Title Page

  • Site conducted

  • Conducted on

  • Prepared by

  • Location

Audit Scope

Scope

  • Provide a brief description of the department, procedure, element, program, or area being audited.

Policy/Procedure

  • Is there a policy that defines the integrated pest control system?

  • What documents contain that policy?

  • Who manages the pest control system (all parties)?

  • What pests are intended targets of pesticide application?

  • What forms of pest control are utilized at the facility?

Physical Site

  • Is there any evidence of pest infestation at the facility?

  • What pests were observed and where?

  • Is there any history of pest infestation according to pest control logs?

  • Explain

  • Is the rat run free of any obstructions?

  • Explain

  • Are there any conditions present at the facility that could attract or harbor pests?

  • Explain

  • Do all pest control devices appear to be in working order?

  • Explain

Responsibilities

  • Who is responsible for ensuring pest control contractors are following appropriate protocols?

  • Who performs inspections of pest control devices?

  • With what frequency are pest control device inspections performed?

GMP

  • Are pest control contractors trained on the company GMP policy?

  • How is the training documented?

Food Safety

  • Our pest control devices do not contain hazardous (poisonous) material.

  • Where are such devices located?

  • Are there SDS's on file for all poisons and pesticides used for pest control?

  • Why not?

  • Are any methods employed to prevent pests from entering the facility instead of just controlling the ones that do?

Quality

  • What is the quality department's role in the pest control system?

Electronic Records

  • Are any form or records stored electronically?

  • What are they?

  • Are all electronic records stored in a secure location?

Record Retention

  • Where and how are physical records such as inspection reports and SDS's stored?

  • Is the program up to date?

Details

Audit Details

  • Documents reviewed:

  • Evaluation Summary:

Findings

  • Minor

  • Minor Finding
  • Description of Finding

  • Major

  • Major Finding
  • Description of Finding

  • Critical

  • Critical Finding
  • Description of Finding

  • Corrective actions from findings:

Follow-up

  • Short term corrective actions completed?

  • Date short term corrective actions completed

  • Long term corrective actions completed?

  • Date long term corrective actions completed

  • Verifier of corrective action completion:

Results

  • Did the system being audited pass or fail?<br>Pass = <10 minor findings and no major or critical findings<br>Fail = >9 minor findings or any major or critical findings

  • Results communicated to auditee?

Signatures

Auditor

  • Auditor Signature

  • Auditor Title

  • Date of Signature

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