AFSA

• Assessment no.

• Document No.

• Audit Title - Premise code

• Client / Site

• Manager / Proprietor

• Location
  Address

• Conducted on

  Date

• Prepared by

Receiving

• Protection from contamination (5(1) of 3.2.2)

  Yes

  No

  N/A

• Identification / traceability of food (5(2 of 3.2.2)

  Yes

  No

  N/A

• Temperature control of PHF(5(3) and (4) of 3.2.2)<br>

  Yes

  No

  N/A

Storage

• Protection from contamination (6(1)(a) of 3.2.2)<br>

  Yes

  No

  N/A

• Appropriate environmental conditions(6(1)(b)of 3.2.2)

  Yes

  No

  N/A

• Temperature control of PHF inc frozen(6(2)of 3.2.2)

  Yes

  No

  N/A

Processing

• Safety and suitable food (7(1)(b)(I) of 3.2.2)

  Yes

  No

  N/A

• Protection from contamination(7(1)(b)(I) of 3.2.2)

  Yes

  No

  N/A

• Adequate cooking / processing (7(1)(b)(ii) of 3.2.2)

  Yes

  No

  N/A

• PHF out of temp control for min time(7(2) of 3.2.2)<br><br><br>

  Yes

  No

  N/A

• Cooling of PHF(7(3) of 3.2.2)

  Yes

  No

  N/A

• Reheating of PHF(7(4)of 3.2.2)

  Yes

  No

  N/A

Display

• Temperature control of PHF inc frozen(8(5) of 3.2.2)<br>

  Yes

  No

  N/A

• Protection from contamination (8(1),(2),(3) & (4) of 3.2.2)

  Yes

  No

  N/A

Packaging

• Appropriate material and process(9 of 3.2.2)

  Yes

  No

  N/A

Transportation and Distribution

• Protection from contamination(10(a) of 3.2.2)

  Yes

  No

  N/A

• Temperature control of PHF(10(b) &(c) of 3.2.2)<br>PHF means potentially hazardous food. See last page for definition.

  Yes

  No

  N/A

Recalling / Food Disposal

• Food for disposal not sold / recall process(11,12 of 3.2.2) <br>

  Yes

  No

  N/A

Health Hygiene and Knowledge

• Health of food handler -responsibilities(14 of 3.2.2)

  Yes

  No

  N/A

• Hygiene of food handlers -responsibilities(15 of 3.2.2)

  Yes

  No

  N/A

• Food business - responsibilities(16,18 of 3.2.2)

  Yes

  No

  N/A

• Adequate hand washing facilities(17 of 3.2.2 and 14 of 3.2.2)

  Yes

  No

  N/A

• Food handling-skill and knowledge(3 of 3.2.2)

  Yes

  No

  N/A

Premises and Hygiene

• Cleanliness of premises fittings, equipment(19 of 3.2.2)

  Yes

  No

  N/A

• Cleaning / sanitising of food contact surfaces(20 of 3.2.2)

  Yes

  No

  N/A

• Suitability and maintenance of premises, fittings and equipment(21 of 3.2.2 and 3,10,11 & 12 of 3.2.3)

  Yes

  No

  N/A

• Temperature measuring device (22 of 3.2.2)

  Yes

  No

  N/A

• Use of "single use" item (23 of 3.2.2)<br><br><br><br><br>

  Yes

  No

  N/A

• Control of animal and pests (24 of 3.2.2)

  Yes

  No

  N/A

• Water supply adequate and potable (4 of 3.2.3)

  Yes

  No

  N/A

• Disposal of sewage and waste water( 5 of 3.2.3)

  Yes

  No

  N/A

• Storage of refuse and recyclable matter (6 of 3.2.3)

  Yes

  No

  N/A

• Adequate ventilation and lighting (7 & 8 of 3.2.3)

  Yes

  No

  N/A

• Storage of personal effect / chemical(15 of 3.2.3)

  Yes

  No

  N/A

• Adequate toilet facilities (16 of 3.2.3)

  Yes

  No

  N/A

Further Action

• Nil

• Reinspection

• Expiation/Notice

• Please attend to any outstanding items by due date.For enquiries contact the officer on the number below.

  Date

• Letter

• Order/Notice

• Signature of proprietor /staff

  Sign

• Environmental Health Officer

  Sign

• Officer contact number