Name (optional): ___________________

Educational Attainment: ____________________

Age: _______

Location of Establishment: __________________

Sex: _______

Date Surveyed: ___________________________

Food Sanitation and Safety Practices Checklist

Direction: Check the boxes that correspond to the practices of food vendors.
Food Handlers
1.
2.
3.
4.
5.

Employees wear clean and proper uniform including shoes

Effective hair restraints are properly worn.
Fingernails are short, unpolished and clean.
Hands are washed properly, frequently and at appropriate times.
Burns, wounds, sores or scabs, or splints and water-proof bandages on hands
are bandaged and completely covered with a food service glove
while handling food.
Vermin Control
6. Spaces where food and drinks are stored, prepared and served shall be so
maintained as to exclude vermin.
7. All opening which connects spaces to the outer is effectively protected
with screen of non-corrosive wire 16-mesh or finer.
8. Door screens are tight-fitting.
9. During deratting or disinfecting operations, all food supplies, utensils, food
preparation and cleaning equipment are covered to protect them from
toxic chemical substances.
10. A vermin abatement program is maintained in the establishment.
Maintenance of Sanitary Utensils
11. Utensils are scraped and pre-rinsed to remove food articles.
12. Utensils are thoroughly cleansed in warm water at 49C with soap and water.
13. Utensils are stored in a clean and dry place adequately protected against
pests and other sources of contamination.
14. Cups, bowls, and glasses, shall be inverted for storage.
15. When not stored in closed cupboards or lockers, utensils and containers shall
be covered or inverted whenever practicable.
Food Servicing Operations
16. Hand contacts with food or drink are avoided.
17. The surfaces of containers and utensils, including glasses and table wares,
which come in contact with food or drink are not handled
18. Disposable cups, plates, spoons and other single-service containers
and utensils are purchased in sanitary cartons and stored in a clean, dry

YES

NO

place until used.

19. Soiled linens, including towels, aprons, and coats, are stored in a closed
bin or locker, suitably marked.
20. Clean cloths, napkins, towels, and other cloth equipment are stored in
clean places designated specifically for them.