Restaurant Hygiene Inspection Form

Restaurant Hygiene Inspection Form
Please complete this form to document the hygiene inspection of the restaurant.
Inspector's Full Name
First NameLast Name
Date of Inspection
MonthDayYear
Date
Restaurant Name
Restaurant Address
Street Address
Street Address Line 2
CityState / ProvincePostal / Zip Code
Cleanliness of Kitchen Area
ExcellentGoodFairPoor
Cleanliness of Dining Area
ExcellentGoodFairPoor
Food Storage Conditions
ExcellentGoodFairPoor
Pest Control Measures
AdequateInadequateNot Observed
Staff Hygiene Practices
ExcellentGoodFairPoor
Additional Comments
Should be Empty: