City of Busselton Low Risk Inspection Report - including Cellar Door

• Site conducted

  Select

• Manager / Proprietor

• Date

  Date

• Risk Rating

  Low

  Medium

  High

  Exempt

• Follow up inspection required on:

  Date

• Select date

  Date

• Additional follow up or inspection

  Date

• Prepared by

• Premises Address
  Address

• INSTRUCTIONS
  
  1. Please answer "Compliant", "Non-Compliant" or "N/A" on the questions below.
  2. Add Photos and Notes by clicking on the Paperclip icon
  3. To add a Corrective Action click on the Paperclip icon then "Add Action", provide a description, assign to a member, set priority, and due date
  4. Complete audit by providing digital signature
  5. Share your report by exporting as PDF, Word, Excel or Web Link
  

Display & Storage

• Storage - Protection from contamination

  Compliant

  Non-Compliant

  N/A

• Add media

  Media

• Storage - Temperature control of PHF

  Compliant

  Non-Compliant

  N/A

• Add media

  Media

Packaging & Labelling

• Appropriate materials & labels

  Compliant

  Non-Compliant

  N/A

Recall

• Recall plan in place

  Compliant

  Non-Compliant

  Not Observed

  N/A

Hand wash basin

• Adequate handwashing facilities

  Compliant

  Non-Compliant

  Not Observed

  N/A

Premises and hygiene

• Cleanliness of premises, fittings & equipment

  Compliant

  Non-Compliant

  N/A

• Maintenance of premises & equipment

  Compliant

  Non-Compliant

  N/A

• Adequate Ventilation & lighting

  Compliant

  Non-Compliant

  N/A

• Water supply scheme or treated

  Compliant

  Non-Compliant

  N/A

Completion

• General Comments

• Assessed by: (Officer's Name and Signature)

  Sign

• Manager/Staff: (Staff Name and Signature)

  Sign