ANNEX_F.pdf

ANNEX F (1)

Building No Date/Time Inspector Contractor Rep

FULL FOOD SERVICE

SAMPLING GUIDE #1-1

PERFORM MENU PLANNING SERVICE - PRS #1

Performance Criteria: Performance of the required tasks for the day of the ONE task evaluation will be rated as satisfactory if not more than fails to meet the stated standards of the Contract.

SAT N/A DEF

1. Contractor shall prepare multi-entrée menus and IMT menu utilizing the Army ____ ____ ____ Menu Standard as a guide IAW DA PAM 30-22 and C.5.1.1.1.

2. Menus meet nutritional standards of para 3-70, DA Pam 30-22 and C.5.1.1.1 ____ ____ ____

3. Menus for the following day with calorie value for each component shall be posted ____ ____ ____ prior to the start of the dinner meal IAW C.5.1.1.

4. Breakfast, lunch and dinner, Contractor shall provide as a minimum items listed in ____ ____ ____ Contract (C.5.1.1.1 & C.5.1.4).

5. Salad bar menu, contractor shall provide as a minimum, items listed in contract ____ ____ ____

(C.5.1.1) & DA PAM 30-22.

6. The entire range of items on the standard deli bar shall be available during the ____ ____ ____ complete meal period IAW C.5.1.4. & DA PAM 30-22.

7. REMARKS: (Fully explain all items which are rated deficient).

Performance Evaluation: Overall rating of this evaluation: ____ ____ ____

SAMPLING GUIDE #1-2a

PERFORM FOOD PREPARATION SERVICE - PRS #2a

BREAKFAST/LUNCH/DINNER – MAIN ENTREE

Performance Criteria: Performance of the required tasks for the day of the TWO task evaluation will be rated as satisfactory if not more than fails to meet the stated standards of the Contract.

SAT N/A DEF

1. Meat/fish/poultry items being prepared during the evaluation period shall be ____ ____ ____ cooked to the minimum internal temperature required by C.5.1.1, TB MED 530, AFMIS, TM 10-412.

2. Food and beverage shall be prepared in compliance with approved recipes and ____ ____ ____ in such a manner to ensure freshness, optimum flavor, color, texture and nutritive valve IAW FM 10-23-2 and AR 40-25.

3. Contractor shall comply with all dining facility SOPs IAW C.5.13 thru C.5 ____ ____ ____

4. Frozen food shall be tempered/thawed IAW TB MED 530. ____ ____ ____

5. Foods & beverages shall be protected against contamination (TB MED 530). ____ ____ ____

6. Raw fruits and vegetables shall be washed before being cooked and/or served ____ ____ ____

(TB MED 530).

7. Potentially hazardous foods shall be reheated to the minimum Internal ____ ____ ____ temperature required by TB MED 530.

8. Food items shall be maintained at temperature required by TB MED 530 prior ____ ____ ____ to being placed on serving line.

9. Thermometers shall be used in cooking, roasting and baking procedures. ____ ____ ____

10. REMARKS: (Fully explain all items which are rated deficient).

SAMPLING GUIDE #1-2b

PERFORM FOOD PREPARATION SERVICE - PRS #2b

SHORT ORDER/DELI BAR

Performance Criteria: Performance of the required tasks for the day of the One task evaluation will be rated as satisfactory if not more than fails to meet the stated standards of the Contract.

SAT N/A DEF

1. Contractor shall provide a short order meal/deli bar daily in addition to the main ____ ____ ____ meal for lunch and dinner meals IAW C.5.1.1.

2. Short order/deli bar, contractor shall provide as a minimum items listed at ____ ____ ____ contract. (C.5.1.3.2)

3. Grilled and cold sandwiches shall be prepared to order and not in advance. ____ ____ ____

4. Food shall be prepared in compliance with approved recipes, and in such a ____ ____ ____ manner to insure freshness, optimum flavor, color, texture and nutritive value

IAW FM 10-23-2 & AR 40-25.

5. Thermometer shall be used during grilling process. ____ ____ ____

6. Items shall be prepared and served for diners at a rate of 5-7 per minute.(C.5.1.4) ____ ____ ____

SAMPLING GUIDE #1-3

PERFORM SUBSISTENCE STORAGE - PRS #3

Performance Criteria: Performance of the required tasks for the day of the ONE task evaluation will be rated as satisfactory if not more than fails to meet the stated standards of the Contract.

SAT N/A DEF

1. Receiving subsistence C5.1.2., IAW DA Pam 30-22, FM 10-23-2, and ____ ____ ____

TB MED 530.

2. Contractor shall store, safeguard and account for subsistence per DA Pam 30-22 ____ ____ ____ (3-20 thru 3-23), TB Med 530, AR 30-22 and FM 10-23-2.

3. Food shall be protected against exposure and condensation IAW TB MED 530. ____ ____ ____

4. Rotating stock shall be utilized IAW DA PAM 30-22 and FM 10-23-2. ____ ____ ____

5. Total dollar value of the monthly inventory does not exceed the total dollar value ____ ____ ____ of the dining facility current month earnings for a 6 day average period IAW AR 30-22, para.3-24 (1).

6. Thermometers shall be used in food storage equipment to assure proper ____ ____ ____ temperature.

SAMPLING GUIDE #1-4

PERFORM FOOD PROTECTION/HANDLING - PRS #4

Performance Criteria: Performance of the required tasks for the day of the ONE task evaluation will be rated as satisfactory if not more than fails to meet the stated standards of the Contract.

SAT N/A DEF

1.Personnel shall wash hands before starting to work, after breaks and as needed ____ ____ ____

IAW TB MED 530.

2. Personnel assigned to clean latrines, outside areas and grease pods shall not be ____ ____ ____ allowed to handle food or food contact surfaces IAW TB MED 530, 3-4 F.

3. Personnel shall have and use thermometer to assure proper temperature IAW ____ ____ ____

TB MED 530.

4. Food shall be maintained at the required temperature at all times IAW ____ ____ ____

TB MED 530.

5. Ice scoops and serving utensils shall be stored IAW TB MED 530. ____ ____ ____

6. Food shall be protected from contamination at all times IAW TB MED 530. ____ ____ ____

SAMPLING GUIDE #1-5

PERFORM FOOD SERVING - PRS #5

Performance Criteria: Performance of the required tasks for the day of the THREE task evaluation will be rated as satisfactory if not more than fails to meet the stated standards of the Contract.

SAT N/A DEF

1. Menu items recorded on the Production Schedule shall be available for patron ____ ____ ____ selection at the scheduled start of the serving period. (C.5.1.5)

2. Left overs shall be processed and maintained IAW C.5.1.5 & TB MED 530. ____ ____ ____

3. Maintain diner flow rate as required. (C.5.1.5) ____ ____ ____

4. Food items on serving line shall be garnished. (FM 10-23-2) ____ ____ ____

5. Spills on serving line, beverage dispensers and stands during meal serving ____ ____ ____ periods shall not be allowed to accumulate IAW TB MED 530.

6. Diners shall be served proper portion of food items IAW approved recipes. ____ ____ ____

7. Separate and proper serving utensil shall be used for each item served and ____ ____ ____ stored between uses as required. (TB MED 530)

8. Food and beverage dispensers, including stands, shall be cleaned after each ____ ____ ____ serving period IAW TB MED 530.

9. Bulk milk tubes shall be cut to standard per operation manual. ____ ____ ____

10. Contractor personnel shall treat soldiers IAW TR 350-6. ____ ____ ____

11. Food items shall be progressively prepared and replenished. ____ ____ ____

12. Serving lines and salad bar shall be cleaned after each serving period IAW ____ ____ ____

TB MED 530.

13. REMARKS: (Fully explain all items which are rated deficient).

SAMPLING GUIDE #1-6

PERFORM ADMINISTRATIVE REQUIREMENTS - PRS #6

Performance Criteria: Performance of the required tasks for the day of the FOUR task evaluation will be rated as satisfactory if not more than fails to meet the stated standards of the Contract.

SAT N/A DEF

1. Employee’s uniform and personal hygiene shall be maintained IAW TB MED 530, ____ ____ ____ C.1.2.1

2. Employee special qualification and training (C.5.1.11) ____ ____ ____

3. A memorandum listing personnel authorized to sign for subsistence shall be on ____ ____ ____ file in dining facility IAW AR 30-22.

4. Files shall be maintained, safeguarded and provided to gov't inspectors upon ____ ____ ____ request in approximately 30 minutes. (AR 25-400-2)

5. Operational rations shall be accounted for IAW AR 30-22 and DA Pam 30-22 ____ ____ ____

6. Food production and usage shall be documented through a completed Production ____ ____ ____ Schedule, DA Form 3034, or AFMIS generated) IAW AR 30-22.

7. Sensitive and high dollar item disposition shall be documented IAW AR 30-22 and ____ ____ ____ DA Pam 30-22.

8. Ration transferred between dining facilities shall be IAW DA Pam 30-22, Para 5-42. ____ ____ ____

9. Headcounters must be present at headcount stations at all times during meals ____ ____ ____ serving periods and headcount policy shall be IAW AR 30-22 and DA Pam 30-22.

10. Maintenance of Government furnished equipment. (C.5.1.7 AR 30-22 and ____ ____ ____ DA Pam 30-22)

11. Headcount records and accountable forms shall be maintained and safeguarded ____ ____ ____ IAW AR 30-22 and DA Pam 30-22.

12. Cash collected shall be properly handled and deposit in according to the ____ ____ ____ appropriate method contained in DA PAM 30.22.

13. Risk Management Data Log shall be maintained IAW DA Pam 30-22 ____ ____ ____

14. A Work Request Log shall be maintained IAW FM 10-23-2 and DA Pam 30-22. ____ ____ ____

15. Equipment Replacement Record shall be maintained IAW AR 30-22 and ____ ____ ____ C.5.17)

16. REMARKS: (Fully explain all items which are rated deficient).

SAMPLING GUIDE #1-7

PERFORM DINING AREA PREPARATION - PRS #7

Performance Criteria: Performance of the required tasks for the day of the THREE task evaluation will be rated as satisfactory if not more than fails to meet the stated standards of the Contract.

SAT N/A DEF

1. Contractor personnel shall provide diners with clean tables, and chairs, without ____ ____ ____ waiting during meal serving period IAW (C.5.1.6)

2. Tray racks, dish and dinnerware dispensers shall be cleaned after each ____ ____ ____ scheduled serving period. (C.5.1.8)

3. Contractor shall provide general housekeeping and cleaning services,(dusting ____ ____ ____ pictures, plastic plants, wall pictures, fans, trophy cases and headcount area IAW C.5.1.6.

4. Chairs, tables, booths and partitions shall be cleaned after each meal serving ____ ____ ____ period, and table linen replaced when soiled IAW (C.5.1.6)

5. Tray bussing carts shall be cleaned after each serving period IAW TB MED 530. ____ ____ ____

6. Napkin holders, salt, pepper & sugar shakers, ketchup, mustard, steak and all ____ ____ ____ sauce bottles shall be cleaned/refilled after each meal serving period. (FM 10-23-2)

7. Napkins, salt, pepper, sugar, ketchup, mustard, steak sauces and other sauces ____ ____ ____ shall be replenished during meal period without a break in service IAW C.5.1.6.

8. Eating ware shall be replenished during meal period so that no diners waits for ____ ____ ____ service IAW C.5.1.8.

9. Foyers and handrails shall be cleaned IAW C.5.1.9. ____ ____ ____

10. Window, window screens, window ledges, window blinds, curtains, door and ____ ____ ____ walls throughout dining facilities shall be cleaned IAW C.5.1.9)

11. Hand-washing sanitizers shall be refilled and cleaned IAW TB MED 530 ____ ____ ____

12. Signs including choking signs shall be posted IAW TB MED 530. ____ ____ ____

13. REMARKS: (Fully explain all items which are rated deficient).

SAMPLING GUIDE #1-8A

PERFORM DISHWASHING SERVICE - PRS #8A

Performance Criteria: Performance of the required tasks for the day of the TWO task evaluation will be rated as satisfactory if not more than fails to meet the stated standards of the Contract.

SAT N/A DEF

1. Operations are in compliance with standards set forth in TB MED 530, FM 8-34, ____ ____ ____ FM 10-23, and C.5.1.8

2. Dinnerware shall be cleaned, sanitized and stored in the proper racks and ____ ____ ____ respective storage areas after each meal serving period. C.5.1.7.8 & TB MED 530.

3. Trash cans shall be covered when not in use IAW TB MED 530. ____ ____ ____

4. Wash down areas shall be cleaned and maintained IAW TB MED 530. ____ ____ ____

5. Pots, pans and other nondinnerware shall not be put through the dishwasher. ____ ____ ____

6. Dishwashing areas shall be cleaned and maintained IAW TB MED 530. ____ ____ ____

7. The dishwashing equipment shall be cleaned IAW TB MED 530 and C.5.1.8. ____ ____ ____

8. Dinnerware storage equipment shall be cleaned IAW TB MED 530 and ____ ____ ____

DA PAM 30-22.

9. Trash and garbage shall be separated and trash cans shall not be allowed to over ____ ____ ____ flow. TB MED 530 and C.5.1.9

SAMPLING GUIDE #1-8B

PERFORM EQUIPMENT CLEANING - PRS #8B

Performance Criteria: Performance of the required tasks for the day of the FOUR task evaluation will be rated as satisfactory if not more than fails to meet the stated standards of the Contract.

SAT N/A DEF

1. Ventilating hoods and components shall be cleaned IAW TB MED 530, ____ ____ ____ para 4-40 & FM 10-23-2.

2.Ovens and ranges shall be cleaned IAW C.5.1.8., TB MED 530, para 4-40. ____ ____ ____

3. Grills and grill stands shall be maintained in clean condition at all times ____ ____ ____ C.5.1.7.8 & TB MED 530, para 4-40.

4. Toasters shall be cleaned after each use C.5.1.8. & TB MED 530. ____ ____ ____

5. Food warmer shall be cleaned IAW TB MED 530, para 4-40. ____ ____ ____

6. Carts, sinks and water fountains shall be cleaned IAW TB MED 530. ____ ____ ____

7. Refrigerators and freezers (including ice cream storage cabinets) shall be cleaned ____ ____ ____ IAW TB MED 530, para 4-40.

8. Ice machines, ice dispensers and vegetable peelers shall be cleaned IAW ____ ____ ____

TB MED 530.

9. Insulated food containers and field beverage dispensers shall be cleaned and ____ ____ ____ stored IAW TB MED 530 and C-5.1.8.12.

10. Deep fat fryers shall be cleaned IAW TB MED 530 & C.5.1.8. ____ ____ ____

11. Food preparation tables shall be cleaned and sanitized IAW TB MED 530. ____ ____ ____

12. Steam kettles and pressure cookers shall be cleaned IAW TB MED 530. ____ ____ ____

13. Slicing equipment shall be cleaned and sanitized IAW TB MED 530, para 4-40. ____ ____ ____

14. Pastry cabinets shall be cleaned IAW TB MED 530, para 4-40. ____ ____ ____

15. Mixing machines and component parts shall be cleaned IAW TB MED 530, ____ ____ ____ para 4-40.

16. Pots, pans, can openers, cutting board, utensils storage racks and storage area ____ ____ ____ shall be cleaned to standard IAW TB MED 530, para 4-43 & C.5.1.8.

17. REMARKS: (Fully explain all items which are rated deficient).

SAMPLING GUIDE #1-9A

PERFORM FLOOR CLEANING SERVICE - PRS #9A

Performance Criteria: Performance of the required tasks for the day of the ONE task evaluation will be rated as satisfactory if not more than fails to meet the stated standards of the Contract.

SAT N/A DEF

1. Floors throughout the facility shall be free of scuff marks and visible signs of dirt ____ ____ ____ or dust. Floors shall be swept and mopped after each serving period. (C.5.1.9)

2. Spill food, water & other foreign matter shall be removed IAW TB MED 530 & ____ ____ ____

FM10-23-2.

3.Mops, brooms, buckets and wringers shall be cleaned, sanitized and stored IAW ____ ____ ____

TB MED 530.

4.Floor baseboards, floor mats and runners shall be cleaned IAW C.5.1.9. & ____ ____ ____

FM 10-23-2

5. Deposits of old wax shall be removed as needed using an approved solvent. ____ ____ ____ (C.5.1.9)

6. The contractor shall not cause floor drains and other drains to become clogged ____ ____ ____ and must be free of scum, slime and residue.

SAMPLING GUIDE #1-9B

PERFORM LATRINE CLEANING - PRS #9B

Performance Criteria: Performance of the required tasks for the day of the ONE task evaluation will be rated as satisfactory if not more than fails to meet the stated standards of the Contract.

SAT N/A DEF

1. Latrines sinks, commodes, urinals and mirrors shall be cleaned IAW TB MED ____ ____ ____ 530, para 5-22.

2. Soap and disposal towels shall be available at each hand washing sink ____ ____ ____ throughout dining facility IAW TB MED 530, para 5-22 & 23, FM 10-23-2.

3. Latrine cleaning implements shall be distinctly marked and are not used in any ____ ____ ____ other area of the facility IAW TB MED 530.

4. Walls, windows, windows screens, doors, wall lockers & vents shall be cleaned ____ ____ ____

IAW TB MED 530.

5. Loading Dock, staging area and outside area around loading dock and dumpster ____ ____ ____ shall be cleaned IAW TB MED 530 & C.5.19.

6. Latrine implements shall be cleaned, sanitized, and stored in a segregated area ____ ____ ____

IAW TB MED 530.

SAMPLING GUIDE #1-10

PERFORM FIELD FEEDING SERVICE - PRS #10

Performance Criteria Performance of the required tasks for the day of the TWO task evaluation will be rated as satisfactory if not more than fails to meet the stated standards of the Contract.

SAT N/A DEF

1. Food shall be prepared in compliance with standard AFMIS recipes. (C.5.1.1) ____ ____ ____

2. Compliance with contractor developed SOP’s. (C.5.1.3) ____ ____ ____

3. Meals shall be packaged in proper food containers using inserts with appropriate ____ ____ ____ gasket and covers. Inserts are preheated or pre-cooled as required. (C.5.1.12)

4. Food Containers shall be cleaned and labeled IAW TB MED 530 and FM 10-23-2. ____ ____ ____

5. Portion control sheet shall be provided for the Government to use in serving ____ ____ ____ diners. (C.5.1.12)

6. Proper serving utensils for each item and required portion shall be provided to ____ ____ ____ each diners. (C.5.1.12)

7. Clean field feeding support items, i.e. food containers, trays, pastry cabinet, etc., ____ ____ ____ shall be provided. (C.5.1.12)

8. Warming beverages and field feedings shall be prepared for Government pickup ____ ____ ____ at the required time. (C.5.1.12)

9. Food items shall be maintained at the proper temperatures when the containers are ____ ____ ____ first opened.

SAMPLING GUIDE #1-11

QUALITY CONTROL - PRS #11

Performance Criteria Performance of the required tasks for the day of the TWO task evaluation will be rated as satisfactory if not more than fails to meet the stated standards of the Contract.

SAT N/A DEF

1. Pest must be controlled IAW TB MED 530, para 5-31 and C.5.1.9 ____ ____ ____

2. The Contractor shall maintain records of all inspections and evaluations ____ ____ ____ performed in the dining facility. (C.5.1.7)

3. QC Manager shall perform a comprehensive inspection in each DFAC at least ____ ____ ____ twice a month (C.1.7).

4. Corrective action taken shall be available for deficiencies noted on QC, Area ____ ____ ____ Manager and Dining Facility Manager Inspection Report. (C.5.1.11)

5. Area Manager is required to perform a comprehensive inspection of DFAC’s ____ ____ ____ under his supervision at least twice a month IAW 3.1 of QC Plan.

6. Energy conservation shall be maintained IAW FM 10-23-1, Chap 7. ____ ____ ____

7. DFAC Managers/Shift leaders shall inspect and complete a comprehensive ____ ____ ____ checklist daily and it will be maintained on file in the DFAC at least 90 days IAW 3.1 of QC Plan. (C.5.1.11)

8. Wood pallets shall not be used nor stored in dining facilities nor accumulate on ____ ____ ____ loading dock IAW TB MED 530.

9. Administrative records shall be made available to gov't inspectors upon request. ____ ____ ____ (C.5.1.11)