Food Poisoning Investigation Checklist

• Conducted on

  Date

• Evaluator name

• Location
  Address

Pre-Investigation

• How many individuals are affected?

• When were symptoms first reported?

  Date

• What symptoms were reported?

• As of writing, how long have symptoms been persisting?

• If applicable, how many workers missed out on work because of this?

• What are the common food items consumed among all affected individuals?

Food Poisoning Investigation Checklist

• Has the suspected source of foodborne toxins and illness identified and controlled?

  Yes

  No

  N/A

• Has the suspected food source been tested?

  Yes

  No

  N/A

• Has the vendor or creator of the food been contacted?

  Yes

  No

  N/A

• Were proper food safety and storage practices followed?

  Yes

  No

  N/A

• Were temperature control risks and food handling risks during transit and while in storage properly mitigated?

  Yes

  No

  N/A

• Were the food labels clear and easily readable?

  Yes

  No

  N/A

• Have the affected individuals been given the necessary support and medical help?

  Yes

  No

  N/A

• Have the affected individuals done the necessary testing and consultation?

  Yes

  No

  N/A

• Are the necessary test results, food investigation results, and reports properly documented and stored?

  Yes

  No

  N/A

Post- Inspection

• Have the necessary local authorities been notified?

  Yes

  No

  N/A

• What steps will be taken moving forward?

• Comments and recommendations

• Evaluator name and signature

  Sign