ANNEX_G.pdf

ANNEX G (1)

Building No Date/Time Inspector Contractor Rep

QUALITY ASSURANCE CHECKLIST FOR

FULL FOOD SERVICE

(PLANNED SAMPLING)

SAT N/A DEF

A: EMPLOYEES

1. Medical Surveillance Requirement (TB MED 530) ____ ____ ____

2. Uniforms (TB MED 530) ____ ____ ____

3. Hair Restraints (TB MED 530 & FM 10-23-2) ____ ____ ____

4. Jewelry (TB MED 530) ____ ____ ____

5. Personal Hygiene (C.1.2.6) ____ ____ ____

6. Use of Tobacco (TB MED 530) ____ ____ ____

7. Meals for Contractor Personnel (AR 30-22) ____ ____ ____

8. Separation of duties (TB MED 530) ____ ____ ____

B. SECURITY

1. Physical Security (C.1.8.10) ____ ____ ____

2. Key Control Roster maintained (C.1.8.10) ____ ____ ____

3. Safeguarding Funds Cash Meal Payment Sheets (IAW AR 30-22) ____ ____ ____

C. TRAINING

1. Serve Safe Training (C.2.2) ____ ____ ____

2. Sanitation (C.1.8.1 and TB MED 530) ____ ____ ____

3. Nutrition (C.1.8.3 and AR 30-22) ____ ____ ____

4. Fire Prevention (C.1.8.7) ____ ____ ____

5. Kitchen Equipment Class for Cook Personnel (DA PAM 30-22) ____ ____ ____

6. Kitchen Equipment Class for Contractor DFAs (DA PAM 30-22) ____ ____ ____

7. Training Certificates (C.1.8.7) ____ ____ ____

8. Safety (C.1.8.7) ____ ____ ____

D. CONTRACTOR FURNISHED ITEMS, SUPPLIES, EQUIP.

1. Floor and Window Care Equipment (C.4.3) ____ ____ ____

2. Bimetallic Thermometers (C.4.3) ____ ____ ____

3. Janitorial Expendable Supplies Equip. (C.4.3) ____ ____ ____

4. Adequacy of Janitorial Expendable Sup Equip (C.4.3) ____ ____ ____

E. MENU

1. Menu Planning (C.5.1.1) ____ ____ ____

2. Full Menu Service (C.5.1.1. thru C.5.1.1.1) ____ ____ ____

3. Fitness Menu (C.5.1.1.1) ____ ____ ____

4. Special Meals (C.5.1.5) ____ ____ ____

5. Menu Posting (C.5.1.5) ____ ____ ____

F. REQUISITIONING AND RECEIVING

1. DA Form 1687 (DA PAM 30-22) ____ ____ ____

2. Requisitioning Subsistence (C.5.1.17) ____ ____ ____

3. Receiving (C.5.1.2) ____ ____ ____

4. Vendor Deliveries (C.5.1.2) ____ ____ ____

G. STORAGE AND USE OF SUBSISTENCE

1. Store, safeguard account for Subsistence (C.5.1.2 & DA PAM 30-22) ____ ____ ____

2. Proper Storage of Food (TB MED 530) ____ ____ ____

3. Cover and Label Food (IAW TB MED 530) ____ ____ ____

4. Chilled Foods, Frozen Foods, & Bulk Storage (IAW TB MED 530) ____ ____ ____

5. Rotating Stock (DA PAM 30-22) ____ ____ ____

6. Excess Subsistence (AR 30-22) ____ ____ ____

H. FOOD PREP., PROTECTION, HANDLING, & SERVICE

1. Standard Recipes (C.5.1.1) ____ ____ ____

2. Food Preparation Surfaces (C.5.1.8 & TB MED 530) ____ ____ ____

3. Wrapped Foods (TB MED 530) ____ ____ ____

4. Protection of Chilled & Frozen Food (TB MED 530) ____ ____ ____

(PLANNED SAMPLING)

SAT N/A DEF

5. Washing Fruits & Vegetables (TB MED 530) ____ ____ ____

6. Use of Ice (TB MED 530) ____ ____ ____

7. Tempering of Raw Frozen Food (TB MED 530) ____ ____ ____

8. Meat, Fish, Poultry and raw PHF are cooked to the minimum internal temperature required ____ ____ ____ by TB MED 530.

9. Reheat PHF IAW TB MED 530 ____ ____ ____

10. Holding, refrigerating, disposal of and transporting PHF items IAW TB MED 530. ____ ____ ____

11. Food display, serving utensils, individual service provided IAW AR 30-22. ____ ____ ____

12. Customer Contamination (TB MED 530) ____ ____ ____

13. Proper Cooking Temperatures (TB MED 530) ____ ____ ____

14. Baked Goods (C.5.1.3.4) ____ ____ ____

15. Serving Lines (C.5.1.5) ____ ____ ____

16. Food Serving Temperature (TB MED 530) ____ ____ ____

17. Serving of Food (C.5.1.5 & FM 10-23-2) ____ ____ ____

18. Progressive Replenishment (C.5.1.5 & FM 10-23-2) ____ ____ ____

19. Leftovers (TB MED 530) ____ ____ ____

20. Short Order Service/ deli bar (C.5.1.3.2 & DA PAM 30-22) ____ ____ ____

21. Cleaning Serving Lines IAW C.5.1.5 & AR 30-22) ____ ____ ____

I. SELF SERVICE

1. Ice and self service items are provided and replenished IAW C.5.1.5 ____ ____ ____

2. Salad Bar Service (C.5.1.1 – C.5.1.5.) ____ ____ ____

3. Condiment & Table Item Service (C.5.1.7.3.1) ____ ____ ____

4. Tableware & Table Items Availability (C.5.1.7.3.3) ____ ____ ____

J. FIELD FEEDING

1. Regular Field Feedings (C.5.1.12) ____ ____ ____

2. Packaging (C.5.1.1.2) ____ ____ ____

3. Field Feeding Support (C.5.1.1.2) ____ ____ ____

4. Refuse (C.5.1.8) ____ ____ ____

5. Warming Beverages (C.5.1.12) ____ ____ ____

K. HEADCOUNT/ CASHIER SERVICE

1. Headcounters (C.5.1.4 and DA PAM 30-22) ____ ____ ____

2. Headcount Procedures (C.5.1.4 and DA PAM 30-22) ____ ____ ____

3. One-Line Entry Procedures (C.5.1.4 and DA PAM 30-22) ____ ____ ____

4. VIP Tour Group (C.5.1.4 and AR 30-22) ____ ____ ____

5. Change Fund (C.5.1.4 and DA PAM 30-22) ____ ____ ____

6. Customer Complaint Forms, DA Form 5477-R ____ ____ ____

L. ADMINISTRATIVE REQUIREMENTS

1. Publications & Blank Forms (C.5.1.7) ____ ____ ____

2. Reports (C.5.1.7) ____ ____ ____

3. Files & Records Maintenance & Disposition (C.5.1.7 and AR 25-400-2) ____ ____ ____

4. DA Form 7455 complete. (C.5.1.7) ____ ____ ____

5. Account Status Reporting (C.5.1.7 and AR 30-22) ____ ____ ____

6. Closing Dining Facility Accounts (C.5.1.7 and AR 30-22) ____ ____ ____

7. Food Service Data Feedback Program (AR 30-22) ____ ____ ____

8. Equipment Replacement (AR 30-22 & C.5.1.7) ____ ____ ____

9. Maintenance of Expendable Supplies (C.5.1.9) ____ ____ ____

10. Replacement of Gov't. Provided Expendable Sup (C.5.1.9) ____ ____ ____

11. Operational Rations (C.5.1.7 and AR 30-22) ____ ____ ____

12. Subsistence Requisitioning (C.5.1.7 and DA PAM 30-22) ____ ____ ____

13. Controlled and Accountable Forms (C.5.1.7 and DA PAM 30-22) ____ ____ ____

14. Accountability of DD Form 1544 (C.5.1.7 and DA PAM 30-22) ____ ____ ____

15. Cash collected must be property handled and deposit (C.5.1.7 and DA PAM 30-22). ____ ____ ____

16. Food Production Controls (C.5.1.1 and DA PAM 30-22) ____ ____ ____

17. Month End Inventory (C.5.1.2 and DA PAM 30-22) ____ ____ ____

18. Headcount Records (C.5.1.7 and AR 30-22) ____ ____ ____

19. Risk Management Data Log maintained (C.5.1.1 and DA Pam 30-22) ____ ____ ____

20. Records are provided to gov't inspectors upon request in a timely manner (C.5.1.11) ____ ____ ____

(PLANNED SAMPLING)

M. MAINTENANCE

1. Preventive Maintenance Self-Help Program (C.5.1.10.1) ____ ____ ____

2. Minor Maintenance (C.5.1.10.1) ____ ____ ____

3. Major Maintenance (C.5.1.10) ____ ____ ____

4. Grounds Maintenance (C.5.1.9 and TB MED 530) ____ ____ ____

N. MISCELLANEOUS REQUIREMENTS

1. Holiday Decorations (C.5.1.6) ____ ____ ____

2. Disposal of Grease (C.5.1.8) ____ ____ ____

O. SANITATION

1. General (C.5.1.6, C.5.1.8 and C.5.1.9) ____ ____ ____

2. Post Sanitation Procedures (C.5.1.6 and TB MED 530) ____ ____ ____

3. Opening/Closing Dining Facilities (C.5.1.8 and AR 30-22) ____ ____ ____

4. Lavatory Dispensers (C.5.1.8 and TB MED 530) ____ ____ ____

5. Storage of Supplies (C.5.1.7 and TB MED 530) ____ ____ ____

6. Linens Storage (C.5.16 and TB MED 530) ____ ____ ____

7. Dining Area Preparation (C.5.16) ____ ____ ____

8. Condiment Containers (C.5.16) ____ ____ ____

9. Tray Bussing Carts (C.5.18) ____ ____ ____

10. Resupplying Eating ware (C.5.1.5) ____ ____ ____

11. Tables, Chairs, Partitions, Booths (C.5.1.6) ____ ____ ____

12. Table Cloths (C.5.1.6) ____ ____ ____ 13 Napkin Holders, Salt, Pepper & Sugar Shakers. (C.5.1.6) ____ ____ ____

14. Dinnerware Dispensers (C.5.1.8) ____ ____ ____

15. Beverage Food Dispensing Equipment (C.5.1.6 and TB MED 530) ____ ____ ____

16. Doors, Foyers, & Handrails (C.5.1.6) ____ ____ ____

17. Storage Areas & Equipment (C.5.1.2 and TB MED 530) ____ ____ ____

18. Windows, window ledges, curtains, blinds (C.5.1.9) ____ ____ ____

19. Floors (C.5.1..9.) ____ ____ ____

20. Walls Doors (C.5.1.9) ____ ____ ____

21. Pictures and Decorations (C.5.16 and TB MED 530) ____ ____ ____

22. Light Fixtures (C.5.1.6 and TB MED 530) ____ ____ ____

23. Trophy Display Cases (C.5.1.6) ____ ____ ____

24. Dishwashing Operation (C.5.1.8) ____ ____ ____

25. Cleaning of Ware-washing Equip & Area (C.5.1.8 and TB MED 530) ____ ____ ____

26. Ventilating Hoods & Grease Filters (C.5.1.9 and TB MED 530) ____ ____ ____

27. Ovens and Ranges (C.5.1.8) ____ ____ ____

28. Grills & Grill Tops (C.5.1.8) ____ ____ ____

29. Toasters (C.5.1.8) ____ ____ ____

30. Mixing Machines and attachment parts (C.5.1.8 and TB MED 530) ____ ____ ____

31. Food Holding Boxes (C.5.1.8 and TB MED 530) ____ ____ ____

32. Refrigeration Equipment & Freezers (C.5.1.8 and TB MED 530) ____ ____ ____

33. Ice Making Machines (C.5.1.8 and TB MED 530) ____ ____ ____

34. Vegetable Peeling Machine (C.5.1.8) ____ ____ ____

35. Deep Fat Fryer (C.5.1.8) ____ ____ ____

36. Food Prep. Tables & Pastry Cabinets (C.5.1.8 and TB MED 530) ____ ____ ____

37. Steam Kettles & Pressure Cookers (C.5.1.8 and TB MED 530) ____ ____ ____

38. Slicing Equipment (C.5.1.8 and TB MED 530) ____ ____ ____

39. Clean and Sanitize (C.5.1.8 & TB MED 530) ____ ____ ____

40. Progressive Cleaning (C.5.1.8) ____ ____ ____

41. Floor Drains (C.5.1.9) ____ ____ ____

42. Grease Traps (C.5.1.9) ____ ____ ____

43. Dining Facility Manager's Office (C.5.1.9 and TB MED 530) ____ ____ ____ 44 Trash and Garbage Separation (C.5.1.9) ____ ____ ____

45. Removal of Garbage (C.5.1.9) ____ ____ ____

46. Trash & Garbage Container Cleaning (C.5.1.9 and TB MED 530) ____ ____ ____

47. Trash & Garbage Disposal Area (C.5.1.9 and TB MED 530) ____ ____ ____

48. Grounds Maintenance Tasks (C.5.1.9 and TB MED 530) ____ ____ ____

49. Cleaning Implements (C.5.1.7.16) ____ ____ ____

50. Latrines (C.5.1.9 and TB MED 530) ____ ____ ____

51. Latrine Cleaning Implements (C.5.1.9) ____ ____ ____

52. Lockers (C.5.1.9 and TB MED 530) ____ ____ ____

53. Insect and Rodent Control (C.5.1.9 and TB MED 530) ____ ____ ____

54. Hand Sanitizer TB MED 530 DA PAM 30-22) ____ ____ ____

55. Pots, pans & other nondinnerware shall not be put through the dishwasher (C.5.1.8) ____ ____ ____

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