Restaurant Risk Assessment Checklist Form

Restaurant Risk Assessment Checklist Form
Use this form to assess restaurant safety, hygiene, facility hazards, and readiness for corrective action. Complete each item based on current on-site conditions.
Kitchen and Food Safety
Food storage temperatures are within safe range
Rows Compliant Needs Attention
Refrigeration and cold holding temperatures are monitored and within safe range
Hot holding temperatures are monitored and within safe range

Raw and cooked foods are properly separated

Rows	Compliant	Needs Attention
Raw meat, poultry, and seafood are stored below ready-to-eat foods
Separate utensils, cutting boards, and prep areas are used for raw and cooked foods
Cross-contamination risks are controlled during preparation and storage

Hygiene, sanitation, and equipment cleanliness are maintained

Rows	Compliant	Needs Attention
Food contact surfaces are cleaned and sanitized regularly
Kitchen equipment is clean and in good working condition
Staff follow proper hand hygiene and sanitation practices

Pest control and food labeling/rotation are in place

Rows	Compliant	Needs Attention
No signs of pests, droppings, or infestation are observed
Food supplies are clearly labeled with contents and preparation or receive dates
First-in, first-out rotation is followed for stored food and ingredients

Facility, Staff, and Emergency Readiness
Slip/Trip hazards observed
Other
Fire safety equipment available and accessible
Other
Staff readiness for emergency response

1
2
3
4
5
6
7
8
9
10
1 is Not prepared, 10 is Fully prepared
Notable operational hazards or corrective actions
Inspection Outcome
Overall Risk Rating

1
2
3
4
5
6
7
8
9
10
1 is Low Risk, 10 is High Risk
Major Concerns or Corrective Actions
Follow-up Status
Should be Empty:

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