Food Safety Audit V1.2

• Document No.

• Dairy ID

• Dairy name

• Dairy contact name

• Conducted on

  Date

• Prepared by

• Location
  Address

Dairy Audit

• Is the visit Pre or Post or Actual FSA?

  Pre FSA

  Post FSA

  Actual FSA

• Is the previous audit available?

  Yes

  No

  N/A

• Did you discuss the previous FSA with producer?

  Yes

  No

• Is the critical certificates for the audit available and valid?

  Yes

  No

• Did the dairy pass the audit?

  Yes

  No

• Is the producer satisfied with the audit?

  Yes

  No

• Any comment from producer

• Did you complete the audit in the most recent spreadsheet?

  Yes

  No

• Did you send the spread sheet to the RIGHT PERSON?

  Yes

  No

• Any comment from producer

• Date that file was completed

  Date