ALL-IN-ONE RECORD FORM

• Conducted on

  Date

• Prepared by

• Location
  Address

Deliveries - 1

• Supplier's Name

• Are the van / driver clean and tidy?

  Yes

  No

  N/A

• Is there proper separation of raw and cooked / ready to eat food?

  Yes

  No

  N/A

• Chilled Food temperature

• Frozen food temperature

• Is the food packaging in good condition?

  Yes

  No

  N/A

• Is the food within date codes for 'use-by' or 'best-before'

  Yes

  No

  N/A

• Does the food delivered match the order and are you aware of the composition of the food?

  Yes

  No

  N/A

• Accept / reject food delivery

  Accept

  Reject

• Corrective Actions taken? Eg Review Supplier / Staff Training.

Deliveries 2

• Supplier's Name

• Are the van / driver clean and tidy?

• Is there proper separation of raw and cooked / ready to eat food?

• Chilled Food temperature

• Frozen food temperature

• Is the food packaging in good condition?

• Is the food within date codes for 'use-by' or 'best-before'

• Does the food delivered match the order and are you aware of the composition of the food?

• Accept / reject food delivery

  Accept

  Reject

• Corrective Actions taken? Eg Review Supplier / Staff Training.

  Yes

  No

  N/A

Refrigerators/Chill/Cold Display - Critical Limit 5oC

• Fridge 1 - AM

• Fridge 1 - PM

• Fridge 2 - AM

• Fridge 2 - PM

• Fridge 3 - AM

• Fridge 3 - PM

• Fridge 4 - AM

• Fridge 4 - PM

Freezers - Critical Limit: -18oC

• Freezer 1 - AM

• Freezer 1 - PM

• Freezer 2 - AM

• Freezer 2 - PM

• Freezer 3 - AM

• Freezer 3 - PM

• Freezer 4 - AM

• Freezer 4 - PM

Function checks (recommended once daily)

• Is food stored correctly?

  Yes

  No

  N/A

• Is food covered?

  Yes

  No

  N/A

• Is food dated?

  Yes

  No

  N/A

• Is cleaning schedule being followed?

  Yes

  No

  N/A

• Any corrective actions required?

  Yes

  No

  N/A

Cooking - Critical Limit: 75oC

Breakfast

• Item 1

• Temperature

• Item 2

• Temperature

• Item 3

• Temperature

• Corrective actions required?

  Yes

  No

  N/A

Lunch

• Item 1

• Temperature

• Item 2

• Temperature

• Item 3

• Temperature

• Corrective actions required?

  Yes

  No

  N/A

Evening

• Item 1

• Temperature

• Item 2

• Temperature

• Item 3

• Temperature

• Corrective Actions required?

  Yes

  No

  N/A

COOLING - Critical Limit: Less than 8oC within 90 minutes

• Item 1

• Start time

  Date

• Finish time

  Date

• Final temperature

• Item 2

• Start time

  Date

• Finish time

  Date

• Final temperature

• Any corrective actions required?

  Yes

  No

  N/A

THAWING - Critical Limit: Above 1oC (thawing only completed in fridge)

• Item 1

• Start Time

  Date

• Finish Time

  Date

• Temperature

• Any corrective actions required?

  Yes

  No

  N/A

REHEATING - Critical Limit: 82oC (Scotland) / 75oC (England)

• Item 1

• Temperature

• Item 2

• Temperature

• Any corrective actions required?

  Yes

  No

  N/A

HOT HOLDING - Critical Limit: 64oC

• Item 1

• Temperature

• Has the food item been discarded?

  Yes

  No

  N/A

SOUS VIDE

• Item 1

• Start time

  Date

• Finish Time

  Date

• Core temperature

Dishwasher

• Dishwasher rinse cycle operating temperature

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