Restaurant Inspection Checklist: Date

RESTAURANT NAME: BERKAT NASI AYAM
Restaurant Inspection Checklist
Date:
CONFIDENTIAL
IDENTIFYING FACTORS EXCELLENT GOOD BAD DETAILS
PERSONAL HYGIENE: Score ( /7)
Employees wear clean and proper clothing, including closed-toe shoes.
Effective hair restraints, such as hairnet or hat and properly worn.
Hands are washed properly, frequently, and at appropriate times.
Eating chewing gum, smoking and using tobacco are allowed only in designated areas away from
preparation, service, and food storage.
Staff beverages have lids and are kept away from food.
Employees use disposable tissues when coughing or sneezing, and immediately wash hands and change
gloves.
Hand sinks are stocked with soap, disposable towels, and warm water.
FOOD PREPARATION: Score ( /5) EXCELLENT GOOD BAD DETAILS
Food equipment, utensils, and food contact surfaces are properly washed, rinsed, and sanitized before every
use.
Frozen food is thawed under refrigeration, in the microwave, cooked to a proper temperature from a frozen
state, or in cold running water.
Food is handled with suitable utensils, such as single-use gloves or tongs.
Clean reusable towels are used only for sanitizing equipment and surface and not for drying hands, utensils
or the floor.
Food is cooked on the proper internal temperature.
REFRIGERATOR AND FREEZER: Score ( /3) EXCELLENT GOOD BAD DETAILS
Refrigerator and freezer units are clean and neat.
Refrigerator temperature is at or below -6℃.
Food is protected from contamination.

FOOD STORAGE AND DRY STORAGE: Score ( /4) EXCELLENT GOOD BAD DETAILS
All food is stored 6-8 inches off the floor.
Food is stored in the original container or a food grade container.
There are bulging or leaking canned goods.
Chemicals are clearly labeled and stored away from food.
UTENSILS AND EQUIPMENTS: Score ( /4) EXCELLENT GOOD BAD DETAILS
Utensils and equipments are cleaned and sanitized between uses.
Work surfaces and utensiles are clean.
Food chart or container used to transport food is cleaned daily.
Can opener is clean.
DISHWASHING: Score ( /3) EXCELLENT GOOD BAD DETAILS
Three-compartment sink is properly set up for ware washing is working properly.
Water temperatures are correct.
Smallware and utensiles are allowed to air dry.
GARBAGE STORAGE AND PEST CONTROL: ( /3) EXCELLENT GOOD BAD DETAILS
Kitchen garbage cans are clean and emptied as necessary.
Boxes and containers are removed from the site.
Evidence of pests is present.
FOOD: Score ( /7) EXCELLENT GOOD BAD DETAILS
Salads/uncooked ready-to-eat food are prepared from throughly washed.
All uncooked salads, vegetables and fruits are freshly prepared.
Cooked food is stored covered and at appropriate temperature.
Cold food are served cold and hot food hot.
Cooked food is not left at room temperature for more than 2 hours.
Surplus food is not mixed up with freshly prepared food.
The price of the food is affordable.

RESTAURANT NAME: MARIANI TOMYAM
Restaurant Inspection Checklist
Date:
CONFIDENTIAL
IDENTIFYING FACTORS EXCELLENT GOOD BAD DETAILS
PERSONAL HYGIENE: Score ( /7)
Employees wear clean and proper clothing, including closed-toe shoes.
Effective hair restraints, such as hairnet or hat and properly worn.
Hands are washed properly, frequently, and at appropriate times.
Eating chewing gum, smoking and using tobacco are allowed only in designated areas away from
preparation, service, and food storage.
Staff beverages have lids and are kept away from food.
Employees use disposable tissues when coughing or sneezing, and immediately wash hands and change
gloves.
Hand sinks are stocked with soap, disposable towels, and warm water.
FOOD PREPARATION: Score ( /5) EXCELLENT GOOD BAD DETAILS
Food equipment, utensils, and food contact surfaces are properly washed, rinsed, and sanitized before every
use.
Frozen food is thawed under refrigeration, in the microwave, cooked to a proper temperature from a frozen
state, or in cold running water.
Food is handled with suitable utensils, such as single-use gloves or tongs.
Clean reusable towels are used only for sanitizing equipment and surface and not for drying hands, utensils
or the floor.
Food is cooked on the proper internal temperature.
REFRIGERATOR AND FREEZER: Score ( /3) EXCELLENT GOOD BAD DETAILS
Refrigerator and freezer units are clean and neat.
Refrigerator temperature is at or below -6℃.
Food is protected from contamination.

FOOD STORAGE AND DRY STORAGE: Score ( /4) EXCELLENT GOOD BAD DETAILS
All food is stored 6-8 inches off the floor.
Food is stored in the original container or a food grade container.
There are bulging or leaking canned goods.
Chemicals are clearly labeled and stored away from food.
UTENSILS AND EQUIPMENTS: Score ( /4) EXCELLENT GOOD BAD DETAILS
Utensils and equipments are cleaned and sanitized between uses.
Work surfaces and utensiles are clean.
Food chart or container used to transport food is cleaned daily.
Can opener is clean.
DISHWASHING: Score ( /3) EXCELLENT GOOD BAD DETAILS
Three-compartment sink is properly set up for ware washing is working properly.
Water temperatures are correct.
Smallware and utensiles are allowed to air dry.
GARBAGE STORAGE AND PEST CONTROL: ( /3) EXCELLENT GOOD BAD DETAILS
Kitchen garbage cans are clean and emptied as necessary.
Boxes and containers are removed from the site.
Evidence of pests is present.
FOOD: Score ( /7) EXCELLENT GOOD BAD DETAILS
Salads/uncooked ready-to-eat food are prepared from throughly washed.
All uncooked salads, vegetables and fruits are freshly prepared.
Cooked food is stored covered and at appropriate temperature.
Cold food are served cold and hot food hot.
Cooked food is not left at room temperature for more than 2 hours.
Surplus food is not mixed up with freshly prepared food.
The price of the food is affordable.

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RESTAURANT NAME: BERKAT NASI AYAM

Restaurant Inspection Checklist

IDENTIFYING FACTORS EXCELLENT GOOD BAD DETAILS

PERSONAL HYGIENE: Score ( /7)

Employees wear clean and proper clothing, including closed-toe shoes.

Effective hair restraints, such as hairnet or hat and properly worn.

Hands are washed properly, frequently, and at appropriate times.

FOOD PREPARATION: Score ( /5) EXCELLENT GOOD BAD DETAILS

Food is handled with suitable utensils, such as single-use gloves or tongs.

Food is cooked on the proper internal temperature.

REFRIGERATOR AND FREEZER: Score ( /3) EXCELLENT GOOD BAD DETAILS

Refrigerator and freezer units are clean and neat.

Refrigerator temperature is at or below -6℃.

Food is protected from contamination.

All food is stored 6-8 inches off the floor.

Food is stored in the original container or a food grade container.

There are bulging or leaking canned goods.

Chemicals are clearly labeled and stored away from food.

UTENSILS AND EQUIPMENTS: Score ( /4) EXCELLENT GOOD BAD DETAILS

Utensils and equipments are cleaned and sanitized between uses.

Work surfaces and utensiles are clean.

Food chart or container used to transport food is cleaned daily.

Can opener is clean.

DISHWASHING: Score ( /3) EXCELLENT GOOD BAD DETAILS

Three-compartment sink is properly set up for ware washing is working properly.

Water temperatures are correct.

Smallware and utensiles are allowed to air dry.

Kitchen garbage cans are clean and emptied as necessary.

Boxes and containers are removed from the site.

Evidence of pests is present.

FOOD: Score ( /7) EXCELLENT GOOD BAD DETAILS

Salads/uncooked ready-to-eat food are prepared from throughly washed.

All uncooked salads, vegetables and fruits are freshly prepared.

Cooked food is stored covered and at appropriate temperature.

Cold food are served cold and hot food hot.

Surplus food is not mixed up with freshly prepared food.

The price of the food is affordable.

IDENTIFYING FACTORS EXCELLENT GOOD BAD DETAILS

PERSONAL HYGIENE: Score ( /7)

Employees wear clean and proper clothing, including closed-toe shoes.

Effective hair restraints, such as hairnet or hat and properly worn.

Hands are washed properly, frequently, and at appropriate times.

FOOD PREPARATION: Score ( /5) EXCELLENT GOOD BAD DETAILS

Food is handled with suitable utensils, such as single-use gloves or tongs.

Food is cooked on the proper internal temperature.

REFRIGERATOR AND FREEZER: Score ( /3) EXCELLENT GOOD BAD DETAILS

Refrigerator and freezer units are clean and neat.

Refrigerator temperature is at or below -6℃.

Food is protected from contamination.

All food is stored 6-8 inches off the floor.

Food is stored in the original container or a food grade container.

There are bulging or leaking canned goods.

Chemicals are clearly labeled and stored away from food.

UTENSILS AND EQUIPMENTS: Score ( /4) EXCELLENT GOOD BAD DETAILS

Utensils and equipments are cleaned and sanitized between uses.

Work surfaces and utensiles are clean.

Food chart or container used to transport food is cleaned daily.

Can opener is clean.