notes made concerning the reason it is marked OUT of compliance.

N.A.

Do Not Mark This Item N.A.

N.O.

Do Not Mark This Item N.O.

WATER

28.

SAFE WATER SOURCE*, HOT & COLD UNDER PRESSURE, ADEQUATE QUANTITY*

IN/ OUT

This item should be marked IN or OUT of compliance, with notes made concerning the reason it is marked OUT of compliance.

N.A.

Do Not Mark This Item N.A.

N.O.

Do Not Mark This Item N.O.

PLUMBING

29.

INSTALLED, MAINTAINED*

IN/ OUT

This item should be marked IN or OUT of compliance, with notes made concerning the reason it is marked OUT of compliance.

N.A.

Do Not Mark This Item N.A.

N.O.

Do Not Mark This Item N.O.

30.

CROSS CONNECTION*, BACK SIPHONAGE, BACKFLOW PREVENTION*

IN/ OUT

This item should be marked IN or OUT of compliance, with notes made concerning the reason it is marked OUT of compliance.

N.A.

Do Not Mark This Item N.A.

N.O.

Do Not Mark This Item N.O.

TOILET FACILITIES

31.

NUMBER, CONVENIENT, ACCESSIBLE, DESIGNED, INSTALLED

IN/ OUT

This item should be marked IN or OUT of compliance, with notes made concerning the reason it is marked OUT of compliance.

N.A.

Do Not Mark This Item N.A.

N.O.

Do Not Mark This Item N.O.

32.

TOILET ROOMS ENCLOSED, SELF-CLOSING DOORS; PROPER WASTE RECEPTACLES

IN/ OUT

This item should be marked IN or OUT of compliance, with notes made concerning the reason it is marked OUT of compliance.

N.A.

Do Not Mark This Item N.A.

N.O.

Do Not Mark This Item N.O.

SEWAGE

33.

SEWAGE AND WASTE WATER DISPOSAL*

IN/ OUT

This item should be marked IN or OUT of compliance, with notes made concerning the reason it is marked OUT of compliance.

N.A.

Do Not Mark This Item N.A.

N.O.

Do Not Mark This Item N.O.

GARBAGE & REFUSE DISPOSAL

34.

CONTAINERS OR RECEPTACLES: COVERED, ADEQUATE NUMBER, INSECT / RODENT PROOF, FREQUENCY OF REMOVAL, CLEAN AREA PROPERLY CONSTRUCTED, NECESSARY IMPLEMENTS, SUPPLIES

IN/ OUT

This item should be marked IN or OUT of compliance, with notes made concerning the reason it is marked OUT of compliance.

N.A.

Do Not Mark This Item N.A.

N.O.

Do Not Mark This Item N.O.

PHYSICAL FACILITY

35.

FLOORS, WALLS, CEILINGS: DESIGNED, CONSTRUCTED, MAINTAINED, CLEAN

IN/ OUT

This item should be marked IN or OUT of compliance, with notes made concerning the reason it is marked OUT of compliance.

N.A.

Do Not Mark This Item N.A.

N.O.

Do Not Mark This Item N.O.

36.

LIGHTING, VENTILATION, DRESSING ROOMS / DESIGNATED AREAS MAINTAINED

IN/ OUT

This item should be marked IN or OUT of compliance, with notes made concerning the reason it is marked OUT of compliance.

N.A.

Do Not Mark This Item N.A.

N.O.

Do Not Mark This Item N.O.

37.

PREMISES MAINTAINED FREE OF LITTER, UNNECESSARY ARTICLES, CLEANING AND MAINTENANCE EQUIPMENT PROPERLY STORED

IN/ OUT

This item should be marked IN or OUT of compliance, with notes made concerning the reason it is marked OUT of compliance.

N.A.

Do Not Mark This Item N.A.

N.O.

Do Not Mark This Item N.O.

PHYSICAL FACILITY

38.

COMPLETE SEPARATION FROM LIVING / SLEEPING QUARTERS; LAUNDRY

IN/ OUT

This item should be marked IN or OUT of compliance, with notes made concerning the reason it is marked OUT of compliance.

N.A.

Do Not Mark This Item N.A.

N.O.

Do Not Mark This Item N.O.

PEST AND ANIMAL CONTROL

39.

PRESENCE OF INSECTS / RODENTS MINIMIZED: OUTER OPENINGS PROTECTED, ANIMALS AS ALLOWED

IN/ OUT

This item should be marked IN or OUT of compliance, with notes made concerning the reason it is marked OUT of compliance.

N.A.

Do Not Mark This Item N.A.

N.O.

Do Not Mark This Item N.O.

40.

IN/ OUT

This item should be marked IN or OUT of compliance, with notes made concerning the reason it is marked OUT of compliance.

N.A.

This item may be marked N.A. if the establishment does not smoke for preservation /cure foods, use additives to preserve foods, and/or package foods using reduced oxygen (1 barrier only).

N.O.

Do Not Mark This Item N.O.

ABREVIATIONS