Title Page
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Site conducted
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Conducted on
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Prepared by
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Location
Audit Scope
Scope
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Provide a brief description of the department, procedure, element, program, or area being audited.
Policy/Procedure
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Is there a policy that defines the integrated pest control system?
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What documents contain that policy?
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Who manages the pest control system (all parties)?
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What pests are intended targets of pesticide application?
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What forms of pest control are utilized at the facility?
Physical Site
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Is there any evidence of pest infestation at the facility?
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What pests were observed and where?
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Is there any history of pest infestation according to pest control logs?
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Explain
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Are there any obstructions in the rat run?
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Explain
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Are there any conditions present at the facility that could attract or harbor pests?
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Explain
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Do all pest control devices appear to be in working order?
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Explain
Responsibilities
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Who is responsible for ensuring pest control contractors are following appropriate protocols?
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Who performs inspections of pest control devices?
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With what frequency are pest control device inspections performed?
GMP
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Are pest control contractors trained on the company GMP policy?
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How is the training documented?
Food Safety
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Do any pest control devices contain hazardous (poisonous) material?
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Where are such devices located?
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Are there SDS's on file for all poisons and pesticides used for pest control?
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Why not?
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Are any methods employed to prevent pests from entering the facility instead of just controlling the ones that do?
Quality
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What is the quality department's role in the pest control system?
Electronic Records
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Are any form or records stored electronically?
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What are they?
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Are all electronic records stored in a secure location?
Record Retention
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Where and how are physical records such as inspection reports and SDS's stored?
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Is the program up to date?
Details
Audit Details
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Documents reviewed:
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Evaluation Summary:
Findings
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Minor
Minor Finding
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Description of Finding
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Major
Major Finding
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Description of Finding
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Critical
Critical Finding
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Description of Finding
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Corrective actions from findings:
Follow-up
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Short term corrective actions completed?
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Date short term corrective actions completed
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Long term corrective actions completed?
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Date long term corrective actions completed
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Verifier of corrective action completion:
Results
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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
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Results communicated to auditee?
Signatures
Auditor
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Auditor Signature
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Auditor Title
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Date of Signature