Académique Documents
Professionnel Documents
Culture Documents
Reg. No:
Officer:
1st
2nd
3rd
Date:
1st
2nd
3rd
1st
2nd
3rd
Person Interviewed:
1st
2nd
3rd
Registration Form:
1st
2nd
3rd
3rd Inspection
Complaints to Investigate
1st Inspection
1st Inspection
2nd Inspection
2nd Inspection
3rd Inspection
3rd Inspection
2nd Inspection
3rd Inspection
Key:
Yes
GENERAL STANDARDS
Training, Instruction and Supervision
1st
2nd
3rd
Adequate supervision
Refresher training
Comments/Deficiencies:
1st
2nd
3rd
Certificates seen
Cleanliness/Repair
1st
Structure/surfaces clean
Structure/surfaces good repair
Equipment clean
Equipment good repair
2nd
3rd
Comments/Deficiencies:
1st
2nd
3rd
No
n/a
Key:
Yes
Personal Hygiene
Implementation of personal
hygiene policy as detailed in
FH1
1st
2nd
3rd
Comments/Deficiencies:
1st
2nd
3rd
Excess Waste
Internal storage adequate
External storage adequate
Suitable Disposal (incl ABP)
1st
2nd
3rd
Comments/Deficiencies:
1st
2nd
3rd
Pest Control
1st
Free from pests
Adequate procedures in place
Records examined
2nd
3rd
Comments/Deficiencies:
1st
2nd
3rd
No
n/a
Key:
Yes
HAZARD ANALYSIS
General
1st
2nd
3rd
1st
2nd
3rd
Receipt of Goods
Controls and Monitoring
Checks documented
Aware of hazards
Storage
Controls and Monitoring
1st
2nd
3rd
Adequate temperatures
Condition of foods
Aware of hazards
Comments/Deficiencies:
1st
2nd
3rd
Comments/Deficiencies:
1st
2nd
3rd
Comments/Deficiencies:
1st
2nd
3rd
No
n/a
Key:
Preparation
Controls and Monitoring
1st
2nd
3rd
Time separation
Surfaces sanitised
Use/control of cloths
Aware of hazards
Yes
Comments/Deficiencies:
1st
Cooking
Controls and Monitoring
1st
2nd
3rd
Suitable time/temperatures
Calibration of probe
Aware of hazards
2nd
3rd
Comments/Deficiencies:
1st
2nd
3rd
No
n/a
Key:
Cooling
Controls and Monitoring
1st
2nd
3rd
Cooling undertaken
Documented records
Aware of hazards
Reheating
Controls and Monitoring
1st
2nd
3rd
Reheating undertaken
Suitable time/temperatures
Aware of hazards
Hot Holding
Controls and Monitoring
1st
2nd
3rd
Suitable time/temperatures
o
ers of hazards
Aware
Yes
Comments/Deficiencies:
1st
2nd
3rd
Comments/Deficiencies:
1st
2nd
3rd
Comments/Deficiencies:
1st
2nd
3rd
No
n/a
Key:
Chill Display
Controls and Monitoring
1st
2nd
3rd
Suitable time/temperatures
Transportation
Controls and Monitoring
1st
2nd
3rd
Food transported
Suitable time/temperatures
Yes
Comments/Deficiencies:
1st
2nd
3rd
Comments/Deficiencies:
1st
2nd
3rd
SUPPLEMENTARY ISSUES
Miscellaneous
1st
2nd
3rd
Use of egg
Awareness of allergies
Comments/Deficiencies:
1st
2nd
3rd
No
n/a
INSPECTION OUTCOME
Officers Assessment of Hazard Analysis at Time of Inspection
Assessment (indicate correct statement with a tick)
1st Inspection
2nd Inspection
3rd Inspection
1st Inspection
Scope of inspection limited: Y / N
Health and Safety issues identified: Y / N
Sampling Required: Y / N
Action:
Verbal Advice
Letter
Formal Action
Hazard Rating:
C1
C2
2nd Inspection
Scope of inspection limited: Y / N
Health and Safety issues identified: Y / N
Sampling Required: Y / N
Action:
Verbal Advice
Letter
Formal Action
Hazard Rating:
C1
C2
3rd Inspection
Scope of inspection limited: Y / N
Health and Safety issues identified: Y / N
Sampling Required: Y / N
Action:
Verbal Advice
Letter
Formal Action
Hazard Rating:
C1
C2