Title Page

  • Conducted on

  • Prepared by

  • Location

Management & Documentation

Managing Visitors & Contractors

  • Visitors and contractors told to sign in using the Monitoring Module

Compliance Centre

  • Authorised persons know their Compliance Centre login details

  • Authorised persons know how to operate the Compliance Centre

  • Audit Module was being used by the site

Helpline

  • Management aware of Helpline

  • Food poisoning incidents reported to Helpline

  • Foreign body incidents reported to Helpline

  • Official officer visits reported to Helpline

  • Accidents reported to Helpline

Monitoring Module Record (H&S)

  • Weekly checks complete

  • Monthly checks complete

  • Monthly internal audit complete

  • Monthly H&S Compliance Review complete

  • Quarterly training review complete

  • Six monthly checks complete

Monitoring Module Records (Food Safety)

  • Delivery temperature Monitoring Module records complete

  • Morning checks (pre-12pm) Monitoring Module records complete

  • Afternoon checks (12pm-4pm) Monitoring Module records complete

  • Evening checks (4-12PM) Monitoring Module records complete

  • Late night checks (12pm-4am) Monitoring Module records (if applicable) complete

  • Weekly food safety review complete

  • Monthly food safety compliance review complete<br>

Chemical Control

  • Staff able to locate completed COSHH risk assessment for approved chemicals

  • Control measures listed in risk assessments followed

Risk Assessments - Statutory

  • 'Young Workers' risk assessment (where applicable) in place and sufficient

  • 'New and Expectant Mothers' risk assessment/policy in place and sufficient

  • Control measures listed in risk assessments followed

  • Risk assessments reviewed regularly

Risk Assessments - Work Practices

  • Control measures listed in the Lone Working risk assessment followed

  • Control measures listed in the Banking and Transit of Cash risk assessment followed

  • Control measures listed in the Violence to Colleagues risk assessment followed

  • Control measures listed in the Agency Workers & Temporary Colleagues risk assessment followed

Risk Assessments - Management

  • Risk assessments reviewed regularly

  • RA's adopted at site level

Asbestos Control

  • 'Managing Asbestos' Register in place and sufficient

  • Action points completed

  • Responsible person was confident if asbestos present on site

  • Identified asbestos suitably managed

Registry Module Items

  • Registry Module was being used by the site

  • Gas safety certification in date/action points in progress

  • PAT testing record in date/action points in progress

  • Electrical installation inspection in date/action points in progress

  • Kitchen duct cleaning in date/action points in progress<br>

  • Air con units/cooling towers clean/filters changed

  • Duty of Care Waste Carriers Licence

  • Boiler service report in date/action points in progress

  • Legionella Risk Assessment in place and sufficient

  • Employers Liability Compulsory Insurance Certificate in date

Fire Safety Management System Documentation

  • Fire risk assessment in place and sufficient

  • Fire risk assessment actions completed/signed off

  • Testing of annual fire system in place and sufficient

  • Testing of emergency lighting (External Contractor - annually) in place and sufficient

  • Testing of fire fighting equipment in place and sufficient

  • Fire suppression (Ansul) system check (where applicable) in place and sufficient

Food Safety Management System Documentation

  • Documented Food Safety Management System available on site

  • Current Recipe Manual available

  • Medical health questionnaire in place and sufficient

  • Return to work medical health questionnaire in place and sufficient

  • The Shield Safety Group FSMS was adopted at site level

  • Responsibilities signed by relevant employees detailed in FSMS

Health & Safety Management System Documentation

  • The Health and Safety Policy Statement is on display

  • Roles and responsibilities signed by relevant employees

Pest Control Documentation

  • Pest control records in place and sufficient

  • Pest control company advice followed

  • Pest control bait plan in place and sufficient

  • Insecticide/rodenticide COSHH data in place and sufficient

  • EFK bulbs changed annually

Signs & Posters

  • HSE Health and Safety poster present

  • HSE Health and Safety poster complete

  • Copy of Employers Liability Compulsory Insurance Certificate to view

  • Premises license on display (if applicable)

  • Fire marshals named on signage

  • Appointed persons/first aiders indicated on signage

  • No smoking signage visible

  • Signage obstructed

First Aid Kit

  • Control measures listed in the Providing First Aid risk assessment followed

  • First aid kit(s) available

  • First aid kit fully stocked

  • First aid kit contains creams, tablets or sprays

  • First aid kit contains blue plasters for food handlers

  • Items in first aid kit are in date

Training Records - Health & Safety

  • Health and safety awareness training records in place and sufficient

  • Level 2 health and safety training records in place and sufficient

  • Appointed Person training records (Manager) in place and sufficient

  • Manual handling training records in place and sufficient

  • COSHH training records in place and sufficient

Training Records - Food Safety

  • Food hygiene awareness training records in place and sufficient

  • Level 2 food safety training records in place and sufficient

  • Allergen awareness training records in place and sufficient

  • Adequate levels of food safety training noted on site

Training Records - Fire Safety

  • Fire awareness training records in place and sufficient

  • Fire marshal training records (Manager) in place and sufficient

Staff Interview & Observations

  • Staff aware of fire safety arrangements

  • Staff aware of accident reporting procedure

  • Staff carry out positive manual handling practices

  • Staff with strong understanding of food safety

  • Staff with strong understanding of allergy information/procedures

  • No evidence of staff smoking in non permitted/unauthorised areas

  • Are there any major concerns in food safety noted

Structure & Environment

Walls

  • Walls are in good condition

  • Glass in good condition and not smashed or cracked

  • Wall paint in good condition

  • Wall covering/material suitable for food rooms

  • Hand rail to steps present

  • Hand rail to steps not faulty

Floors

  • Control measures listed in Slips, Trips and Falls risk assessments followed

  • Floor in good condition

  • Floor level changes clearly marked

  • Floor level change is appropriate and does not require any structural work

  • Worn steps are repaired or replaced

  • Edging to steps clearly marked or painted

  • Non-slip surface required on floor/steps in place and sufficient

  • Floor not considered slippery when wet

  • Spillages to floors/steps dealt with appropriately

Housekeeping & Environment

  • Cables are neat and tidy

  • Good general housekeeping evident

Ceilings

  • Ceiling in good condition

  • Ceiling tiles all present

  • Ceiling vents and covers all present

  • Ceiling paint in good condition

  • Padding/signage present for low ceilings

Environmental Conditions

  • Adequate levels of lighting

  • Diffuser covers on strip lighting (in food areas) all present

  • Bulbs working (posing a risk to health and safety)

  • Adequate drainage

Structural Pest Control

  • No evidence of rodent infestation

  • No evidence of insect/fruit fly infestation

  • Pest proofing adequate

  • Electric Fly Killer (EFK) present

  • Bristle strip to external door in place and sufficient

  • No potential sources of harbourage for pests

Fire Safety Structure

  • Fire escape route(s) clear and not obstructed

  • Fire door(s) clear and open/close freely

  • No internal fire door(s) propped/wedged open

  • Signage to alarm call points/equipment present

  • Fire signage not obstructed

  • Adequate amount of fire evacuation notices

  • Content of fire evacuation notice adequate

  • Adequate storage of combustible materials

Maintenance Areas

  • Plant room door locked

  • Boiler Room door locked

  • Access to electrical areas restricted

  • Access to loft/roof is restricted

Staff Facilities

  • Storage area for staff belongings

  • Staff belongings stored away from working areas

  • Lockers available and in good condition

  • Stock stored in staff room

  • Designated staff smoking area/area untidy

Staff Toilets

  • Staff toilets in good condition

  • Staff toilets are clean

  • Soap available in staff toilets

  • Soap in dispenser in staff toilets

  • Paper towels/air dryer available in staff toilets

  • Paper towels in dispenser in staff toilets

  • Toilet paper in toilets

  • 'Wash your hands' signs in staff toilets

  • No damaged/broken mirror in toilets

External Refuse Disposal

  • Control measures listed in Emptying Bins risk assessments followed

  • Bin area clean

  • Bin lids closed

  • Bin lids present and in good condition

  • Sufficient bin collections

  • Floor area even and in good condition

  • Adequate lighting (evenings)

External Refuse Disposal - Compactor

  • The waste compactor was adequately managed

  • Key not left in waste compactor

  • Emergency stop button/interlocking mechanism working

Electrical Safety

  • Control measures listed in Electrical Equipment risk assessments followed

  • Emergency shut off/isolation switches clearly signed/ labelled

  • Emergency shut off valve adequate and not obstructed

  • No damaged electrical equipment

  • No damaged electrical wiring

  • Plug sockets/adaptors not overloaded

  • Correct plug adaptors in use

  • Electric fuse box access restricted

  • Electric cupboard/plant rooms locked

Gas Safety

  • Control measures listed in Gas Safety risk assessments followed

  • Emergency gas shut off clearly signed/labelled

  • Emergency gas shut off valve adequate and not obstructed

  • Gas Cylinders (Propane etc.) correctly stored

Customer Care - Internal Areas

  • Straps on high chairs in good condition (if Chopstix/ Yangtze owned)

  • Babies bottles (not Policy to do so)

  • Customer area tidy (if Chopstix/ Yangtze owned)

  • Furniture not damaged or worn (if Chopstix/ Yangtze owned)

Customer Care - External Areas

  • External area not damaged/worn

  • External area clean

  • External canopy or signage clean

Work Practices

Temperature Probe

  • Working temperature probe

  • Probe test completed correctly

  • Probe cleaned between uses

  • Probe wipes available

  • Probe wipes were not dry

  • Probe not damaged

  • Probe stored correctly

Delivery

  • Only approved suppliers used

  • Chilled/frozen deliveries put away within 30 mins

  • Delivery procedures suitable

  • Good structural condition of loading area

Personal Hygiene

  • Food handlers hands in good condition

  • Food handlers do not wear jewellery/watches

  • Hats worn

  • Uniform is clean

  • Suitable footwear

  • Food handlers not ill/show signs of food poisoning

  • Long hair tied up

  • Food handlers shaven

  • Staff use gloves if appropriate

Wash Hand Basins

  • Wash hand basin

  • Wash hand basin obstructed

  • Adequate number of wash hand basins

  • Wash hand basin ideally situated

  • Wash hand basin is clean

  • Staff not using whb for food/utensils

  • Hot water to wash hand basin

  • Hot water tap not damaged/broken

  • Cold water to wash hand basin

  • Cold water tap not damaged/broken

Hand Washing

  • Hand soap to whb

  • Paper towels to whb

  • Staff washing hands when required

  • Staff washing hands correctly

  • Staff not washing hands in food wash sink

Physical Contamination

  • No pins on notice board in kitchen/storage

  • Staff not wearing clothing with pockets (if presents a risk)

  • Electric Fly Killer (EFK) positioned appropriately

  • No glass stored in food preparation area

  • Empty containers stored correctly

  • Chopping boards not worn or damaged

  • No damaged equipment/kitchen work surface

  • Food covered

Cleaning - Floors

  • No evidence of grime/dirt to floor

Cleaning - Walls

  • No evidence of grime/dirt to walls

Cleaning - Ceiling

  • No evidence of grime/dirt to ceiling

Cleaning - Surfaces

  • No evidence of grime/dirt to surfaces

  • Hand contact surface cleaned/sanitised

  • Food contact surface cleaned/sanitised

  • Food contact items washed correctly

Cleaning - Equipment

  • Hot water for cleaning activities

  • No evidence of grime/dirt to equipment

  • Access to areas restricted due to fixed equipment

  • Multi stage cleaning process in use

  • Staff aware of sanitiser contact time

Ventilation

  • Control measures listed in Changing Grease Filters risk assessments followed

  • Adequate ventilation

  • Extraction grease filters clean

  • Ventilation canopy clean

Cleaning Materials

  • Control measures listed in Using Cleaning/Cleaning Materials risk assessments followed

  • No insufficient or damaged cleaning cloths

  • Sanitiser spray in use with correct concentration

  • No dirty cloths being used

  • Adequate cleaning schedule

  • Cleaning schedule followed

  • Cleaning records complete

  • Cleaning equipment stored correctly

  • Colour coded cleaning equipment used

Chemical Control

  • No risk of food contamination by chemicals

  • PPE in place and sufficient

  • PPE in good condition or clean

  • Chemicals stored appropriately

  • Chemical stored in marked containers

  • Only approved chemicals in use

  • Chemicals stored in lockable cupboard

Cooking, Reheating & Hot Holding

  • Food cooked/reheated above 75°C (or equivalent time/temp combination)

  • Food hot held above 63°C

  • Food being cooked/reheated prior to hot holding

  • No evidence of food being reheated more than once

  • Food discarded after 2 hours of hot holding (if dropped below 63°C)

  • Hot held food adequately protected

  • Hot held food being replenished appropriately

  • High-risk food not held for longer than 4 hours out of refrigeration

Defrosting

  • Defrosting foods adequately covered

  • Correct defrosting method used

Date Labelling

  • No unfit food noted

  • Product within use by date

  • Product within best before date

  • Product within in-house date label

  • Date label on all products

  • Open products labelled

  • Product shelf life not exceeding stipulated durability on company Shelf Life Chart

  • Evidence of good stock rotation (FIFO)

Dry Good Storage

  • Product stored off the floor

  • No open bags and lids on products

  • Dry goods area stocked appropriately

  • Open sauces stored seperately from dry storage area

  • Racking suitable

  • Racking in good condition

  • Sufficient storage space

  • Items stored below shoulder height

Refrigerated Storage

  • Refrigerator/display unit operating at or below 5°C

  • Refrigerator/display unit operating at or below 8°C

  • Refrigerator/display unit not overloaded

  • Refrigeration unit clean

  • Door seals clean and in good condition

  • Product stored off the floor

  • Product stored covered

  • Product appropriately stacked

Refrigerated Storage Equipment

  • Control measures listed in Walk-in Chiller and Freezer risk assessments followed

  • No damaged/missing fridge(s) handles

  • No damaged/missing fridge(s) seals

  • No evidence of rust to refrigerator

  • No damaged or rusting shelving

  • Condenser clean and not blocked

  • No items stored on top of cold room/refrigerator

  • Coldroom opening/closing mechanism in good condition

Frozen Storage

  • Freezer operating at or below -18°C

  • Frozen product colder than -12°C

  • Freezer unit not overloaded

  • Door seals clean and in good condition

  • Freezer unit clean

  • Product stored off the floor

  • Product stored covered

  • Product appropriately stacked

  • Freezer defrosted regularly and no build up of ice

Frozen Storage Equipment

  • Control measures listed in Walk-in Chiller and Freezer risk assessments followed

  • No damaged or missing freezer(s) handles

  • No damaged or missing freezer(s) seals

  • No evidence of rust to freezer

  • No damaged or rusting shelving

  • Condenser clean and not blocked

  • No items stored on top of freezer

  • Freezer opening/closing mechanism in good condition

Food Transportation

  • Transported foods protected from risk of contamination

  • Adequate procedures for transporting hot food

Manual Handling

  • Control measures listed in the Manual Handling risk assessments followed

  • Manual handling or lifting aids in good repair

  • Delivery cages/trolleys not overloaded

Working at Height

  • Control measures listed in Ladders/Work at Height risk assessments followed

  • Ladders damaged/in good condition

  • Kickalongs in good condition

Knives & Sharp Equipment

  • Correct storage of knives/sharp equipment

  • Knives used/sharpened/cleaned safely

Burns & Scalds

  • Oil changing procedures sufficient

  • Good management of hot pans/moving of pans or trays/positioning of pan handles

Ice

  • Ice machine clean/well maintained

  • No ice/pooling water around machine

  • Ice scoop not stored in machine/storage area

  • No glass stored around machine

  • No items stored in ice

Allergens

  • Allergens separate in food storage area

  • Allergen poster on display to staff

  • Allergen info signposted to customers

  • Staff with strong understanding of allergy information/procedures

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.