Food Establishment Pre-Opening Questionnaire

Food Establishment Pre-Opening Questionnaire

Southwest District Health (SWDH) encourages all businesses within our district to follow the phases outlined in the Guidelines for Opening Up Idaho available at https://rebound.idaho.gov. The Recommended Guidance for Food Establishments document is intended to help food establishments to plan for safe and appropriate business operations as allowed within the phases of reopening.

Please complete the following questionnaire below and submit for review prior to re-opening to:

Southwest District Health

13307 Miami Ln.
Caldwell, ID 83607
Fax: 208-455-5405
Email: Preopening.Plan@phd3.idaho.gov

Before opening your establishment:

  • Follow Idaho Food Code regulations
  • Retrain staff on all illnesses that they cannot come to work with
  • Throw away any previously opened food items
  • Discard any food items that are past the expiration or best by dates
  • Re-educate staff on cleaning and sanitizing practices
  • Provide listing of surfaces that are routinely touched by staff and customers and assign employee to disinfect their surfaces
  • Thoroughly clean and sanitize entire facility, especially if it has been closed.

Southwest District Health recommends establishments follow any local or state public health legal orders regarding opening and operating. Approval of this plan does not exempt establishments from legal orders in place by local or state public health authorities.

For each section please check yes or no and provide a statement as to how the items will be met. At the end of each section, we are supplying additional good practices that may be taken to reduce the risk of COVID-19 spread

If you have any questions filling out this form, please contact our office at (208) 455-5400.

You may CLICK HERE to download the Food Establishment Pre-Opening Questionnaire.  Please fill out and return to Preopening.Plan@phd3.idaho.gov or fax to 208-455-5405.

You may also fill out and submit the questionnaire electronically by using the form below.

Food Establishment Pre-Opening Questionnaire

Establishment Information
Name of Establishment:
Address of Establishment:
Contact:
Phone Number:
Email Address:
Verify Email:
Food Safety Measures
1
Does your establishment have self-service soda fountain, salad bar, buffets, and other self-service operations?
Self-service operations?
Please provide actions to be taken:
Please provide actions to be taken:
2
Will your establishment offer condiments, such as coffee creamer, sugar packages, ketchup, mustard and salsa to your customers and ensure they are protected? Examples include providing condiments in reusable containers if the container can be sanitized after every use. Single use packages, or portioned single service cups may also be used.
Condiments offered?
Please provide actions to be taken:
Please provide actions to be taken:
SWDH recommends when possible that the restaurant take into account the following items. These items will not delay the review of your plan. When available use single use utensils. Provide no touch waste bins in the kitchen and dining room. Ensure all employees food and drink are maintained in a dedicated area away from food, food prep, utensils, and equipment. Provide face masks when more than one staff member is in the assigned break area.
Cleaning and Sanitizing
3
What is your establishment’s plan to routinely disinfect commonly touched non-food contact surfaces e.g., counters, desks, seating, tables, chairs, digital ordering devices, pens, restrooms, door handles, menus, pens, and other areas used by customers or serving staff per CDC disinfection guidelines? See Human Touch list for equipment list for sanitizing.
Routinely disinfect?
Please provide actions to be taken:
Please provide actions to be taken:
SWDH recommends when possible that the restaurant take into account the following items. These items will not delay the review of your plan. Recommend providing additional temporary hand washing set ups in the dining area for guests to wash hands prior to eating. This set up should include soap, water, and single use paper towels. Provide hand sanitizer if possible. Have a disinfectant available for commonly touched surface that food is not placed on. Provide additional hand sanitizer at locations where staff may handle cash or credit cards. Provide single use non-medical gloves for staff handling cash or credit cards.
Employee Health Monitoring and Personal Hygiene
4
Will the facility develop a pre-shift health check of employees to help screen COVID-19 and other conditions when a food employee should be restricted or excluded?
Pre-shift health check?
Please provide actions to be taken:
5
Will the establishment discourage sharing of phones, headsets, desks, or other work tools and equipment?
Discourage tool sharing?
Please provide actions to be taken:
SWDH recommends when possible that the restaurant take into account the following items. These items will not delay the review of your plan. Attempt to maintain staff a minimum of six (6) feet apart when working in the kitchen. When possible, schedule the same group of staff to work on the same shifts to reduce risk of transferring illness to multiple shifts. Assign one employee to handle money or cards from guests to limit transfer. Limit the number of patrons allowed inside at one time.
Social Distancing Measures
6
Will the establishment post signage at entrance asking patrons to not enter if they feel ill with symptoms including fever, cough, and shortness of breath?
Symptom signage at entrances?
Please provide actions to be taken:
7
Will face masks and gloves be made available for servers or those that will be in close contact with guests or other employees?
Masks and gloves for servers?
Please provide actions to be taken:
8
Will your establishment require face masks be worn?
Require face masks?
Please provide actions to be taken:
9
Will social distancing be achieved where guests will be dining?
Social distancing for guests?
Please provide actions to be taken:
10
Will the dining room maintain tables at least six (6) feet apart from each other?
Tables 6 feet apart?
Please provide actions to be taken:
11
Will there be a seating limit to ten (10) people or less at each table? When updating the seating, consider revising access to and from the kitchen and restrooms to assist in mitigating proximity to employees and guests.
Limit seating =<10 per table?
Please provide actions to be taken:
12
Will guests in waiting areas maintain a distance of at least six (6) feet apart from other guests? Examples include signs or tape to designate six (6) feet spaces.
6 ft distancing for guests in waiting area?
Please provide actions to be taken:
13
Will the establishment’s menu provided to the customer be changed so it can be cleaned and disinfected between customers? Consider use of laminated menus that can be sanitized after use, single use menus that are discarded after use, menu boards, or electronic options.
Disinfect menus between customers?
Please provide actions to be taken:
SWDH recommends when possible that the restaurant take into account the following items. These items will not delay the review of your plan. Consider utilizing technology to reduce person to person interaction such as mobile menus, and offering texts to guests when their table is ready to reduce lines in waiting areas. Use of contactless forms of payments If possible control flow of guests in one door and out another. Position tables so that guests are not located under air returns.
Communication
14
Will the establishment implement a plan/strategy for employee education regarding ill employees for when they cannot come to work and a re-entry plan for when they can return to work?
Ill employee strategy?
Please provide actions to be taken:
15
Does the establishment have a plan for how information will be relayed to employees and those delivery operations and other business partners?
Communication plan between employees & partners?
Please provide actions to be taken:
For questions about filling out this form please contact Southwest District Health at (208) 455-5400.

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