Food Safety (2)

• Document No.

• Self assessment questionnaire administered during a visit.

• Uniform ref:

• Food Business Name

• Location
  Address

• Conducted on

  Date

• Officer:

Details of business

• If any of your details in this box are incorrect or missing, please amend the details clearly. Cross through any incorrect information and print any new details using capital letters. If necessary please attach a separate sheet of paper.

• Proprietors Name:

• Managers Name:

• Trading Name:

• Premises Address:

• Telephone Number:

• Mobile Number:

• Email Address:

• Is there a separate head office?

  Yes

  No

  N/A

• Business Name

• Address

• Email

Section 2

• Which of the following best describes your business ? (Please tick one box only)

• Restaurant/Café/Canteen

• Pub/Club

• Caring Establishment (eg. care home)

• Village hall / Community centre

• Importer / Exporter

• Home Caterer

• Hotel/ Guest House

• Take-away

• Mobile food unit (selling ready to eat food – hot or cold)

• Small retailer (e.g. grocer, confectioner, fishmonger, green grocer, health food shop, baker newsagent, off licence, garage mini market, small supermarket etc)

• Distributor

• Other

• Please describe:

Section 3

• Please describe the nature of your business.

Section 4A

• Do you?

• Operate the Safer Food Better Business food safety management system?

• Operate any other food safety management system?

• Keep records of temperature checks?

• Sell bought in sandwiches/rolls?

• Sell frozen foods?

• Keep up to date training records?

• Keep a record of all your suppliers?

• Provide your staff with food safety training?

• Sell unwrapped meat?

• Make sandwiches?

• Use a refrigerator?

• Keep or handle food on the premises?

• Display hot foods (e.g. pies/pasties/sausage rolls)?

Section 4B

• Do you ...

• Use any of the following equipment for food preparation? • bandsaw • mincer • slicing machine

• Have an internal staircase or corridor which leads from the commercial premises to other types of occupancy, e.g. sleeping accommodation?

• Have a trap door in the floor that provides access to any basement area?

• Operate a gaming machine on the premises?

• Sell or supply alcohol?

Section 5

• Do you do any of the following at these premises?

• Cook food from raw?

• Cook-chill food processing?

• Sous-vide food processing (i.e. low temperature cooking of food in airtight plastic bags)

• Vacuum pack food?

• Keep food hot ready for service/sale?

• Are you part of a ...

• local chain?

• National chain?

• Franchise?

• International chain?

• Signed

  Sign

• Position in business?