University Dining Inspection Form
Complete this form to assess compliance and safety standards in university dining facilities.
Inspector Full Name
*
First Name
Last Name
Inspector Email Address
*
example@example.com
Inspector Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Dining Facility Name
*
Dining Facility Location (Building/Area)
*
Date and Time of Inspection
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Cleanliness and Sanitation Assessment
*
Rows
Excellent
Good
Fair
Poor
Dining area cleanliness
1
2
3
4
Kitchen cleanliness
5
6
7
8
Restroom cleanliness
9
10
11
12
Handwashing stations available
13
14
15
16
Waste disposal management
17
18
19
20
Food Handling and Storage Assessment
*
Rows
Compliant
Needs Improvement
Non-Compliant
Proper food storage temperatures
21
22
23
Separation of raw and cooked foods
24
25
26
Food labeled and dated
27
28
29
No expired food items
30
31
32
Safe thawing practices
33
34
35
Staff Hygiene Practices
*
Rows
Yes
No
Staff wear clean uniforms
36
37
Handwashing observed
38
39
Hair restraints used
40
41
No jewelry on hands/arms
42
43
Equipment and Facilities Condition
*
Rows
Satisfactory
Unsatisfactory
Refrigerators/Freezers operational
44
45
Cooking equipment clean
46
47
Ventilation systems functional
48
49
Sinks and drains clear
50
51
Pest Control and Evidence of Pests
*
No evidence of pests
Minor evidence (e.g., single sighting, trace evidence)
Major evidence (multiple sightings, infestation)
Additional Comments or Observations
Submit Inspection
Should be Empty: