|
CFSAN/Office of Compliance
September 14, 2004
| DATA ITEM # | DATA ITEM | # IN | # OUT | # NO | # NA | |
|---|---|---|---|---|---|---|
| Food From Unsafe Sources | 1A | All food from Regulated Food Processing Plants/No Home prepared/canned foods | 97 | 0 | 0 | 0 |
| 1B | All shellfish from NSSP listed sources. No recreationally caught shellfish received or sold | 0 | 0 | 0 | 97 | |
| 1C | Game, wild mushrooms harvested with approval of Regulatory Authority | 0 | 0 | 1 | 96 | |
| 2A | Food received at proper temperatures/protected from contamination during transportation and receiving/food is safe, unadulterated | 96 | 1 | 0 | 0 | |
| 3A | Shellstock tags/labels retained for 90 days from the data the container is emptied | 0 | 0 | 0 | 97 | |
| 3B | As required, written documentation of parasite destruction maintained for 90 days for fish products | 0 | 0 | 0 | 97 | |
| 3C | CCP monitoring records maintained in accordance with HACCP plan when required | 0 | 0 | 0 | 97 | |
| Inadequate Cooking | 4A | Raw shell eggs broken for immediate service cooked to 145 °F (63 °C) for 15 seconds. Raw shell eggs broken but not prepared for immediate service cooked to155 °F (68 °C) for 15 seconds | 10 | 0 | 57 | 30 |
| 4B | Comminuted Fish, Meats, Game animals cooked to 155 °F (68 °C) for 15 seconds | 40 | 1 | 54 | 2 | |
| 4C | Roasts, including formed roasts, are cooked to 130 °F (54 °C) for 112 minutes or as Chart specified and according to oven parameters per Chart | 8 | 1 | 76 | 12 | |
| 4D | Poultry; stuffed fish, stuffed meat, stuffed pasta, stuffed poultry, stuffed ratites, or stuffing containing fish, meat, poultry or ratites cooked to 165 °F (74 °C) for 15 seconds | 40 | 7 | 48 | 2 | |
| 4E | Wild game animals cooked to 165 °F (74 °C) for 15 seconds | 0 | 0 | 1 | 96 | |
| 4F | Raw animal foods cooked in microwave are rotated, stirred, covered, and heated to 165 °F (74 °C). Food is allowed to stand covered for 2 minutes after cooking | 0 | 0 | 6 | 91 | |
| 4G | Pork, ratites, injected meats are cooked to 155 °F (68 °C) for 15 seconds. | 17 | 1 | 69 | 10 | |
| 4H | All other PHF cooked to 145 °F (63 °C) for 15 seconds | 41 | 0 | 54 | 2 | |
| 5A | PHF that is cooked and cooled on premises is rapidly reheated to 165 °F (74 °C) for 15 seconds for hot holding | 30 | 2 | 62 | 3 | |
| 5B | Food reheated in a microwave is heated to 165 °F (74 °C) or higher | 5 | 1 | 25 | 66 | |
| 5C | Commercially processed ready-to-eat food, reheated to 140 °F (60 °C) or above for hot holding | 46 | 3 | 45 | 3 | |
| 5D | Remaining unsliced portions of roasts are reheated for hot holding using minimum oven parameters | 2 | 0 | 68 | 27 | |
| Improper Holding/Time & Temperature | 6A | Cooked PHF is cooled from 140 °F (60 °C) to 70 °F (21 °C) within 2 hours and from 140 ○F (60 °C) to 41 °F (5 °C) or below within 6 hours | 16 | 23 | 57 | 1 |
| 6B | PHF (prepared from ingredients at ambient temperature) is cooled to 41 °F (5 °C) or below within 4 hours | 20 | 9 | 59 | 9 | |
| 6C | Foods received at a temperature according to Law are cooled to 41 °F (5 °C) within 4 hours | 12 | 2 | 82 | 1 | |
| 7A | PHF is maintained at 41 °F (5 °C) or below, except during preparation, cooking, cooling or when time is used as a public health control. | 41 | 56 | 0 | 0 | |
| 8A | PHF is maintained at 140 °F (60 °C) or above, except during preparation, cooking, or cooling or when time is used as a public health control. | 59 | 36 | 2 | 0 | |
| 8B | Roasts are held at a temperature of 130 °F (54 °C) or above | 5 | 0 | 71 | 21 | |
| 9A | Ready-to-eat PHF held for more than 24 hours is date marked as required (prepared on-site) | 60 | 33 | 2 | 2 | |
| 9B | Discard RTE PHF and/or opened commercial container exceeding 7 days at ≤ 41 °F (5 °C) or 4 days at ≤ 45 °F (7 °C) | 55 | 12 | 29 | 1 | |
| 9C | Opened Commercial container of prepared ready-to-eat PHF is date marked as required | 44 | 41 | 10 | 2 | |
| 9D | When time only is used as a public health control, food is cooked and served within 4 hours as required | 2 | 0 | 4 | 91 | |
| Contaminated Equipment/Protection from Contamination | 10A | Food is protected from cross contamination by separating raw animal foods from raw ready-to-eat food and by separating raw animal foods from cooked ready-to-eat food | 75 | 22 | 0 | 0 |
| 10B | Raw animal foods are separated from each other during storage, preparation, holding, and display | 82 | 14 | 1 | 0 | |
| 10C | Food is protected from environmental contamination -- critical Items | 85 | 12 | 0 | 0 | |
| 10D | After being served or sold to a consumer, food is not re-served | 68 | 1 | 20 | 8 | |
| 11A | Food-contact surfaces and utensils are clean to sight and touch and sanitized before use | 60 | 37 | 0 | 0 | |
| Poor Personal Hygiene | 12A | Hands are clean and properly washed when and as required | 63 | 32 | 2 | 0 |
| 13A | Food employees eat, drink, and use tobacco only in designated areas/do not use a utensil more than once to taste food that is sold or served / do not handle or care for animals present. Food employees experiencing persistent sneezing, coughing, or runny nose do not work with exposed food, clean equipment, utensils, linens, unwrapped single-service or single-use articles | 79 | 17 | 1 | 0 | |
| 14A | Employees do not contact exposed, ready-to-eat food with their bare hands. | 86 | 9 | 2 | 0 | |
| 15A | Handwash facilities conveniently located and accessible for Employees | 82 | 15 | 0 | 0 | |
| 15B | Handwash facilities supplied with hand cleanser/sanitary towels/hand drying devices | 86 | 11 | 0 | 0 | |
| Other/Chemical | 16A | If used, only approved food or color additives. Sulfites are not applied to fresh fruits and vegetables intended for raw Consumption | 29 | 0 | 0 | 68 |
| 16B | Poisonous or toxic materials, chemicals, lubricants, pesticides, medicines, first aid supplies, and other personal care items are properly identified, stored and used | 80 | 17 | 0 | 0 | |
| 16C | Poisonous or toxic materials held for retail sale are properly stored | 1 | 0 | 0 | 96 | |
| Supplemental Items -- New Areas of Study | 17A | Pork is cooked to 145 °F (63 °C) or above for 15 seconds | 18 | 0 | 69 | 10 |
| 17B | Ratites and injected meats are cooked to 155 °F (68 °C) for 15 seconds | 1 | 0 | 76 | 20 | |
| 18A | PHF is maintained at 135 °F (57 °C) or above, except during preparation, cooking, or cooling or when time is used as a public health control | 65 | 30 | 1 | 1 | |
| 19A | Facility has a written policy that is consistent with 2-201 of the Food Code for excluding and restricting employees on the basis of their health and activities as they relate to diseases that are transmissible through food. Written policy includes a statement regarding employee responsibility to notify management of symptoms and illnesses identified in the Food Code. | 29 | 68 | 0 | 0 | |
| 20A | When packaged in a food establishment, juice is treated under a HACCP Plan to reduce pathogens or be labeled as specified in the Food Code | 3 | 0 | 0 | 94 | |
| 21A | After receiving, raw shell eggs are immediately placed under refrigeration that maintains ambient air temperature of 45 °F (7 °C) or less | 18 | 0 | 60 | 19 | |
| 22A | After receipt, raw shell eggs are stored in refrigerated equipment that maintains ambient air temperature of 45 °F (7 °C) or less | 75 | 0 | 3 | 19 | |
| 23A | Prepackaged juice/beverage containing juice with a warning label (21 CFR, Section 101.17(g)) not served | 96 | 0 | 0 | 1 | |
| 23B | Pasteurized eggs or egg products substituted for raw shell eggs in preparation of foods that are not cooked to minimum required temperatures, (specified in Section 4.0 of this Baseline Form), unless cooked to order & immediately served; broken immediately before baking and thoroughly cooked; or included as an ingredient for a recipe supported by a HACCP plan that controls Salmonella Enteritidis | 71 | 4 | 19 | 3 | |
| 23C | Raw or partially cooked animal food and raw seed sprouts not served | 90 | 2 | 2 | 3 |
| DATA ITEM # | DATA ITEM | # IN | # OUT | # NO | # NA | |
|---|---|---|---|---|---|---|
| Food From Unsafe Sources | 1A | All food from Regulated Food Processing Plants/No Home prepared/canned foods | 94 | 0 | 0 | 0 |
| 1B | All shellfish from NSSP listed sources. No recreationally caught shellfish received or sold | 1 | 0 | 0 | 93 | |
| 1C | Game, wild mushrooms harvested with approval of Regulatory Authority | 0 | 0 | 1 | 93 | |
| 2A | Food received at proper temperatures/protected from contamination during transportation and receiving/food is safe, unadulterated | 88 | 6 | 0 | 0 | |
| 3A | Shellstock tags/labels retained for 90 days from the data the container is emptied | 0 | 0 | 3 | 91 | |
| 3B | As required, written documentation of parasite destruction maintained for 90 days for fish products | 0 | 0 | 2 | 92 | |
| 3C | CCP monitoring records maintained in accordance with HACCP plan when required | 1 | 0 | 0 | 93 | |
| Inadequate Cooking | 4A | Raw shell eggs broken for immediate service cooked to 145 °F (63 °C) for 15 seconds. Raw shell eggs broken but not prepared for immediate service cooked to155 °F (68 °C) for 15 seconds | 6 | 3 | 65 | 20 |
| 4B | Comminuted Fish, Meats, Game animals cooked to 155 °F (68 °C) for 15 seconds | 26 | 0 | 65 | 3 | |
| 4C | Roasts, including formed roasts, are cooked to 130 °F (54 °C) for 112 minutes or as Chart specified and according to oven parameters per Chart | 4 | 0 | 79 | 11 | |
| 4D | Poultry; stuffed fish, stuffed meat, stuffed pasta, stuffed poultry, stuffed ratites, or stuffing containing fish, meat, poultry or ratites cooked to 165 °F (74 °C) for 15 seconds | 22 | 1 | 67 | 4 | |
| 4E | Wild game animals cooked to 165 °F (74 °C) for 15 seconds | 0 | 0 | 2 | 92 | |
| 4F | Raw animal foods cooked in microwave are rotated, stirred, covered, and heated to 165 °F (74 °C). Food is allowed to stand covered for 2 minutes after cooking | 0 | 0 | 3 | 91 | |
| 4G | Pork, ratites, injected meats are cooked to 155 °F (68 °C) for 15 seconds. | 14 | 0 | 71 | 9 | |
| 4H | All other PHF cooked to 145 °F (63 °C) for 15 seconds | 32 | 0 | 56 | 6 | |
| 5A | PHF that is cooked and cooled on premises is rapidly reheated to 165 °F (74 °C) for 15 seconds for hot holding | 12 | 3 | 63 | 16 | |
| 5B | Food reheated in a microwave is heated to 165 °F (74 °C) or higher | 1 | 0 | 24 | 69 | |
| 5C | Commercially processed ready-to-eat food, reheated to 140 °F (60 °C) or above for hot holding | 33 | 1 | 48 | 12 | |
| 5D | Remaining unsliced portions of roasts are reheated for hot holding using minimum oven parameters | 3 | 0 | 64 | 27 | |
| Improper Holding/Time & Temperature | 6A | Cooked PHF is cooled from 140 °F (60 °C) to 70 °F (21 °C) within 2 hours and from 140 ○F (60 °C) to 41 °F (5 °C) or below within 6 hours | 9 | 17 | 57 | 11 |
| 6B | PHF (prepared from ingredients at ambient temperature) is cooled to 41 °F (5 °C) or below within 4 hours | 7 | 7 | 72 | 8 | |
| 6C | Foods received at a temperature according to Law are cooled to 41 °F (5 °C) within 4 hours | 25 | 3 | 65 | 1 | |
| 7A | PHF is maintained at 41 °F (5 °C) or below, except during preparation, cooking, cooling or when time is used as a public health control. | 60 | 34 | 0 | 0 | |
| 8A | PHF is maintained at 140 °F (60 °C) or above, except during preparation, cooking, or cooling or when time is used as a public health control. | 53 | 17 | 18 | 6 | |
| 8B | Roasts are held at a temperature of 130 °F (54 °C) or above | 5 | 1 | 67 | 21 | |
| 9A | Ready-to-eat PHF held for more than 24 hours is date marked as required (prepared on-site) | 61 | 26 | 2 | 5 | |
| 9B | Discard RTE PHF and/or opened commercial container exceeding 7 days at ≤ 41 °F (5 °C) or 4 days at ≤ 45 °F (7 °C) | 56 | 5 | 30 | 3 | |
| 9C | Opened Commercial container of prepared ready-to-eat PHF is date marked as required | 43 | 32 | 11 | 8 | |
| 9D | When time only is used as a public health control, food is cooked and served within 4 hours as required | 2 | 0 | 2 | 90 | |
| Contaminated Equipment/Protection from Contamination | 10A | Food is protected from cross contamination by separating raw animal foods from raw ready-to-eat food and by separating raw animal foods from cooked ready-to-eat food | 65 | 23 | 2 | 4 |
| 10B | Raw animal foods are separated from each other during storage, preparation, holding, and display | 74 | 14 | 3 | 3 | |
| 10C | Food is protected from environmental contamination -- critical Items | 81 | 13 | 0 | 0 | |
| 10D | After being served or sold to a consumer, food is not re-served | 56 | 1 | 24 | 13 | |
| 11A | Food-contact surfaces and utensils are clean to sight and touch and sanitized before use | 59 | 35 | 0 | 0 | |
| Poor Personal Hygiene | 12A | Hands are clean and properly washed when and as required | 51 | 34 | 9 | 0 |
| 13A | Food Employees eat, drink, and use tobacco only in designated areas/do not use a utensil more than once to taste food that is sold or served / do not handle or care for animals present. Food employees experiencing persistent sneezing, coughing, or runny nose do not work with exposed food, clean equipment, utensils, linens, unwrapped single-service or single-use articles | 77 | 11 | 6 | 0 | |
| 14A | Employees do not contact exposed, ready-to-eat food with their bare hands. | 71 | 18 | 5 | 0 | |
| 15A | Handwash facilities conveniently located and accessible for employees | 78 | 16 | 0 | 0 | |
| 15B | Handwash facilities supplied with hand cleanser/sanitary towels/hand drying devices | 82 | 12 | 0 | 0 | |
| Other/Chemical | 16A | If used, only approved food or color additives. Sulfites are not applied to fresh fruits and vegetables intended for raw consumption | 22 | 0 | 0 | 72 |
| 16B | Poisonous or toxic materials, chemicals, lubricants, pesticides, medicines, first aid supplies, and other personal care items are properly identified, stored and used | 73 | 21 | 0 | 0 | |
| 16C | Poisonous or toxic materials held for retail sale are properly stored | 0 | 0 | 0 | 94 | |
| Supplemental Items -- New Areas of Study | 17A | Pork is cooked to 145 °F (63 °C) or above for 15 seconds | 14 | 0 | 71 | 9 |
| 17B | Ratites and injected meats are cooked to 155 °F (68 °C) for 15 Seconds | 0 | 0 | 73 | 21 | |
| 18A | PHF is maintained at 135 °F (57 °C) or above, except during preparation, cooking, or cooling or when time is used as a public health control | 54 | 16 | 18 | 6 | |
| 19A | Facility has a written policy that is consistent with 2-201 of the Food Code for excluding and restricting employees on the basis of their health and activities as they relate to diseases that are transmissible through food. Written policy includes a statement regarding employee responsibility to notify management of symptoms and illnesses identified in the Food Code. | 12 | 82 | 0 | 0 | |
| 20A | When packaged in a food establishment, juice is treated under a HACCP Plan to reduce pathogens or be labeled as specified in the Food Code | 3 | 0 | 0 | 91 | |
| 21A | After receiving, raw shell eggs are immediately placed under refrigeration that maintains ambient air temperature of 45 °F (7 °C) or less | 32 | 0 | 54 | 8 | |
| 22A | After receipt, raw shell eggs are stored in refrigerated equipment that maintains ambient air temperature of 45 °F (7 °C) or less | 77 | 2 | 5 | 10 | |
| 23A | Prepackaged juice/beverage containing juice with a warning label (21 CFR, Section 101.17(g)) not served | 90 | 0 | 1 | 3 | |
| 23B | Pasteurized eggs or egg products substituted for raw shell eggs in preparation of foods that are not cooked to minimum required temperatures, (specified in Section 4.0 of this Baseline Form), unless cooked to order & immediately served; broken immediately before baking and thoroughly cooked; or included as an ingredient for a recipe supported by a HACCP plan that controls Salmonella Enteritidis. | 47 | 18 | 20 | 9 | |
| 23C | Raw or partially cooked animal food and raw seed sprouts not served | 73 | 10 | 6 | 5 |
| DATA ITEM # | DATA ITEM | # IN | # OUT | # NO | # NA | |
|---|---|---|---|---|---|---|
| Food From Unsafe Sources | 1A | All food from Regulated Food Processing Plants/No Home prepared/canned foods | 98 | 0 | 0 | 0 |
| 1B | All shellfish from NSSP listed sources. No recreationally caught shellfish received or sold | 0 | 3 | 0 | 95 | |
| 1C | Game, wild mushrooms harvested with approval of Regulatory Authority | 0 | 0 | 2 | 96 | |
| 2A | Food received at proper temperatures/protected from contamination during transportation and receiving/food is safe, unadulterated | 92 | 6 | 0 | 0 | |
| 3A | Shellstock tags/labels retained for 90 days from the data the container is emptied | 0 | 0 | 2 | 96 | |
| 3B | As required, written documentation of parasite destruction maintained for 90 days for fish products | 0 | 0 | 2 | 96 | |
| 3C | CCP monitoring records maintained in accordance with HACCP plan when required | 0 | 0 | 0 | 98 | |
| Inadequate Cooking | 4A | Raw shell eggs broken for immediate service cooked to 145 °F (63 °C) for 15 seconds. Raw shell eggs broken but not prepared for immediate service cooked to155 °F (68 °C) for 15 seconds | 1 | 0 | 18 | 79 |
| 4B | Comminuted Fish, Meats, Game animals cooked to 155 °F (68 °C) for 15 seconds | 9 | 0 | 27 | 62 | |
| 4C | Roasts, including formed roasts, are cooked to 130 °F (54 °C) for 112 minutes or as Chart specified and according to oven parameters per Chart | 0 | 0 | 20 | 78 | |
| 4D | Poultry; stuffed fish, stuffed meat, stuffed pasta, stuffed poultry, stuffed ratites, or stuffing containing fish, meat, poultry or ratites cooked to 165 °F (74 °C) for 15 seconds | 2 | 0 | 37 | 59 | |
| 4E | Wild game animals cooked to 165 °F (74 °C) for 15 seconds | 0 | 0 | 0 | 98 | |
| 4F | Raw animal foods cooked in microwave are rotated, stirred, covered, and heated to 165° F (74 °C). Food is allowed to stand covered for 2 minutes after cooking | 0 | 0 | 0 | 98 | |
| 4G | Pork, ratites, injected meats are cooked to 155 °F (68 °C) for 15 seconds. | 0 | 0 | 14 | 84 | |
| 4H | All other PHF cooked to 145 °F (63 °C) for 15 seconds | 17 | 0 | 21 | 60 | |
| 5A | PHF that is cooked and cooled on premises is rapidly reheated to 165 °F (74 °C) for 15 seconds for hot holding | 9 | 1 | 43 | 45 | |
| 5B | Food reheated in a microwave is heated to 165 °F (74 °C) or higher | 0 | 1 | 12 | 85 | |
| 5C | Commercially processed ready-to-eat food, reheated to 140 °F (60 °C) or above for hot holding | 58 | 1 | 27 | 12 | |
| 5D | Remaining unsliced portions of roasts are reheated for hot holding using minimum oven parameters | 0 | 0 | 11 | 87 | |
| Improper Holding/Time & Temperature | 6A | Cooked PHF is cooled from 140 °F (60 °C) to 70 °F (21 °C) within 2 hours and from 140 ○F (60 °C) to 41 °F (5 °C) or below within 6 hours | 3 | 5 | 57 | 33 |
| 6B | PHF (prepared from ingredients at ambient temperature) is cooled to 41 °F (5 °C) or below within 4 hours | 6 | 1 | 59 | 32 | |
| 6C | Foods received at a temperature according to Law are cooled to 41 °F (5 °C) within 4 hours | 25 | 1 | 67 | 5 | |
| 7A | PHF is maintained at 41 °F (5 °C) or below, except during preparation, cooking, cooling or when time is used as a public health control. | 70 | 28 | 0 | 0 | |
| 8A | PHF is maintained at 140 °F (60 °C) or above, except during preparation, cooking, or cooling or when time is used as a public health control. | 61 | 21 | 13 | 3 | |
| 8B | Roasts are held at a temperature of 130 °F (54 °C) or above | 0 | 0 | 18 | 80 | |
| 9A | Ready-to-eat PHF held for more than 24 hours is date marked as required (prepared on-site) | 29 | 22 | 11 | 36 | |
| 9B | Discard RTE PHF and/or opened commercial container exceeding 7 days at ≤ 41 °F (5 °C) or 4 days at ≤ 45 °F (7 °C) | 35 | 8 | 33 | 22 | |
| 9C | Opened Commercial container of prepared ready-to-eat PHF is date marked as required | 32 | 32 | 8 | 26 | |
| 9D | When time only is used as a public health control, food is cooked and served within 4 hours as required | 4 | 0 | 0 | 94 | |
| Contaminated Equipment/Protection from Contamination | 10A | Food is protected from cross contamination by separating raw animal foods from raw ready-to-eat food and by separating raw animal foods from cooked ready-to-eat food | 41 | 7 | 4 | 46 |
| 10B | Raw animal foods are separated from each other during storage, preparation, holding, and display | 34 | 1 | 2 | 61 | |
| 10C | Food is protected from environmental contamination -- critical Items | 87 | 11 | 0 | 0 | |
| 10D | After being served or sold to a consumer, food is not re-served | 59 | 2 | 22 | 15 | |
| 11A | Food-contact surfaces and utensils are clean to sight and touch and sanitized before use | 73 | 25 | 0 | 0 | |
| Poor Personal Hygiene | 12A | Hands are clean and properly washed when and as required | 64 | 30 | 4 | 0 |
| 13A | Food Employees eat, drink, and use tobacco only in designated areas/do not use a utensil more than once to taste food that is sold or served / do not handle or care for animals present. Food employees experiencing persistent sneezing, coughing, or runny nose do not work with exposed food, clean equipment, utensils, linens, unwrapped single- service or single-use articles | 83 | 13 | 2 | 0 | |
| 14A | Employees do not contact exposed, ready-to-eat food with their bare hands. | 77 | 15 | 6 | 0 | |
| 15A | Handwash facilities conveniently located and accessible for employees | 85 | 13 | 0 | 0 | |
| 15B | Handwash facilities supplied with hand cleanser/sanitary towels/hand drying devices | 91 | 7 | 0 | 0 | |
| Other/Chemical | 16A | If used, only approved food or color additives. Sulfites are not applied to fresh fruits and vegetables intended for raw consumption | 13 | 0 | 0 | 85 |
| 16B | Poisonous or toxic materials, chemicals, lubricants, pesticides, medicines, first aid supplies, and other personal care items are properly identified, stored and used | 74 | 24 | 0 | 0 | |
| 16C | Poisonous or toxic materials held for retail sale are properly stored | 2 | 0 | 0 | 96 | |
| Supplemental Items -- New Areas of Study | 17A | Pork is cooked to 145 °F (63 °C) or above for 15 seconds | 0 | 0 | 14 | 84 |
| 17B | Ratites and injected meats are cooked to 155 °F (68 °C) for 15 seconds | 0 | 0 | 14 | 84 | |
| 18A | PHF is maintained at 135 °F (57 °C) or above, except during preparation, cooking, or cooling or when time is used as a public health control | 62 | 20 | 12 | 4 | |
| 19A | Facility has a written policy that is consistent with 2-201 of the Food Code for excluding and restricting employees on the basis of their health and activities as they relate to diseases that are transmissible through food. Written policy includes a statement regarding employee responsibility to notify management of symptoms and illnesses identified in the Food Code. | 12 | 86 | 0 | 0 | |
| 20A | When packaged in a food establishment, juice is treated under a HACCP Plan to reduce pathogens or be labeled as specified in the Food Code | 2 | 0 | 0 | 96 | |
| 21A | After receiving, raw shell eggs are immediately placed under refrigeration that maintains ambient air temperature of 45 °F (7 °C) or less | 16 | 0 | 15 | 67 | |
| 22A | After receipt, raw shell eggs are stored in refrigerated equipment that maintains ambient air temperature of 45 °F (7 °C) or less | 30 | 0 | 2 | 66 | |
| 23A | Prepackaged juice/beverage containing juice with a warning label (21 CFR, Section 101.17(g)) not served | 85 | 0 | 4 | 9 | |
| 23B | Pasteurized eggs or egg products substituted for raw shell eggs in preparation of foods that are not cooked to minimum required temperatures, (specified in Section 4.0 of this Baseline Form), unless cooked to order & immediately served; broken immediately before baking and thoroughly cooked; or included as an ingredient for a recipe supported by a HACCP plan that controls Salmonella Enteritidis. | 37 | 4 | 8 | 49 | |
| 23C | Raw or partially cooked animal food and raw seed sprouts not served | 70 | 0 | 0 | 28 |
| DATA ITEM # | DATA ITEM | # IN | # OUT | # NO | # NA | |
|---|---|---|---|---|---|---|
| Food From Unsafe Sources | 1A | All food from Regulated Food Processing Plants/No Home prepared/canned foods | 108 | 0 | 0 | 0 |
| 1B | All shellfish from NSSP listed sources. No recreationally caught shellfish received or sold | 0 | 0 | 0 | 108 | |
| 1C | Game, wild mushrooms harvested with approval of Regulatory Authority | 0 | 0 | 2 | 106 | |
| 2A | Food received at proper temperatures/protected from contamination during transportation and receiving/food is safe, unadulterated | 103 | 5 | 0 | 0 | |
| 3A | Shellstock tags/labels retained for 90 days from the data the container is emptied | 0 | 0 | 1 | 107 | |
| 3B | As required, written documentation of parasite destruction maintained for 90 days for fish products | 0 | 0 | 0 | 108 | |
| 3C | CCP monitoring records maintained in accordance with HACCP plan when required | 0 | 0 | 0 | 108 | |
| Inadequate Cooking | 4A | Raw shell eggs broken for immediate service cooked to 145 °F (63 °C) for 15 seconds. Raw shell eggs broken but not prepared for immediate service cooked to155 °F (68 °C) for 15 seconds | 8 | 0 | 20 | 80 |
| 4B | Comminuted Fish, Meats, Game animals cooked to 155 °F (68 °C) for 15 seconds | 42 | 8 | 18 | 40 | |
| 4C | Roasts, including formed roasts, are cooked to 130 °F (54 °C) for 112 minutes or as Chart specified and according to oven parameters per Chart | 4 | 0 | 6 | 98 | |
| 4D | Poultry; stuffed fish, stuffed meat, stuffed pasta, stuffed poultry, stuffed ratites, or stuffing containing fish, meat, poultry or ratites cooked to 165 °F (74 °C) for 15 seconds | 48 | 1 | 28 | 31 | |
| 4E | Wild game animals cooked to 165 °F (74 °C) for 15 seconds | 0 | 0 | 0 | 108 | |
| 4F | Raw animal foods cooked in microwave are rotated, stirred, covered, and heated to 165° F (74 °C). Food is allowed to stand covered for 2 minutes after cooking | 0 | 0 | 4 | 104 | |
| 4G | Pork, ratites, injected meats are cooked to 155 °F (68 °C) for 15 seconds. | 4 | 0 | 35 | 69 | |
| 4H | All other PHF cooked to 145 °F (63 °C) for 15 seconds | 23 | 0 | 37 | 48 | |
| 5A | PHF that is cooked and cooled on premises is rapidly reheated to 165 °F (74 °C) for 15 seconds for hot holding | 6 | 4 | 37 | 61 | |
| 5B | Food reheated in a microwave is heated to 165 °F (74 °C) or higher | 3 | 0 | 23 | 82 | |
| 5C | Commercially processed ready-to-eat food, reheated to 140 °F (60 °C) or above for hot holding | 31 | 4 | 37 | 36 | |
| 5D | Remaining unsliced portions of roasts are reheated for hot holding using minimum oven parameters |
0 | 0 | 7 | 101 | |
| Improper Holding/Time & Temperature | 6A | Cooked PHF is cooled from 140 °F (60 °C) to 70 °F (21 °C) within 2 hours and from 140 ○F (60 °C) to 41 °F (5 °C) or below within 6 hours | 2 | 10 | 55 | 41 |
| 6B | PHF (prepared from ingredients at ambient temperature) is cooled to 41 °F (5 °C) or below within 4 hours | 7 | 5 | 36 | 60 | |
| 6C | Foods received at a temperature according to Law are cooled to 41 °F (5 °C) within 4 hours | 12 | 2 | 76 | 18 | |
| 7A | PHF is maintained at 41 °F (5 °C) or below, except during preparation, cooking, cooling or when time is used as a public health control. | 47 | 61 | 0 | 0 | |
| 8A | PHF is maintained at 140 °F (60 °C) or above, except during preparation, cooking, or cooling or when time is used as a public health control. | 66 | 28 | 3 | 11 | |
| 8B | Roasts are held at a temperature of 130 °F (54 °C) or above | 3 | 3 | 3 | 99 | |
| 9A | Ready-to-eat PHF held for more than 24 hours is date marked as required (prepared on-site) | 35 | 24 | 4 | 45 | |
| 9B | Discard RTE PHF and/or opened commercial container exceeding 7 days at ≤ 41 °F (5 °C) or 4 days at ≤ 45 °F (7 °C) | 38 | 5 | 46 | 19 | |
| 9C | Opened Commercial container of prepared ready-to-eat PHF is date marked as required | 28 | 38 | 8 | 34 | |
| 9D | When time only is used as a public health control, food is cooked and served within 4 hours as required | 14 | 4 | 1 | 89 | |
| Contaminated Equipment/Protection from Contamination | 10A | Food is protected from cross contamination by separating raw animal foods from raw ready-to-eat food and by separating raw animal foods from cooked ready-to-eat food | 74 | 17 | 0 | 17 |
| 10B | Raw animal foods are separated from each other during storage, preparation, holding, and display | 75 | 6 | 0 | 27 | |
| 10C | Food is protected from environmental contamination -- critical Items | 91 | 17 | 0 | 0 | |
| 10D | After being served or sold to a consumer, food is not re-served | 46 | 0 | 37 | 25 | |
| 11A | Food-contact surfaces and utensils are clean to sight and touch and sanitized before use | 53 | 55 | 0 | 0 | |
| Poor Personal Hygiene | 12A | Hands are clean and properly washed when and as required | 48 | 56 | 4 | 0 |
| 13A | Food Employees eat, drink, and use tobacco only in designated areas/do not use a utensil more than once to taste food that is sold or served / do not handle or care for animals present. Food employees experiencing persistent sneezing, coughing, or runny nose do not work with exposed food, clean equipment, utensils, linens, unwrapped single- service or single-use articles | 81 | 23 | 4 | 0 | |
| 14A | Employees do not contact exposed, ready-to-eat food with their bare hands. | 52 | 53 | 3 | 0 | |
| 15A | Handwash facilities conveniently located and accessible for employees | 92 | 16 | 0 | 0 | |
| 15B | Handwash facilities supplied with hand cleanser/sanitary towels/hand drying devices | 91 | 17 | 0 | 0 | |
| Other/Chemical | 16A | If used, only approved food or color additives. Sulfites are not applied to fresh fruits and vegetables intended for raw consumption | 12 | 0 | 0 | 96 |
| 16B | Poisonous or toxic materials, chemicals, lubricants, pesticides, medicines, first aid supplies, and other personal care items are properly identified, stored and used | 74 | 34 | 0 | 0 | |
| 16C | Poisonous or toxic materials held for retail sale are properly stored | 0 | 0 | 0 | 108 | |
| Supplemental Items -- New Areas of Study | 17A | Pork is cooked to 145 °F (63 °C) or above for 15 seconds | 3 | 0 | 35 | 70 |
| 17B | Ratites and injected meats are cooked to 155 °F (68 °C) for 15 seconds | 1 | 0 | 36 | 71 | |
| 18A | PHF is maintained at 135 °F (57 °C) or above, except during preparation, cooking, or cooling or when time is used as a public health control | 71 | 23 | 2 | 12 | |
| 19A | Facility has a written policy that is consistent with 2-201 of the Food Code for excluding and restricting employees on the basis of their health and activities as they relate to diseases that are transmissible through food. Written policy includes a statement regarding employee responsibility to notify management of symptoms and illnesses identified in the Food Code. | 16 | 92 | 0 | 0 | |
| 20A | When packaged in a food establishment, juice is treated under a HACCP Plan to reduce pathogens or be labeled as specified in the Food Code | 0 | 1 | 0 | 107 | |
| 21A | After receiving, raw shell eggs are immediately placed under refrigeration that maintains ambient air temperature of 45 °F (7 °C) or less | 5 | 0 | 25 | 77 | |
| 22A | After receipt, raw shell eggs are stored in refrigerated equipment that maintains ambient air temperature of 45 °F (7 °C) or less | 29 | 2 | 0 | 77 | |
| 23A | Prepackaged juice/beverage containing juice with a warning label (21 CFR, Section 101.17(g)) not served | 0 | 0 | 0 | 108 | |
| 23B | Pasteurized eggs or egg products substituted for raw shell eggs in preparation of foods that are not cooked to minimum required temperatures, (specified in Section 4.0 of this Baseline Form), unless cooked to order & immediately served; broken immediately before baking and thoroughly cooked; or included as an ingredient for a recipe supported by a HACCP plan that controls Salmonella Enteritidis | 0 | 0 | 0 | 108 | |
| 23C | Raw or partially cooked animal food and raw seed sprouts not served | 0 | 0 | 0 | 108 |
| DATA ITEM # | DATA ITEM | # IN | # OUT | # NO | # NA | |
|---|---|---|---|---|---|---|
| Food From Unsafe Sources | 1A | All food from Regulated Food Processing Plants/No Home prepared/canned foods | 98 | 1 | 0 | 0 |
| 1B | All shellfish from NSSP listed sources. No recreationally caught shellfish received or sold | 24 | 4 | 0 | 71 | |
| 1C | Game, wild mushrooms harvested with approval of Regulatory Authority | 2 | 0 | 2 | 95 | |
| 2A | Food received at proper temperatures/protected from contamination during transportation and receiving/food is safe, unadulterated | 91 | 8 | 0 | 0 | |
| 3A | Shellstock tags/labels retained for 90 days from the data the container is emptied | 6 | 13 | 4 | 76 | |
| 3B | As required, written documentation of parasite destruction maintained for 90 days for fish products | 0 | 6 | 1 | 92 | |
| 3C | CCP monitoring records maintained in accordance with HACCP plan when required | 0 | 1 | 0 | 98 | |
| Inadequate Cooking | 4A | Raw shell eggs broken for immediate service cooked to 145 °F (63 °C) for 15 seconds. Raw shell eggs broken but not prepared for immediate service cooked to155 °F (68 °C) for 15 seconds | 21 | 3 | 54 | 21 |
| 4B | Comminuted Fish, Meats, Game animals cooked to 155 °F (68 °C) for 15 seconds | 41 | 3 | 43 | 12 | |
| 4C | Roasts, including formed roasts, are cooked to 130 °F (54 °C) for 112 minutes or as Chart specified and according to oven parameters per Chart | 2 | 0 | 43 | 54 | |
| 4D | Poultry; stuffed fish, stuffed meat, stuffed pasta, stuffed poultry, stuffed ratites, or stuffing containing fish, meat, poultry or ratites cooked to 165 °F (74 °C) for 15 seconds | 38 | 9 | 49 | 3 | |
| 4E | Wild game animals cooked to 165 °F (74 °C) for 15 seconds | 0 | 1 | 3 | 95 | |
| 4F | Raw animal foods cooked in microwave are rotated, stirred, covered, and heated to 165° F (74 °C). Food is allowed to stand covered for 2 minutes after cooking | 0 | 0 | 1 | 98 | |
| 4G | Pork, ratites, injected meats are cooked to 155 °F (68 °) for 15 seconds. | 11 | 2 | 60 | 26 | |
| 4H | All other PHF cooked to 145 °F (63 °C) for 15 seconds | 41 | 5 | 49 | 4 | |
| 5A | PHF that is cooked and cooled on premises is rapidly reheated to 165 °F (74 °C) for 15 seconds for hot holding | 25 | 11 | 54 | 9 | |
| 5B | Food reheated in a microwave is heated to 165 °F (74 °C) or higher | 3 | 1 | 21 | 74 | |
| 5C | Commercially processed ready-to-eat food, reheated to 140 °F (60 °C) or above for hot holding | 19 | 2 | 45 | 33 | |
| 5D | Remaining unsliced portions of roasts are reheated for hot holding using minimum oven parameters | 1 | 1 | 31 | 66 | |
| Improper Holding/Time & Temperature | 6A | Cooked PHF is cooled from 140 °F (60 °C) to 70 °F (21 °C) within 2 hours and from 140 ○F (60 °C) to 41 °F (5 °C) or below within 6 hours | 10 | 34 | 51 | 4 |
| 6B | PHF (prepared from ingredients at ambient temperature) is cooled to 41 °F (5 °C) or below within 4 hours | 9 | 7 | 61 | 22 | |
| 6C | Foods received at a temperature according to Law are cooled to 41 °F (5 °C) within 4 hours | 12 | 6 | 80 | 1 | |
| 7A | PHF is maintained at 41 °F (5 °C) or below, except during preparation, cooking, cooling or when time is used as a public health control. | 22 | 77 | 0 | 0 | |
| 8A | PHF is maintained at 140 °F (60 °C) or above, except during preparation, cooking, or cooling or when time is used as a public health control. | 45 | 42 | 11 | 1 | |
| 8B | Roasts are held at a temperature of 130 °F (54 °C) or above | 2 | 3 | 32 | 62 | |
| 9A | Ready-to-eat PHF held for more than 24 hours is date marked as required (prepared on-site) | 24 | 69 | 2 | 4 | |
| 9B | Discard RTE PHF and/or opened commercial container exceeding 7 days at ≤ 41 °F (5 °C) or 4 days at ≤ 45 °F (7 °C) | 20 | 16 | 59 | 4 | |
| 9C | Opened Commercial container of prepared ready-to-eat PHF is date marked as required | 24 | 43 | 10 | 22 | |
| 9D | When time only is used as a public health control, food is cooked and served within 4 hours as required | 2 | 3 | 3 | 91 | |
| Contaminated Equipment/Protection from Contamination | 10A | Food is protected from cross contamination by separating raw animal foods from raw ready-to-eat food and by separating raw animal foods from cooked ready-to-eat food | 51 | 45 | 1 | 2 |
| 10B | Raw animal foods are separated from each other during storage, preparation, holding, and display | 70 | 24 | 1 | 4 | |
| 10C | Food is protected from environmental contamination -- critical Items | 64 | 35 | 0 | 0 | |
| 10D | After being served or sold to a consumer, food is not re-served | 46 | 3 | 39 | 11 | |
| 11A | Food-contact surfaces and utensils are clean to sight and touch and sanitized before use | 43 | 56 | 0 | 0 | |
| Poor Personal Hygiene | 12A | Hands are clean and properly washed when and as required | 27 | 72 | 0 | 0 |
| 13A | Food Employees eat, drink, and use tobacco only in designated areas/do not use a utensil more than once to taste food that is sold or served / do not handle or care for animals present. Food employees experiencing persistent sneezing, coughing, or runny nose do not work with exposed food, clean equipment, utensils, linens, unwrapped single- service or single-use articles | 64 | 33 | 0 | 0 | |
| 14A | Employees do not contact exposed, ready-to-eat food with their bare hands. | 40 | 53 | 6 | 0 | |
| 15A | Handwash facilities conveniently located and accessible for employees | 76 | 23 | 0 | 0 | |
| 15B | Handwash facilities supplied with hand cleanser/sanitary towels/hand drying devices | 77 | 22 | 0 | 0 | |
| Other/Chemical | 16A | If used, only approved food or color additives. Sulfites are not applied to fresh fruits and vegetables intended for raw consumption | 25 | 0 | 0 | 74 |
| 16B | Poisonous or toxic materials, chemicals, lubricants, pesticides, medicines, first aid supplies, and other personal care items are properly identified, stored and used | 61 | 38 | 0 | 0 | |
| 16C | Poisonous or toxic materials held for retail sale are properly stored | 0 | 0 | 0 | 99 | |
| Supplemental Items -- New Areas of Study | 17A | Pork is cooked to 145 °F (63 °C) or above for 15 seconds | 10 | 0 | 63 | 26 |
| 17B | Ratites and injected meats are cooked to 155 °F (68 °C) for 15 seconds | 4 | 0 | 62 | 33 | |
| 18A | PHF is maintained at 135 °F (57 °C) or above, except during preparation, cooking, or cooling or when time is used as a public health control | 48 | 39 | 10 | 2 | |
| 19A | Facility has a written policy that is consistent with 2-201 of the Food Code for excluding and restricting employees on the basis of their health and activities as they relate to diseases that are transmissible through food. Written policy includes a statement regarding employee responsibility to notify management of symptoms and illnesses identified in the Food Code. | 7 | 92 | 0 | 0 | |
| 20A | When packaged in a food establishment, juice is treated under a HACCP Plan to reduce pathogens or be labeled as specified in the Food Code | 1 | 0 | 0 | 98 | |
| 21A | After receiving, raw shell eggs are immediately placed under refrigeration that maintains ambient air temperature of 45 °F (7 °C) or less | 10 | 2 | 76 | 11 | |
| 22A | After receipt, raw shell eggs are stored in refrigerated equipment that maintains ambient air temperature of 45 °F (7 °C) or less | 71 | 13 | 4 | 11 | |
| 23A | Prepackaged juice/beverage containing juice with a warning label (21 CFR, Section 101.17(g)) not served | 0 | 0 | 0 | 99 | |
| 23B | Pasteurized eggs or egg products substituted for raw shell eggs in preparation of foods that are not cooked to minimum required temperatures, (specified in Section 4.0 of this Baseline Form), unless cooked to order & immediately served; broken immediately before baking and thoroughly cooked; or included as an ingredient for a recipe supported by a HACCP plan that controls Salmonella Enteritidis | 0 | 0 | 0 | 99 | |
| 23C | Raw or partially cooked animal food and raw seed sprouts not served | 0 | 0 | 0 | 99 |
| DATA ITEM # | DATA ITEM | # IN | # OUT | # NO | # NA | |
|---|---|---|---|---|---|---|
| Food From Unsafe Sources | 1A | All food from Regulated Food Processing Plants/No Home prepared/canned foods | 107 | 1 | 0 | 0 |
| 1B | All shellfish from NSSP listed sources. No recreationally caught shellfish received or sold | 0 | 0 | 0 | 108 | |
| 1C | Game, wild mushrooms harvested with approval of Regulatory Authority | 0 | 0 | 0 | 108 | |
| 2A | Food received at proper temperatures/protected from contamination during transportation and receiving/food is safe, unadulterated | 103 | 5 | 0 | 0 | |
| 3A | Shellstock tags/labels retained for 90 days from the data the container is emptied | 0 | 0 | 0 | 108 | |
| 3B | As required, written documentation of parasite destruction maintained for 90 days for fish products | 0 | 2 | 0 | 106 | |
| 3C | CCP monitoring records maintained in accordance with HACCP plan when required | 0 | 3 | 0 | 105 | |
| Inadequate Cooking | 4A | Raw shell eggs broken for immediate service cooked to 145 °F (63 °C) for 15 seconds. Raw shell eggs broken but not prepared for immediate service cooked to155 °F (68 °C) for 15 seconds | 4 | 1 | 21 | 82 |
| 4B | Comminuted Fish, Meats, Game animals cooked to 155 °F (68 °C) for 15 seconds | 7 | 1 | 26 | 74 | |
| 4C | Roasts, including formed roasts, are cooked to 130 °F (54 °C) for 112 minutes or as Chart specified and according to oven parameters per Chart | 3 | 0 | 15 | 90 | |
| 4D | Poultry; stuffed fish, stuffed meat, stuffed pasta, stuffed poultry, stuffed ratites, or stuffing containing fish, meat, poultry or ratites cooked to 165 °F (74 °C) for 15 seconds | 67 | 4 | 32 | 5 | |
| 4E | Wild game animals cooked to 165 °F (74 °C) for 15 seconds | 0 | 0 | 0 | 108 | |
| 4F | Raw animal foods cooked in microwave are rotated, stirred, covered, and heated to 165° F (74 °C). Food is allowed to stand covered for 2 minutes after cooking | 0 | 1 | 2 | 105 | |
| 4G | Pork, ratites, injected meats are cooked to 155 °F (68 °C) for 15 seconds. | 15 | 1 | 29 | 63 | |
| 4H | All other PHF cooked to 145 °F (63 °C) for 15 seconds | 11 | 0 | 34 | 63 | |
| 5A | PHF that is cooked and cooled on premises is rapidly reheated to 165 °F (74 °C) for 15 seconds for hot holding | 9 | 1 | 33 | 65 | |
| 5B | Food reheated in a microwave is heated to 165 °F (74 °C) or higher | 0 | 0 | 17 | 91 | |
| 5C | Commercially processed ready-to-eat food, reheated to 140 °F (60 °C) or above for hot holding | 23 | 5 | 49 | 31 | |
| 5D | Remaining unsliced portions of roasts are reheated for hot holding using minimum oven parameters |
0 | 0 | 12 | 96 | |
| Improper Holding/Time & Temperature | 6A | Cooked PHF is cooled from 140 °F (60 °C) to 70 °F (21 °C) within 2 hours and from 140 ○F (60 °C) to 41 °F (5 °C) or below within 6 hours | 12 | 16 | 64 | 16 |
| 6B | PHF (prepared from ingredients at ambient temperature) is cooled to 41 °F (5 °C) or below within 4 hours | 7 | 6 | 47 | 48 | |
| 6C | Foods received at a temperature according to Law are cooled to 41 °F (5 °C) within 4 hours | 8 | 1 | 44 | 55 | |
| 7A | PHF is maintained at 41 °F (5 °C) or below, except during preparation, cooking, cooling or when time is used as a public health control. | 34 | 74 | 0 | 0 | |
| 8A | PHF is maintained at 140 °F (60 °C) or above, except during preparation, cooking, or cooling or when time is used as a public health control. | 38 | 59 | 6 | 5 | |
| 8B | Roasts are held at a temperature of 130 °F (54 °C) or above | 2 | 2 | 12 | 92 | |
| 9A | Ready-to-eat PHF held for more than 24 hours is date marked as required (prepared on-site) | 30 | 51 | 4 | 23 | |
| 9B | Discard RTE PHF and/or opened commercial container exceeding 7 days at ≤ 41 °F (5 °C) or 4 days at ≤ 45 °F (7 °C) | 21 | 27 | 56 | 4 | |
| 9C | Opened Commercial container of prepared ready-to-eat PHF is date marked as required | 20 | 79 | 4 | 5 | |
| 9D | When time only is used as a public health control, food is cooked and served within 4 hours as required | 2 | 0 | 4 | 102 | |
| Contaminated Equipment/Protection from Contamination | 10A | Food is protected from cross contamination by separating raw animal foods from raw ready-to-eat food and by separating raw animal foods from cooked ready-to-eat food | 84 | 21 | 0 | 3 |
| 10B | Raw animal foods are separated from each other during storage, preparation, holding, and display | 78 | 4 | 2 | 24 | |
| 10C | Food is protected from environmental contamination -- critical Items | 94 | 14 | 0 | 0 | |
| 10D | After being served or sold to a consumer, food is not re-served | 32 | 0 | 40 | 36 | |
| 11A | Food-contact surfaces and utensils are clean to sight and touch and sanitized before use | 45 | 63 | 0 | 0 | |
| Poor Personal Hygiene | 12A | Hands are clean and properly washed when and as required | 44 | 58 | 6 | 0 |
| 13A | Food Employees eat, drink, and use tobacco only in designated areas/do not use a utensil more than once to taste food that is sold or served / do not handle or care for animals present. Food employees experiencing persistent sneezing, coughing, or runny nose do not work with exposed food, clean equipment, utensils, linens, unwrapped single- service or single-use articles | 95 | 11 | 2 | 0 | |
| 14A | Employees do not contact exposed, ready-to-eat food with their bare hands. | 94 | 10 | 3 | 1 | |
| 15A | Handwash facilities conveniently located and accessible for employees | 84 | 24 | 0 | 0 | |
| 15B | Handwash facilities supplied with hand cleanser/sanitary towels/hand drying devices | 87 | 21 | 0 | 0 | |
| Other/Chemical | 16A | If used, only approved food or color additives. Sulfites are not applied to fresh fruits and vegetables intended for raw consumption | 23 | 0 | 0 | 85 |
| 16B | Poisonous or toxic materials, chemicals, lubricants, pesticides, medicines, first aid supplies, and other personal care items are properly identified, stored and used | 78 | 30 | 0 | 0 | |
| 16C | Poisonous or toxic materials held for retail sale are properly stored | 6 | 0 | 0 | 102 | |
| Supplemental Items -- New Areas of Study | 17A | Pork is cooked to 145 °F (63 °C) or above for 15 seconds | 16 | 0 | 29 | 63 |
| 17B | Ratites and injected meats are cooked to 155 °- F (68 °C) for 15 seconds | 2 | 0 | 33 | 73 | |
| 18A | PHF is maintained at 135 °F (57 °C) or above, except during preparation, cooking, or cooling or when time is used as a public health control | 41 | 56 | 6 | 5 | |
| 19A | Facility has a written policy that is consistent with 2-201 of the Food Code for excluding and restricting employees on the basis of their health and activities as they relate to diseases that are transmissible through food. Written policy includes a statement regarding employee responsibility to notify management of symptoms and illnesses identified in the Food Code. | 18 | 90 | 0 | 0 | |
| 20A | When packaged in a food establishment, juice is treated under a HACCP Plan to reduce pathogens or be labeled as specified in the Food Code | 0 | 1 | 0 | 107 | |
| 21A | After receiving, raw shell eggs are immediately placed under refrigeration that maintains ambient air temperature of 45 °F (7 °C) or less | 6 | 3 | 17 | 82 | |
| 22A | After receipt, raw shell eggs are stored in refrigerated equipment that maintains ambient air temperature of 45 °F (7 °C) or less | 18 | 3 | 4 | 83 | |
| 23A | Prepackaged juice/beverage containing juice with a warning label (21 CFR, Section 101.17(g)) not served | 0 | 0 | 0 | 108 | |
| 23B | Pasteurized eggs or egg products substituted for raw shell eggs in preparation of foods that are not cooked to minimum required temperatures, (specified in Section 4.0 of this Baseline Form), unless cooked to order & immediately served; broken immediately before baking and thoroughly cooked; or included as an ingredient for a recipe supported by a HACCP plan that controls Salmonella Enteritidis | 0 | 0 | 0 | 108 | |
| 23C | Raw or partially cooked animal food and raw seed sprouts not served | 0 | 0 | 0 | 108 |
| DATA ITEM # | DATA ITEM | # IN | # OUT | # NO | # NA | |
|---|---|---|---|---|---|---|
| Food From Unsafe Sources | 1A | All food from Regulated Food Processing Plants/No Home prepared/canned foods | 108 | 1 | 0 | 0 |
| 1B | All shellfish from NSSP listed sources. No recreationally caught shellfish received or sold | 11 | 3 | 0 | 95 | |
| 1C | Game, wild mushrooms harvested with approval of Regulatory Authority | 4 | 0 | 0 | 105 | |
| 2A | Food received at proper temperatures/protected from contamination during transportation and receiving/food is safe, unadulterated | 105 | 4 | 0 | 0 | |
| 3A | Shellstock tags/labels retained for 90 days from the data the container is emptied | 2 | 3 | 6 | 98 | |
| 3B | As required, written documentation of parasite destruction maintained for 90 days for fish products | 0 | 0 | 0 | 109 | |
| 3C | CCP monitoring records maintained in accordance with HACCP plan when required | 0 | 1 | 0 | 108 | |
| Inadequate Cooking | 4A | Raw shell eggs broken for immediate service cooked to 145 °F (63 °C) for 15 seconds. Raw shell eggs broken but not prepared for immediate service cooked to155 °F (68 °C) for 15 seconds | 0 | 0 | 0 | 109 |
| 4B | Comminuted Fish, Meats, Game animals cooked to 155 °F (68 °C) for 15 seconds | 0 | 0 | 5 | 104 | |
| 4C | Roasts, including formed roasts, are cooked to 130 °F (54 °C) for 112 minutes or as Chart specified and according to oven parameters per Chart | 0 | 0 | 1 | 108 | |
| 4D | Poultry; stuffed fish, stuffed meat, stuffed pasta, stuffed poultry, stuffed ratites, or stuffing containing fish, meat, poultry or ratites cooked to 165 °F (74 °C) for 15 seconds | 1 | 1 | 3 | 104 | |
| 4E | Wild game animals cooked to 165 °F (74 °C) for 15 seconds | 0 | 0 | 0 | 109 | |
| 4F | Raw animal foods cooked in microwave are rotated, stirred, covered, and heated to 165° F (74 °C). Food is allowed to stand covered for 2 minutes after cooking | 0 | 0 | 0 | 109 | |
| 4G | Pork, ratites, injected meats are cooked to 155 °F (68 °C) for 15 seconds. | 0 | 0 | 5 | 104 | |
| 4H | All other PHF cooked to 145 °F (63 °C) for 15 seconds | 0 | 0 | 5 | 104 | |
| 5A | PHF that is cooked and cooled on premises is rapidly reheated to 165 °F (74 °C) for 15 seconds for hot holding | 0 | 0 | 0 | 109 | |
| 5B | Food reheated in a microwave is heated to 165 °F (74 °C) or higher | 0 | 0 | 0 | 109 | |
| 5C | Commercially processed ready-to-eat food, reheated to 140 °F (60 °C) or above for hot holding | 0 | 0 | 0 | 109 | |
| 5D | Remaining unsliced portions of roasts are reheated for hot holding using minimum oven parameters |
0 | 0 | 0 | 109 | |
| Improper Holding/Time & Temperature | 6A | Cooked PHF is cooled from 140 °F (60 °C) to 70 °F (21 °C) within 2 hours and from 140 ○F (60 °C) to 41 °F (5 °C) or below within 6 hours |
0 | 1 | 3 | 105 |
| 6B | PHF (prepared from ingredients at ambient temperature) is cooled to 41 °F (5 °C) or below within 4 hours | 2 | 0 | 6 | 101 | |
| 6C | Foods received at a temperature according to Law are cooled to 41 °F (5 °C) within 4 hours | 1 | 0 | 13 | 101 | |
| 7A | PHF is maintained at 41 °F (5 °C) or below, except during preparation, cooking, cooling or when time is used as a public health control. | 90 | 19 | 0 | 0 | |
| 8A | PHF is maintained at 140 °F (60 °C) or above, except during preparation, cooking, or cooling or when time is used as a public health control. | 0 | 2 | 5 | 102 | |
| 8B | Roasts are held at a temperature of 130 °F (54 °C) or above | 0 | 0 | 0 | 109 | |
| 9A | Ready-to-eat PHF held for more than 24 hours is date marked as required (prepared on-site) | 7 | 9 | 0 | 93 | |
| 9B | Discard RTE PHF and/or opened commercial container exceeding 7 days at ≤ 41 °F (5 °C) or 4 days at ≤ 45 °F (7 °C) | 8 | 5 | 14 | 82 | |
| 9C | Opened Commercial container of prepared ready-to-eat PHF is date marked as required | 5 | 12 | 3 | 89 | |
| 9D | When time only is used as a public health control, food is cooked and served within 4 hours as required | 0 | 0 | 1 | 108 | |
| Contaminated Equipment/Protection from Contamination | 10A | Food is protected from cross contamination by separating raw animal foods from raw ready-to-eat food and by separating raw animal foods from cooked ready-to-eat food | 61 | 26 | 0 | 22 |
| 10B | Raw animal foods are separated from each other during storage, preparation, holding, and display | 81 | 26 | 0 | 2 | |
| 10C | Food is protected from environmental contamination -- critical items | 100 | 9 | 0 | 0 | |
| 10D | After being served or sold to a consumer, food is not re-served | 26 | 0 | 23 | 60 | |
| 11A | Food-contact surfaces and utensils are clean to sight and touch and sanitized before use | 63 | 46 | 0 | 0 | |
| Poor Personal Hygiene | 12A | Hands are clean and properly washed when and as required | 53 | 31 | 25 | 0 |
| 13A | Food Employees eat, drink, and use tobacco only in designated areas/do not use a utensil more than once to taste food that is sold or served / do not handle or care for animals present. Food employees experiencing persistent sneezing, coughing, or runny nose do not work with exposed food, clean equipment, utensils, linens, unwrapped single-service or single-use articles | 78 | 7 | 24 | 0 | |
| 14A | Employees do not contact exposed, ready-to-eat food with their bare hands. | 35 | 3 | 24 | 47 | |
| 15A | Handwash facilities conveniently located and accessible for Employees | 86 | 23 | 0 | 0 | |
| 15B | Handwash facilities supplied with hand cleanser/sanitary towels/hand drying devices | 82 | 27 | 0 | 0 | |
| Other/Chemical | 16A | If used, only approved food or color additives. Sulfites are not applied to fresh fruits and vegetables intended for raw Consumption | 10 | 0 | 0 | 99 |
| 16B | Poisonous or toxic materials, chemicals, lubricants, pesticides, medicines, first aid supplies, and other personal care items are properly identified, stored and used | 90 | 19 | 0 | 0 | |
| 16C | Poisonous or toxic materials held for retail sale are properly stored | 3 | 1 | 0 | 105 | |
| Supplemental Items -- New Areas of Study | 17A | Pork is cooked to 145 °F (63 °C) or above for 15 seconds | 0 | 0 | 5 | 104 |
| 17B | Ratites and injected meats are cooked to 155 °F (68 °C) for 15 seconds | 0 | 0 | 5 | 104 | |
| 18A | PHF is maintained at 135 °F (57 °C) or above, except during preparation, cooking, or cooling or when time is used as a public health control | 1 | 1 | 5 | 102 | |
| 19A | Facility has a written policy that is consistent with 2-201 of the Food Code for excluding and restricting employees on the basis of their health and activities as they relate to diseases that are transmissible through food. Written policy includes a statement regarding employee responsibility to notify management of symptoms and illnesses identified in the Food Code. | 18 | 91 | 0 | 0 | |
| 20A | When packaged in a food establishment, juice is treated under a HACCP Plan to reduce pathogens or be labeled as specified in the Food Code | 0 | 0 | 0 | 109 | |
| 21A | After receiving, raw shell eggs are immediately placed under refrigeration that maintains ambient air temperature of 45 °F (7 °C) or less | 2 | 1 | 2 | 104 | |
| 22A | After receipt, raw shell eggs are stored in refrigerated equipment that maintains ambient air temperature of 45 °F (7 °C) or less | 4 | 1 | 0 | 104 | |
| 23A | Prepackaged juice/beverage containing juice with a warning label (21 CFR, Section 101.17(g)) not served | 0 | 0 | 0 | 109 | |
| 23B | Pasteurized eggs or egg products substituted for raw shell eggs in preparation of foods that are not cooked to minimum required temperatures, (specified in Section 4.0 of this Baseline Form), unless cooked to order & immediately served; broken immediately before baking and thoroughly cooked; or included as an ingredient for a recipe supported by a HACCP plan that controls Salmonella Enteritidis | 0 | 0 | 0 | 109 | |
| 23C | Raw or partially cooked animal food and raw seed sprouts not served | 0 | 0 | 0 | 109 |
| DATA ITEM # | DATA ITEM | # IN | # OUT | # NO | # NA | |
|---|---|---|---|---|---|---|
| Food From Unsafe Sources | 1A | All food from Regulated Food Processing Plants/No Home prepared/canned foods | 104 | 1 | 0 | 0 |
| 1B | All shellfish from NSSP listed sources. No recreationally caught shellfish received or sold | 75 | 3 | 0 | 27 | |
| 1C | Game, wild mushrooms harvested with approval of Regulatory Authority | 0 | 0 | 0 | 105 | |
| 2A | Food received at proper temperatures/protected from contamination during transportation and receiving/food is safe, unadulterated | 103 | 2 | 0 | 0 | |
| 3A | Shellstock tags/labels retained for 90 days from the data the container is emptied | 39 | 31 | 4 | 31 | |
| 3B | As required, written documentation of parasite destruction maintained for 90 days for fish products | 2 | 6 | 0 | 97 | |
| 3C | CCP monitoring records maintained in accordance with HACCP plan when required | 0 | 4 | 0 | 101 | |
| Inadequate Cooking | 4A | Raw shell eggs broken for immediate service cooked to 145 °F (63 °C) for 15 seconds. Raw shell eggs broken but not prepared for immediate service cooked to155 °F (68 °C) for 15 seconds | 0 | 0 | 0 | 105 |
| 4B | Comminuted Fish, Meats, Game animals cooked to 155 °F (68 °C) for 15 seconds | 0 | 0 | 2 | 103 | |
| 4C | Roasts, including formed roasts, are cooked to 130 °F (54 °C) for 112 minutes or as Chart specified and according to oven parameters per Chart | 0 | 0 | 0 | 105 | |
| 4D | Poultry; stuffed fish, stuffed meat, stuffed pasta, stuffed poultry, stuffed ratites, or stuffing containing fish, meat, poultry or ratites cooked to 165 °F (74 °C) for 15 seconds | 0 | 0 | 3 | 102 | |
| 4E | Wild game animals cooked to 165 °F (74 °C) for 15 seconds | 0 | 0 | 0 | 105 | |
| 4F | Raw animal foods cooked in microwave are rotated, stirred, covered, and heated to 165 °F (74 °C). Food is allowed to stand covered for 2 minutes after cooking | 0 | 0 | 2 | 103 | |
| 4G | Pork, ratites, injected meats are cooked to 155 °F (68 °C) for 15 seconds. | 0 | 0 | 0 | 105 | |
| 4H | All other PHF cooked to 145 °F (63 °C) for 15 seconds | 4 | 0 | 49 | 52 | |
| 5A | PHF that is cooked and cooled on premises is rapidly reheated to 165 °F (74 °C) for 15 seconds for hot holding | 0 | 1 | 0 | 104 | |
| 5B | Food reheated in a microwave is heated to 165 °F (74 °C) or higher | 0 | 0 | 0 | 105 | |
| 5C | Commercially processed ready-to-eat food, reheated to 140 °F (60 °C) or above for hot holding | 1 | 1 | 2 | 101 | |
| 5D | Remaining unsliced portions of roasts are reheated for hot holding using minimum oven parameters |
0 | 0 | 0 | 105 | |
| Improper Holding/Time & Temperature | 6A | Cooked PHF is cooled from 140 °F (60 °C) to 70 °F (21 °C) within 2 hours and from 140 ○F (60 °C) to 41 °F (5 °C) or below within 6 hours | 1 | 1 | 18 | 85 |
| 6B | PHF (prepared from ingredients at ambient temperature) is cooled to 41 °F (5 °C) or below within 4 hours | 3 | 2 | 15 | 85 | |
| 6C | Foods received at a temperature according to Law are cooled to 41 °F (5 °C) within 4 hours | 8 | 0 | 45 | 52 | |
| 7A | PHF is maintained at 41 °F (5 °C) or below, except during preparation, cooking, cooling or when time is used as a public health control. | 88 | 17 | 0 | 0 | |
| 8A | PHF is maintained at 140 °F (60 °C) or above, except during preparation, cooking, or cooling or when time is used as a public health control. | 3 | 3 | 1 | 98 | |
| 8B | Roasts are held at a temperature of 130 °F (54 °C) or above | 0 | 0 | 0 | 105 | |
| 9A | Ready-to-eat PHF held for more than 24 hours is date marked as required (prepared on-site) | 7 | 18 | 2 | 78 | |
| 9B | Discard RTE PHF and/or opened commercial container exceeding 7 days at ≤ 41 °F (5 °C) or 4 days at ≤ 45 °F (7 °C) | 9 | 9 | 53 | 34 | |
| 9C | Opened Commercial container of prepared ready-to-eat PHF is date marked as required | 10 | 45 | 11 | 39 | |
| 9D | When time only is used as a public health control, food is cooked and served within 4 hours as required | 1 | 0 | 1 | 103 | |
| Contaminated Equipment/Protection from Contamination | 10A | Food is protected from cross contamination by separating raw animal foods from raw ready-to-eat food and by separating raw animal foods from cooked ready-to-eat food | 75 | 23 | 3 | 4 |
| 10B | Raw animal foods are separated from each other during storage, preparation, holding, and display | 72 | 16 | 0 | 17 | |
| 10C | Food is protected from environmental contamination -- critical Items | 97 | 8 | 0 | 0 | |
| 10D | After being served or sold to a consumer, food is not re-served | 23 | 0 | 26 | 56 | |
| 11A | Food-contact surfaces and utensils are clean to sight and touch and sanitized before use | 68 | 37 | 0 | 0 | |
| Poor Personal Hygiene | 12A |
