Menu Compliance Audit Form

Menu Compliance Audit Form
General Information
Auditor Name*
First NameLast Name
School Name*
Health Inspection Date*
MonthDayYear
Health Inspection Score*

1 2 3 4 5 6 7 8 9 10
1 is Worst, 10 is Best
Offer vs. Serve
Lunch
Serving of Meat/Meat Alternative offered?*
YesNo
Serving of Grain offered?*
YesNo
Serving of Vegetable offered?*
YesNo
Serving of Fruit offered?*
YesNo
Serving of Milk offered?*
YesNo
Menu Compliance
Entree A*
Other Entree A on Menu
Is the approved menu item available?*
YesNo
If no, is there a substitution for the actual menu item?
YesNo
If there is a substitution, what is the substitution item?
Does the substitution meet the nutritional needs?
YesNo
Entree B
Other Entree B on Menu
Is the approved menu item available?
YesNo
If no, is there a substitution for the actual menu item?
YesNo
If there is a substitution, what is the substitution item?
Does the substitution meet the nutritional needs?
YesNo
Vegetable (s)*
Other Vegetable on Menu
Is the approved menu item available?*
YesNo
If no, is there a substitution for the actual menu item?
YesNo
If there is a substitution, what is the substitution item?
Does the substitution meet the nutritional needs?
YesNo
Fruit (s)*
Other Fruit on Menu
Is the approved menu item available?*
YesNo
If no, is there a substitution for the actual menu item?
YesNo
If there is a substitution, what is the substitution item?
Does the substitution meet the nutritional needs?
YesNo
Milk*
1% WhiteFat-Free ChocolateNo milk available
Other
Hot Entree Tasted*
Taste/Food Quality Comments:*
Salad Bowl Items Available*
Tossed Leafy GreensCucumberTomatoApple WedgesOrange WedgesSliced PeachesBananasMixed FruitApplesauceRaisinsFresh BroccoliBaby CarrotsCelery SticksColeslawCornPeasBlack Bean SaladWhole Wheat Pasta SaladCucumber, Red Onion & Tomato SaladPicklesOnionsSliced PearsChilled CornDiced PineapplesKidney bean saladTangerinesGarbanzo BeansOther
Serving line set up appropriately at time of arrival?*
YesNo
Are all menu items available for all students? If answer is no, see additional comment for specifics.*
YesNo
Positive attitude and body language*
YesNo
Professional interaction with customers?*
YesNo
Is potable water available to all students?*
YesNo
Additional Comments
Signature*
Clear
Should be Empty:

Menu Compliance Audit Form

General Information

Offer vs. Serve

Lunch

Menu Compliance

Other