Checklist template

Food safety for convenience store foodservice

A ready-to-use checklist with 118 items in 6 sections, covering Temperatures, Dating, Hygiene, Cleaning, Equipment, Logs. Use it as-is in Bindy, or adapt it to your own standards in minutes.

  • 6 Sections
  • 118 Items
  • 101 Yes / No checks
  • 5 Scored ratings
  • 126 Points

Use this template How audits work

1. Temperatures 22 items

  1. The open-air grab-and-go cooler holds product at 41°F (5°C) or below, measured with a probe between two packages Yes / No 1 pt
  2. Temperature measured in the open-air grab-and-go cooler (°F or °C) Number
  3. Product in the open-air cooler is stocked below the load line, clear of the air curtain Yes / No 1 pt
  4. The undercounter food refrigerator reads 41°F (5°C) or below on its internal thermometer Yes / No 1 pt
  5. The food freezer keeps product frozen solid, at 0°F (-18°C) or below Yes / No 1 pt
  6. Temperature read in the food freezer (°F or °C) Number
  7. Hot dogs and taquitos on the holding zone of the roller grill probe at 135°F (57°C) or above Yes / No 1 pt
  8. Temperature of one roller grill item probed in the holding zone (°F or °C) Number
  9. Nacho cheese sauce in the dispenser probes at 135°F (57°C) or above Yes / No 1 pt
  10. Chili in the dispenser or kettle probes at 135°F (57°C) or above Yes / No 1 pt
  11. Soup held for self-service probes at 135°F (57°C) or above Yes / No 1 pt
  12. Fried chicken, wedges and other items in the heated display case probe at 135°F (57°C) or above Yes / No 1 pt
  13. Cooked food that has cooled is brought to 165°F (74°C) in the oven or microwave, never warmed up in the hot case or on the roller grill Yes / No 1 pt
  14. Pizza held on time rather than temperature carries a discard time within the limit on the hold time chart Yes / No 1 pt
  15. Refrigerated creamer in the coffee dispenser is at 41°F (5°C) or below Yes / No 1 pt
  16. Milk in the cappuccino or iced coffee dispenser is at 41°F (5°C) or below Yes / No 1 pt
  17. Cut produce on the condiment bar (onions, tomatoes, jalapenos) sits in a chilled well or on ice at 41°F (5°C) or below Yes / No 1 pt
  18. Frozen breakfast items and pizza dough are thawed in the refrigerator, never on the counter Yes / No 1 pt
  19. Deliveries of refrigerated food are probed on arrival, before the driver leaves Yes / No 1 pt
  20. Refrigerated food delivered above 41°F (5°C) is refused Yes / No 1 pt
  21. Food is moved from the delivery tote to refrigeration within the time set by company policy Yes / No 1 pt
  22. Temperature control found during the visit Rating
    • Every reading within range 5 pts
    • One reading out of range, corrected on the spot 3 pts
    • Several readings out of range 1 pt

2. Dating 18 items

  1. Every opened package of hot dogs, deli meat or cheese carries the date it was opened Yes / No 1 pt
  2. Opened ready-to-eat food is discarded by the use-by day on the shelf-life chart Yes / No 1 pt
  3. The shelf-life chart for the food program is posted where labels are written Yes / No 1 pt
  4. Bags of nacho cheese and chili are marked with the date and time they were loaded in the dispenser Yes / No 1 pt
  5. Bags of nacho cheese and chili are discarded at the end of the dispenser life stated by the supplier Yes / No 1 pt
  6. Refrigerated creamer and milk bags in dispensers are marked with the date they were tapped Yes / No 1 pt
  7. Thawed sandwiches and burritos carry a use-by date counted from the day they were pulled from the freezer Yes / No 1 pt
  8. Pastries in the self-serve bakery case are marked or logged with the day they were set out Yes / No 1 pt
  9. Cut condiments on the condiment bar are replaced at the interval stated on the shelf-life chart Yes / No 1 pt
  10. Hard-boiled eggs, yogurt parfaits and cut fruit in the cooler are within the date printed or labeled Yes / No 1 pt
  11. Milk and dairy for sale in the food cooler are within date on a check of 10 items Yes / No 1 pt
  12. Product in the food freezer is in its original case or labeled with the product name and date received Yes / No 1 pt
  13. Stock in the food refrigerator is rotated with the earliest date used first Yes / No 1 pt
  14. Out-of-date food pulled from sale is discarded or placed in a container marked "not for sale" Yes / No 1 pt
  15. Recalled food items named in the latest recall notice have been removed from sale Yes / No 1 pt
  16. Out-of-date food items found during the visit Number
  17. Opened packages found without a date during the visit Number
  18. Date marking of opened and prepared food Rating
    • Every item dated and within date 5 pts
    • A few items undated 3 pts
    • Out-of-date or mostly undated food 1 pt

3. Hygiene 19 items

  1. A sink used only for handwashing is within reach of the food preparation area Yes / No 1 pt
  2. The handwashing sink has hot running water Yes / No 1 pt
  3. The handwashing sink has liquid soap in a dispenser Yes / No 1 pt
  4. The handwashing sink has single-use paper towels Yes / No 1 pt
  5. A handwashing sign is posted at the handwashing sink Yes / No 1 pt
  6. The cashier washes hands after handling money or working on the forecourt, before touching food, as observed Yes / No 1 pt
  7. Ready-to-eat food is handled with tongs, deli paper or single-use gloves, never bare hands Yes / No 1 pt
  8. Gloves are changed after touching the register, the phone or the trash Yes / No 1 pt
  9. Employees preparing food have no open cuts or sores; a cut is covered by a bandage and a glove Yes / No 1 pt
  10. Employees preparing food wear a clean uniform or apron Yes / No 1 pt
  11. Aprons are taken off before taking out trash, cleaning restrooms or going to the forecourt Yes / No 1 pt
  12. Hair is restrained by a cap, visor or hairnet during food preparation Yes / No 1 pt
  13. Employees do not eat, drink from open cups or vape in the food preparation area Yes / No 1 pt
  14. Employees can name the symptoms (vomiting, diarrhea, fever with sore throat, jaundice) that must be reported before working with food Yes / No 1 pt
  15. The employee illness reporting agreement is signed by each employee who handles food Yes / No 1 pt
  16. No employee who reported these symptoms in the last 30 days worked with food while ill Yes / No 1 pt
  17. The person in charge holds a food safety certificate where local regulation requires one Yes / No 1 pt
  18. Tongs or bakery tissue are provided for customers at the self-serve bakery case Yes / No 1 pt
  19. Handwashing by employees observed during the visit Rating
    • Washed at every required moment 5 pts
    • Missed some moments 3 pts
    • Not washing 1 pt

4. Cleaning 20 items

  1. Sanitizer in the spray bottle or bucket at the food station tests within the range printed on the test strip chart Yes / No 1 pt
  2. Sanitizer solution is remade at the interval set by company policy Yes / No 1 pt
  3. Tongs for the roller grill and bakery case are washed, rinsed and sanitized at least every 4 hours Yes / No 1 pt
  4. Probe thermometers are wiped with an alcohol swab or sanitized between foods Yes / No 1 pt
  5. The nacho cheese and chili dispenser nozzles are taken apart and cleaned daily Yes / No 1 pt
  6. Coffee creamer dispenser nozzles and tubes are cleaned on the supplier's schedule Yes / No 1 pt
  7. Frozen beverage machine parts are taken apart, washed and sanitized on the manufacturer's schedule Yes / No 1 pt
  8. Fountain ice chute and nozzles show no slime or mold Yes / No 1 pt
  9. The interior of the ice bin shows no slime, mold or foreign objects Yes / No 1 pt
  10. The customer microwave has no dried food on the walls, ceiling or turntable Yes / No 1 pt
  11. The condiment bar pump heads and lids are free of dried product Yes / No 1 pt
  12. Cutting boards are free of deep grooves and staining Yes / No 1 pt
  13. Food contact surfaces are cleaned with detergent before sanitizer is applied Yes / No 1 pt
  14. Cleaning chemicals are stored below and away from food, packaging and single-use cups Yes / No 1 pt
  15. Chemical spray bottles at the food station are labeled with their contents Yes / No 1 pt
  16. Cloths used at the food station are not used for the forecourt or restrooms Yes / No 1 pt
  17. No droppings, gnaw marks or live insects were found in the food preparation or storage areas Yes / No 1 pt
  18. Floor drains near the food and beverage equipment are free of standing water and fruit flies Yes / No 1 pt
  19. Sanitizer concentration measured during the visit (ppm) Number
  20. Cleanliness of food contact equipment Rating
    • Clean and sanitized throughout 5 pts
    • Clean to the eye, some parts overdue 3 pts
    • Visible residue, slime or mold 1 pt

5. Equipment 19 items

  1. A calibrated thin-tip probe thermometer is kept at the food station Yes / No 1 pt
  2. The probe thermometer read 32°F (0°C), within 2°F (1°C), in ice water during the visit Yes / No 1 pt
  3. Each refrigerator and freezer holding food has a thermometer placed in the warmest part Yes / No 1 pt
  4. Door gaskets on the food refrigerator and freezer are intact and seal fully Yes / No 1 pt
  5. The air grilles of the open-air cooler are free of dust and not blocked by product or price strips Yes / No 1 pt
  6. Evaporator coils and fans in the food freezer are free of heavy ice Yes / No 1 pt
  7. The sneeze guard at the roller grill and condiment bar covers the food from the customer's side Yes / No 1 pt
  8. The heated display case doors or flaps close fully Yes / No 1 pt
  9. The roller grill rollers all turn Yes / No 1 pt
  10. The temperature dial or display of the roller grill is readable and working Yes / No 1 pt
  11. The three-compartment sink or the warewashing arrangement approved for the store is free of stored items Yes / No 1 pt
  12. Shelving in the food refrigerator is free of rust and peeling coating Yes / No 1 pt
  13. Food and single-use items are stored at least 6 in (15 cm) off the floor Yes / No 1 pt
  14. Single-use cups, lids and utensils are stored covered or inverted Yes / No 1 pt
  15. Light bulbs over food preparation and display are shielded or shatter-resistant Yes / No 1 pt
  16. The ice scoop is stored in a holder outside the ice or with its handle up, not buried Yes / No 1 pt
  17. Water filters on the coffee, fountain and ice equipment were changed on schedule, per the tag Yes / No 1 pt
  18. Date of the last filter change on the ice machine Date
  19. Date of the last calibration check of the probe thermometer Date

6. Logs 20 items

  1. Refrigerator and freezer temperatures are logged at the frequency set by company policy Yes / No 1 pt
  2. Hot holding temperatures are logged at the interval set by company policy Yes / No 1 pt
  3. The temperature logs for the last 7 days have no blank entries Yes / No 1 pt
  4. Logged readings are plausible, not the same figure repeated for every entry Yes / No 1 pt
  5. A reading taken during this visit is within 3°F (2°C) of the last logged reading for the same unit Yes / No 1 pt
  6. Each out-of-range reading in the log has a written action (product moved, discarded, service called) Yes / No 1 pt
  7. The roller grill log shows the time each batch was loaded Yes / No 1 pt
  8. The cleaning log for dispensers and the frozen beverage machine is initialed for the last 7 days Yes / No 1 pt
  9. Delivery temperature checks are written on the delivery sheet or a receiving log Yes / No 1 pt
  10. The manager initials the food safety logs each week Yes / No 1 pt
  11. The most recent health department inspection report is on file at the store Yes / No 1 pt
  12. Each violation on the last health inspection report has a documented correction Yes / No 1 pt
  13. The pest control service report for the last visit is on file Yes / No 1 pt
  14. Food safety training records are on file for each employee who handles food Yes / No 1 pt
  15. Customer complaints of illness or foreign objects are recorded and sent to the office the same day Yes / No 1 pt
  16. Date of the last health department inspection Date
  17. Blank entries counted in the temperature logs of the last 7 days Number
  18. Name of the person in charge during the visit Short text
  19. Overall food safety at this store Rating
    • Strong 5 pts
    • Acceptable with corrections 3 pts
    • Unsafe conditions found 1 pt
  20. Corrective actions required Comments

About this template

This checklist is part of the Bindy template library. Yes / No checks score 1 point when met; ratings score the points shown for each option. The overall score is the percentage of points earned, with N/A answers excluded. In Bindy you can add photos, assign corrective actions, require sign-off and compare results across sites.

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