HICCP

Unannounced Certification
Checklist
for
Department of Education
 Inspector’s Full Name:

Is this Certification during the Summer School period? [ ] Yes [ ]No

Inspection Date: (MM/DD/YYYY) ____ / ____ / ________

School Code (SF Code):

School Name:

School Address:

School Borough:
[ ] Manhattan [ ] Bronx [ ] Queens [ ] Brooklyn [ ] Staten Island

Type of Inspection:
[ ] Initial Certification (New School) [ ] Certification Renewal
[ ] Unannounced [ ] Remediation

Inspector Status: [ ] Certified Inspector [ ] Trainee

Appointed Inspection Time: ______ : ______ [ AM / PM]

Time Signed In: ______ : ______ [ AM / PM]

Time Signed Out: ______ : ______ [ AM / PM]

(Complete the following after completing sign-out and inspection)

School Halal Inspection Evaluation: [ ] Pass [ ]Fail [ ] Re-visit

Inspector’s Signature:

Are there other schools attached to this building besides the school you are inspecting? If so, please list the
other schools here:

What floor is the Kitchen located on?

From the front security desk, what are the directions for locating the kitchen?

1
 Check-in Questions Yes No

Were you asked to sign your signature at the Front Desk sign-in?

Did you sign into the Kitchen’s Visitor Log book?

Documents and information to ask from the Manager or Cook

The following are documents and information to be requested from the Manager (if present) or Cook. Please keep in mind
that the Manager is NOT obligated to be present for today’s entire observatory visit

Staff list of all current employees

HACCP inspection
DOH inspection
Halal approved items list (make sure is posted)
Halal menu list (make sure is posted)
Halal Certification (make sure is posted)

From what time is breakfast served? ___:____ AM/PM - ___:____AM/PM

From what time is lunch served? ___:____ AM/PM - ___:____ AM/PM

___:____ AM/PM - ___:____ AM/PM
___:____ AM/PM - ___:____ AM/PM

How many students are served breakfast?

How many students are served lunch?

How many total students are registered in the school?

What percentage of total students that eat in the cafeteria are consuming Halal? (1-100%)

PHASE 1: Delivery Inspection

This is the very first phase to check, and should be briskly done so that you can move on to the next phase.

Incident:

2
 Remedy:

Conclusion:

PHASE 2: Refrigerator and Freezer Inspection

Please use this unannounced visit to immediately inspect, not just Halal-labeled refrigerators and freezers,
but ALL refrigerators and freezers for any discrepancies. Is anything placed where it should NOT be? Be
sure to take photos of the Halal refrigerator and freezer’s contents. Be vigilant. Do not jump to conclusions.
After this phase, quickly move on to the next phase.

Incident:

Remedy:

Conclusion:

Is the Freezer area clean? [ ] Yes [ ] No [ ] Pending

Is the Refrigerator area clean? [ ] Yes [ ] No [ ] Pending

Are the Halal products stored separately from non-Halal? [ ] Yes [ ] No [ ] Pending

Halal products remain in boxes/pallets until fully depleted? [ ] Yes [ ] No [ ] Pending

Based on your inspection, are the Halal boxes clearly labeled? [ ] Yes [ ] No [ ] Pending

PHASE 3: Preparation Inspection

Please observe how the Halal food is being prepped and cooked. This phase comes right before the actual
serving. Since this inspection begins in the morning, the first meal they will be preparing as soon as you enter
the kitchen will be breakfast. Please carefully observe if they are preparing the Halal-foods on the
Halal-designated countertops. If they are not, do not quickly jump to conclusions, please inquire and
investigate. In this phase, you should know what is on the menu for today —both Halal and non-halal— so
you can know what to look out for in terms of any possible cross contamination during preparation. To find
out what is on the menu for today, inquire with the Manager or Cook.

3
Incident:

Remedy:

Conclusion:

MACHINES & STATIONS

Halal Machine S/N Machine Type Designation Swab
Test

S/N: [ ]Refrigerator [ ]Halal [ ]Pass

[ ]Freezer [ ]Mixed-use [ ]Fail
[ ]Oven [ ]N/A [ ]N/A
[ ]Warmer

S/N: [ ]Refrigerator [ ]Halal [ ]Pass

[ ]Freezer [ ]Mixed-use [ ]Fail
[ ]Oven [ ]N/A [ ]N/A
[ ]Warmer

S/N: [ ]Refrigerator [ ]Halal [ ]Pass

[ ]Freezer [ ]Mixed-use [ ]Fail
[ ]Oven [ ]N/A [ ]N/A
[ ]Warmer

S/N: [ ]Refrigerator [ ]Halal [ ]Pass

[ ]Freezer [ ]Mixed-use [ ]Fail
[ ]Oven [ ]N/A [ ]N/A
[ ]Warmer

S/N: [ ]Refrigerator [ ]Halal [ ]Pass

[ ]Freezer [ ]Mixed-use [ ]Fail
[ ]Oven [ ]N/A [ ]N/A
[ ]Warmer

S/N: [ ]Refrigerator [ ]Halal [ ]Pass

[ ]Freezer [ ]Mixed-use [ ]Fail
[ ]Oven [ ]N/A [ ]N/A
[ ]Warmer

S/N: [ ]Refrigerator [ ]Halal [ ]Pass

[ ]Freezer [ ]Mixed-use [ ]Fail
[ ]Oven [ ]N/A [ ]N/A

4
 [ ]Warmer

Oven: Is the staff putting Halal-approved items into the Halal-designated ovens?
(Make sure not to jump to conclusions and be very observant. Keep in mind that this kitchen may serve
two of the same items: one Halal and the other as non-Halal)

Is the staff putting Halal-approved items into the Haram ovens? [ ] Yes [ ] No

Is the staff putting Haram items into the Halal ovens? [ ] Yes [ ] No

Countertop [ ] Halal Only [ ] Mixed Use [ ] N/A

Do you see any Halal products on any unmarked countertops? [ ] Yes [ ] No

If Countertop is jointly used with non-halal products, how does the staff ensure no pathogens
from non-halal remain?

[ ] Water [ ]Water & Soap [ ]Water & Bleach [ ]Other: _____________________

Do you see some Halal products being prepared OUTSIDE of the Halal-designated
Countertop(s)? [ ]Yes [ ]No

Do all of the Machines have large and clear ‘Halal’-signs on them?

[ ] Yes [ ] No [ ] Pending [ ] Other:____________________

UTENSILS
Quantity Utensil Type Designation Swab Test
[ ] Pots [ ] Trays [ ] Soup Pans [ ] Serving tools [ ] Halal [ ]Mixed-use [ [ ] Pass [ ]Fail [ ] N/A
]N/A

[ ] Pots [ ] Trays [ ] Soup Pans [ ] Serving tools [ ] Halal [ ]Mixed-use [ [ ] Pass [ ]Fail [ ] N/A
]N/A

[ ] Pots [ ] Trays [ ] Soup Pans [ ] Serving tools [ ] Halal [ ]Mixed-use [ [ ] Pass [ ]Fail [ ] N/A
]N/A

[ ] Pots [ ] Trays [ ] Soup Pans [ ] Serving tools [ ] Halal [ ]Mixed-use [ [ ] Pass [ ]Fail [ ] N/A
]N/A

5
 Are the Utensils stored in a designated Halal area/container? [ ]Yes [ ]No [ ]Other

Are the Utensils marked/labeled exclusively for Halal usage? [ ]Yes [ ]No [ ]Other

Is staff currently using Halal-designated utensils while prepping the Halal food? [ ] Yes [ ] No

SIGNS
Clear Halal-sign for:

Freezer Refrigerator Oven Warmer Counter Top Sink

[ ] Yes [ ]No [ ] Yes [ ]No [ ] Yes [ ]No [ ] Yes [ ]No [ ] Yes [ ]No [ ] Yes [ ]No

PHASE 4: Serving Inspection

For this phase, please carefully observe how the halal-food is served, where it is placed in the serving
line and how the Halal-product flows from the Oven/Warmer to the serving area. Look out for any
visibility issues with the students, can they clearly see the Halal-option? Is the staff taking
precautions to avoid any cross contamination?

Incident:

Remedy:

Conclusion:

Where is the Halal product served?

[ ] In Halal designated serving location

[ ] In a Halal/Haram mixed serving location
[ ] Other:

What about the Halal product’s positioning in the serving line? Is the Halal food option clearly
visible for the consumer to see and choose as an option amongst the other non-Halal options?
[ ] Halal product is clear for consumer to see and choose as an option
[ ] Halal product is not clearly visible for consumers to see or choose
[ ] Other:

6
 Is there a ‘Halal’-sign at the serving area visible for consumers? [ ] Yes [ ] No
(Either on a stand, posted or hanging.
An upright plastic stand that holds a 8.5”x11” Halal-sign on the serving line is highly
recommended since it is removable)

How is the Halal product served?

[ ] Staff-served Cafeteria Style

[ ] Self-serve Buffet Style
[ ] Self-Serve Pre-packaged Stations
[ ] Vending Machine Stye
[ ] Other: ________________

Are they required to wear food safety gear while serving the Halal product? (e.g., gloves)

[ ]Yes [ ]No [ ]Other:___________________

Are they using separate gloves when touching Halal food? [ ]Yes [ ]No

Are they using separate Serving Utensils for the Halal product?

[ ] Yes, they’re using Halal-designated Utensils while serving the Halal product
[ ] No, they’re using the same Utensils between Halal and Haram food
[ ] Other

Is the serving area properly lit?

[ ]Yes [ ] No [ ] Other:________________

SIGNS
Clear Halal-sign for:

Serving line (optional) Plastic Stand (strongly recommended) Queue line (optional)

[ ] Yes [ ]No [ ] Yes [ ]No [ ] Yes [ ]No

PHASE 5: Waste Management Inspection

After serving the final lunch period, the staff will begin final cleanup. It is your responsibility to make sure the is
no cross contamination between Halal trays and Haram trays. Make sure they are being washed separately.
Confirm which trays are halal and which trays are not. Check to see where the Halal trays are left to dry .

7
Incident:

Remedy:

Conclusion:

CLEANING
How often is the kitchen cleaned? [ ] Once a day [ ] Twice a day [ ] Other:_____________

Are Halal-designated Pots, Pans, Trays washed SEPARATELY from Haram? [ ]Yes [ ]No [ ]Other

During cleanup, are the Halal Serving Utensils washed separately? [ ]Yes [ ]No [ ]Other

If Utensils are jointly used with non-halal products, how does the staff ensure no pathogens from
Haram elements remain? What is used to wash them?

[ ]Water & Soap [ ]Water & Bleach [ ]Other: ___________________

What chemicals are used to sanitize?

[ ] Water only [ ] Soap & Water [ ] Bleach & Water [ ] Soap, Bleach and Water [ ] Other

Does the facility have any bad odors due to poor ventilation?

[ ] Yes [ ] No [ ] Other

GARBAGE
How often are the garbage cans emptied? [ ] Once everyday [ ] Other: ______________

PHASE 6: Bathroom Inspection

Incident:

Remedy:

Conclusion:

8
Does Kitchen staff have a separate bathroom for themselves? [ ] Yes [ ] No

Men’s Staff Bathroom available? [ ]Yes [ ]No

Women’s Staff Bathroom available? [ ]Yes [ ]No

Does the bathroom have adequate soap available? [ ]Yes [ ]No [ ]Other

Are the Faucets running properly? [ ]Yes [ ]No [ ]Other

Who cleans the restrooms? [ ] Staff [ ] Janitor

How Often is the bathroom cleaned? [ ] Once a day [ ]Twice [ ]Other: ________

Signs for ‘Wash Hands’ visible upon entry and exit? [ ]Yes [ ]No

Signs for ‘Remove Apron’ visible upon entry and exit? [ ]Yes [ ]No

Is the bathroom properly ventilated? [ ]Yes [ ]No

PHASE 7: Inspection Records

Incident:

Remedy:

Conclusion:

When was the last HACCP inspection? (MM/DD/YYYY) ____ / ____ / ________

When was the last DOH inspection? (MM/DD/YYYY) ____ / ____ / ________

When was the last Halal Food inspection? [ ] N/A or ____ / ____ / ________

Has this school ever failed a food safety inspection? [ ]Yes [ ]No

If yes, when? (MM/DD/YYYY) ____ / ____ / ________

9
Is our Halal Certification posted and visible in the kitchen? [ ]Yes [ ]No [ ] Pending

Is the latest Halal Approved Items list posted in the kitchen? [ ]Yes [ ]No [ ] Pending

Is the latest Halal Serving Menu list posted in the kitchen? [ ]Yes [ ]No [ ] Pending

Have you ensured that all three of the aforementioned documents (Halal Certificate, Approved
Items list, and Serving Menu list) are posted next together and visible?
[ ]Yes [ ]No [ ] Pending

PHASE 8: Staff Evaluation

Incident:

Remedy:

Conclusion:

What is the total number of kitchen staff (including Manager)? _________

How many staff were present? ____ out of ____

Was the staff on time for the inspection? [ ] Yes [ ] No

Was the staff cooperative? [ ] Yes [ ] No

Was the staff engaged? [ ] Yes [ ] No

Did the staff allow adequate time for inspection? [ ] Yes [ ] No

How inclined is the Manager about integrating Halal in this Kitchen?

[ ] Not at all [ ]Slightly negative [ ]Neutral [ ]Slightly inclined [ ]Very enthusiastic [ ] N/A

How inclined is the Cook about integrating Halal in this Kitchen?

[ ] Not at all [ ]Slightly negative [ ]Neutral [ ]Slightly inclined [ ]Very enthusiastic [ ] N/A

10
How inclined is the Staff overall about integrating Halal in this Kitchen?

[ ] Not at all [ ]Slightly negative [ ]Neutral [ ]Slightly inclined [ ]Very enthusiastic [ ] N/A

Notes:

PHASE 9: Halal Training

Incident:

Remedy:

Conclusion:

After this visit, have all staff been trained? [ ] Yes [ ] No

How many total staff are trained? ____ out of ____

How many staff still remain untrained? ____ out of ____

Has the Manager been trained? [ ] Yes [ ] No

Has the Cook been trained? [ ] Yes [ ] No

PHASE 10: Contamination Risk

Incident:

Remedy:

Conclusion:

11
What is the contamination potential in this facility? Are there any issues in this particular school
that raises any concern for Halal-Haram cross-contamination?

[ ]None [ ] Low [ ] High

Does this facility require an immediate followup visit? [ ] Yes [ ] No

Final Comments:

*Go to first page to complete the sign out and inspection outcome*

12