Professional Documents
Culture Documents
Before printing and using these forms verify that the standards listed are correct
according to your local health department standards. Change the forms as needed to
reflect your region's standards and comply with county, state and federal health
codes.
Best practice is to save each form for 90 days so as to provide documentation should the Health
Department require it.
Chef's Resources Inc disclaims all liability for the health department information provided in this file
and makes no endorsement of or representation or warranty regarding the information listed in this
file. Should you decide to use the information provided in this file, you will be solely responsible for
verifying the accuracy of the information according to your local regulations, and Chef's Resources Inc
will have no liability for any of the information provided here.
Service Period:
Date:
Time
Initials
Product
Corrective
Action
Manager's Signature:
Date:
Use this form to record hot or cold held foods every 60 minutes (or whatever standard you choose).
Save records for 90 days to document safe handling procedures.
Service Period:
Station:
Date:
Cold
Holding
Temp
First Hot
Temp
30
Minutes
1 Hr
1.5 Hr
2 Hr
Time
Disposed
Initials
Time
Product
Manager's Signature:
Date:
Temp
Month:
Initials
Corrective Action
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Handsink Standards:
Handsink hot water temperature must be at least 110 F.
Corrective Action:
"1" - Call Maintenance to adjust temperature. Use another sink until spec temperature is reached.
"M" - Inform Chef/Supervisor.
Form QAF-9
Manager's Signature:
Date Verified:
Date
Opening
Temp
Refrigerator/Freezer ID:
Initials
Mid-day
Temp
Initials
Closing
Temp
Initials
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Standard:
Cooler temperature must be maintained at
41 F (4 C) or below.
Ideal freezer temperature is 0 F (-18 C) or below.
Manager Signature:
Date Verified:
Corrective
Action
Venue:
Chefs Resources.com
Time
Date
Start
Time
Start
Temp
Initials
1
Hour
2
Hour
3
Hour
4
Hour
5
Hour
Item
6
Hour
Initials
Action
Taken
Enter the date and product, the start time, the starting temperature, and initial the sheet. Every hour, document the current
temperature in hours 1 thru 6. At hour 6, if the product has met the cooling standards... label, date, store. If the product has not
meet the standard, notify your supervisor or manager.
STANDARD:
ACTION TAKEN:
Manager's Signature:
Date Verified:
Month:
Thermometer ID
Temp
Initials
Corrective Action
Thermometer Standards:
Corrective Action:
Manager's Signature:
Date Verified:
Month:
Time
Concentration
Initials
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Standard:
Quat sanitizer solution must have a concentration of 200 ppm.
Corrective Action:
"1" - Adjust concentration by adding more water. Retest.
"2" - Adjust concentration by adding more quat sanitizer. Retest.
"M" - Inform Chef/Supervisor if concentration is not 200 ppm.
Corrective Action
Manager's Signature:
Date:
Month:
Time
Concentration
Initials
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Standard:
Bleach sanitizer solution must have a concentration of 100 ppm.
Corrective Action:
n Log
Corrective Action
Date: