OBSERVATION FORM - HEALTHY CANTEEN: NUTRITION GOES TO SCHOOL
Email address *
School Name *
Your answer
Name of School Principal *
Your answer
School Address *
Your answer
Name of Observer *
Your answer
Group Name *
Your Group Name
Your answer
Rules
Put a check mark in YES answer if the particular item is PRACTICED or AVAILABLE or
put a check mark in NO answer if the particular item is NOT PRACTICED or NOT AVAILABLE at school, or
put a check mark in IRRELEVANT answer, if this item is IRRELEVANT/ UNSUITABLE to be asked for school condition.
1st Pillar - MANAGEMENT & COMMITMENT
1. A written commitment from the school to improve food safety in school canteen is available *
2. Healthy School team is established *
Notes for 1st Pillar
IF NECESSARY, the notes column can be used to record additional information on canteen’s condition during observation.
Your answer
2nd Pillar - HUMAN RESOURCES
3. Food handlers use Personal Protective Equipment (PPE), e.g. gloves, mask, and hair nets *
4. Food handlers maintain a high degree of personal cleanliness (clothes, hands) and health condition (not suffering from duiarrheaa, influenza, cough, etc.), do not have open wounds, and not use to much jewelry *
5. Food handlers have received training on food safety (food/ personal hygiene and sanitation) *
Notes for 2nd Pillar
IF NECESSARY, the notes column can be used to record additional information on canteen’s condition during observation.
Your answer
3rd Pillar - FACILITIES
6. A permanent school canteen building *
7. Canteen layout functioning to prevent contamination *
8. Non-absorbent, flat, and dry flooring surface *
9. Smooth, non-absorbent, and easy to clean wall surface *
10. Good ventilation to ensure air circulation for removing steam, gas, odor, and dust in the room *
11. Good lighting to assist during food processing and room cleaning *
12. Sufficient water supply *
13. Wastewater flows smoothly, sewage system shall be a close system and work well, drain shall be made of waterproof material *
14. Toilets available with sufficient clean water and soap *
15. Closed trash bins available and the waste shall be disposed regularly *
16. Hand washing stations provided with sufficient clean running water and soap *
17. Washing basins for utensils provided with sufficient clean running water and soap *
18. Cleaning kit available (broom, mop, brush, and cleaning materials) *
19.Preparation and serving area areprotected from animals (such as flies, cockroach, rats, cats, etc.) that can contaminate foods *
20. Efforts for keeping foods away from pests and insects e.g. food cover, cupboard, insecator, fly trap, mouse trap, etc. *
21. Kitchen area is clean, having sufficient space, having smoke drain *
22. Dining area is clean and having sufficient space *
23. Washing, drying, and storage of cooking and eating utensils are proper and clean *
24. Using safe food container or packaging (not styrofoam or non-food grade plastic bag) *
25. Functionate food storage facility (refrigerator, freezer) *
26. Food tong or gloves used to prevent contamination *
27. Protected food serving or display *
Notes for FACILITIES
IF NECESSARY, the notes column can be used to record additional information on canteen’s condition during observation.
Your answer
4th Pillar - FOOD QUALITY
28. Foods expected not containing hazardous chemical substances, e.g. formalin, borax, textile dyes *
29. Nutrient rich foods available (vitamin, mineral, protein) *
Notes for 4th Pillar
IF NECESSARY, the notes column can be used to record additional information on canteen’s condition during observation.
Your answer
A copy of your responses will be emailed to the address you provided.
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