School Cafeteria Sanitation Inspection Form
Complete this form to assess and document the sanitation status of a school cafeteria.
Inspector Name
*
First Name
Last Name
Inspector Contact Email
*
example@example.com
School Name
*
Cafeteria Location/Area
*
Inspection Date and Time
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Sanitation Inspection Checklist
*
Rows
Compliant
Non-Compliant
Not Applicable
Floors and surfaces are clean and free of debris
1
2
3
Food storage areas are organized and sanitary
4
5
6
Refrigerators/freezers are at correct temperatures
7
8
9
Handwashing stations are clean and stocked
10
11
12
Trash is properly disposed and covered
13
14
15
No evidence of pests (insects/rodents)
16
17
18
Utensils and equipment are sanitized
19
20
21
Restrooms are clean and supplied
22
23
24
Staff follow hygiene protocols
25
26
27
Overall Cafeteria Cleanliness Rating
*
1
2
3
4
5
Comments or Observations
Corrective Actions Required (if any)
Is immediate follow-up inspection required?
*
Yes
No
Inspector Signature
*
Submit Inspection
Submit Inspection
Should be Empty: