Food Safety Assessment

• Audit Title

• Document No.

• Conducted on

  Date

• Prepared by

  Select Kim Morrison - Environmental Health Officer Callum Morrison - Environmental Health Coordinator

  • Kim Morrison - Environmental Health Officer
  • Callum Morrison - Environmental Health Coordinator
• Location
  Address

• Client

GENERAL INFORMATION

• Reference No.

• Date and Time

  Date

• Authorised officer conducting assessment

  Kim Morrison - Environmental Health Officer

  Callum Morrison - Environmental Health Coordinator

• Business Name

• Name of proprietor or staff in attendance

• Premises Address
  Address

ASSESSMENT TYPE

• Reason for the assessment

  Select Assessment Class 1 Premises Assessment Class 2 Premises Annual Inspection Class 3 Premises Routine Inspection Follow Up - Routine Registration Inspection Complaint Inspection Other

  • Assessment Class 1 Premises
  • Assessment Class 2 Premises
  • Annual Inspection Class 3 Premises
  • Routine Inspection
  • Follow Up - Routine
  • Registration Inspection
  • Complaint Inspection
  • Other

RECEIVING

• 1. Protection from contamination (5(1) of 3.2.2)<br>

  Critically Non Compliant

  Marginal

  Compliant

• Select 1. Protection from contamination Do not accept deliveries of food unless they are in suitable or appropriate containers or packaging Do not accept deliveries of food which are in damaged containers or packaging

  • 1. Protection from contamination
  • Do not accept deliveries of food unless they are in suitable or appropriate containers or packaging
  • Do not accept deliveries of food which are in damaged containers or packaging

• Identification/traceability of food (5(2) of 3.2.2)

  Critically Non Compliant

  Marginal

  Compliant

• Yes

  No

  N/A

• Temperature control of PHF (5(3) and (4) of 3.2.2

  Critically Non Compliant

  Marginal

  Compliant

• Yes

  No

  N/A

STORAGE

• Protection from contamination (6(1)(a) of 3.2.2)

  Critically Non Compliant

  Marginal

  Compliant

• Select Nil Follow up Inspection Letter Order/Notice

  • Nil
  • Follow up Inspection
  • Letter
  • Order/Notice

• Appropriate environmental conditions (6(1)(b) of 3.2.2

  Critically Non Compliant

  Marginal

  Compliant

• Yes

  No

  N/A

• Temperature control of PHF inc frozen (6(2) of 3.2.2)

  Critically Non Compliant

  Marginal

  Compliant

• Yes

  No

  N/A

PROCESSING

• Safe and suitable food (7(1)(a) of 3.2.2)

  Critically Non Compliant

  Marginal

  Compliant

• Yes

  No

  N/A

• Protection from contamination (7(1)(b)(i) of 3.2.2)

  Critically Non Compliant

  Marginal

  Compliant

• Yes

  No

  N/A

• Adequate cooking/processing (7(1)(b)(ii) of 3.2.2)

  Critically Non Compliant

  Marginal

  Compliant

• Yes

  No

  N/A

• PHF out of temp. control for min. time (7(2) of 3.2.2)

  Critically Non Compliant

  Marginal

  Compliant

• Yes

  No

  N/A

• Cooling of PHF (7(3) of 3.2.2)

  Critically Non Compliant

  Marginal

  Compliant

• Yes

  No

  N/A

• Reheating of PHF (7(4) of 3.2.2)

  Critically Non Compliant

  Marginal

  Compliant

• Yes

  No

  N/A

DISPLAY

• Protection from contamination (8(1), (2), (3) & (4) of 3.2.2)

  Critically Non Compliant

  Marginal

  Compliant

• Yes

  No

  N/A

• Temperature control of PHF incl. frozen (8(5) of 3.2.2)

  Critically Non Compliant

  Marginal

  Compliant

• Yes

  No

  N/A

PACKAGING

• Appropriate materials and process (9 of 3.2.2)

  Critically Non Compliant

  Marginal

  Compliant

• Yes

  No

  N/A

TRANSPORTATION AND DISTRIBUTION

• Protection from contamination (10(a) of 3.2.2)

  Critically Non Compliant

  Marginal

  Compliant

• Yes

  No

  N/A

• Temperature control PHF (10(b) & (c) of 3.2.2)

  Critically Non Compliant

  Marginal

  Compliant

• Yes

  No

  N/A

RECALLS/FOOD DISPOSAL

• Food for disposal not sold/recall process (11, 12 of 3.2.2)

  Critically Non Compliant

  Marginal

  Compliant

• Yes

  No

  N/A

HEALTH, HYGIENE & KNOWLEDGE

• Health of food handlers - responsibilities (14 of 3.2.2)

  Critically Non Compliant

  Marginal

  Compliant

• Yes

  No

  N/A

• Hygiene of food handlers - responsibilities (13, 15 of 3.2.2)

  Critically Non Compliant

  Marginal

  Compliant

• Yes

  No

  N/A

• Food business - responsibilities (16, 18 of 3.2.2)

  Critically Non Compliant

  Marginal

  Compliant

• Yes

  No

  N/A

• Adequate hand washing facilities (17 of 3.2.2)

  Critically Non Compliant

  Marginal

  Compliant

• Yes

  No

  N/A

• Food handling - skills & knowledge (3 of 3.2.2)

  Critically Non Compliant

  Marginal

  Compliant

• Yes

  No

  N/A

PREMISES AND HYGIENE

• Cleanliness of premises, fittings, equipment (19 of 3.2.2)

  Critically Non Compliant

  Marginal

  Compliant

• Yes

  No

  N/A

• Cleaning/sanitising of food contact surfaces (20 of. 3.2.2)

  Critically Non Compliant

  Marginal

  Compliant

• Yes

  No

  N/A

• Suitability and maintenance of premises, fittings and equipment (21 of 3.2.2 and 3, 10, 11 & 12 of 3.2.2)

  Critically Non Compliant

  Marginal

  Compliant

• Yes

  No

  N/A

• Temperature measuring device (22 of 3.2.2)

  Critically Non Compliant

  Marginal

  Compliant

• Yes

  No

  N/A

• Use of "single use" items (23 of 3.2.2)

  Critically Non Compliant

  Marginal

  Compliant

• Yes

  No

  N/A

• Control of animals and pests (24 of 3.2.2)

  Critically Non Compliant

  Marginal

  Compliant

• Yes

  No

  N/A

• Water supply adequate and potable (4 of 3.2.3)

  Critically Non Compliant

  Marginal

  Compliant

• Yes

  No

  N/A

• Disposal of sewage and waste water (5 of 3.2.3)

  Critically Non Compliant

  Marginal

  Compliant

• Yes

  No

  N/A

• Storage of refuse & recyclable matter (6 of 3.2.3)

  Critically Non Compliant

  Marginal

  Compliant

• Yes

  No

  N/A

• Adequate ventilation and lighting (7 & 8 of 3.2.3)

  Critically Non Compliant

  Marginal

  Compliant

• Yes

  No

  N/A

• Storage of personal effects/chemicals (15 of 3.2.3)

  Critically Non Compliant

  Marginal

  Compliant

• Yes

  No

  N/A

• Adequate toilet facilities (16 of 3.2.3)

  Critically Non Compliant

  Marginal

  Compliant

• Yes

  No

  N/A

COMMENTS/ACTIONS TO BE TAKEN

• Additional comments and actions:

FURTHER ACTIONS

• Further Action?

  Nil

  Follow up Inspection

  Letter

  Order/Notice

REINSPECTION DATE

• Select date

  Date

SIGNATURES

• Proprietor/staff:
  The above information is true and correct

• Signature of Proprietor/Staff

  Sign

• Signature of Officer

  Sign

GENERAL INFORMATION