Title Page

  • Business Name

  • Location
  • Licence Number:

  • Proprietor

  • Business Email Address

  • Officer

  • Officer Phone

  • Inspection Date

  • Code

  • Report Discussed with

  • Inspection Result

  • High Risk Food Processes onsite

  • During an inspection of this premises items of non-compliance were observed. The corrective action and direction/s below require attention under the following Act/s, by the due date/s listed:

  • Corrective Actions and Directions
  • undefined

Scope & Nature of Business

  • General Observations / Comments

  • Food Process/es Assessed

  • Nominated Food Safety Supervisor (FSS)

  • Copy of Certificate on file

Assessment Details

Food Allergen Handling

Food Allergens

  • Foods free of specific allergens are clearly, accurately marked on menu/ labels. Ingredients available on request.

  • Allergen-free requests are handled according to a process/ procedure, which clearly identifies the allergen-free request through ordering/preparation/cooking/serving/to receipt by customer to prevent contamination or mixing up orders

  • Ingredients for allergen-free foods are stored safety to prevent contamination and are clearly labelled, stored in dedicated containers or areas. Ingredient labels are regularly checked for accuracy

  • Foods free of specific allergens are processed safety to prevent allergen-contamination during receival, storage, processing, cooking/cooling, packaging, display, serving of foods

  • Food handlers are knowledgeable, can identify declared allergens, and demonstrate process control measures to prevent allergen contamination

  • Foods free of specific allergens are adequately protected from contamination during display and have designated serving utensils

  • Cleaning processes are in place to prevent allergen contamination throughout all aspects of the processing environment, equipment and utensils

Foods Received & Delivery Inwards

Purchase Receival and Delivery Into Premises

  • Foods are received at correct temperatures, not kept out of temperature after delivery

  • Foods checked for labelling, protection from contamination and intact packaging, products purchased from identifiable/ approved/ registered suppliers

Cold and Frozen Storage & Handling

Dry Storage

  • Foods appropriately protected from contamination

  • Containers/packaging intact, labelled, stock rotated and stored correctly

Cold & Frozen Storage

  • Refrigerators keep foods below 5°C & freezers keep foods frozen hard/ at -15°C or below

  • Foods appropriately protected from contamination; adequately covered/packaged, labelled, stock rotated correctly

  • Separation of raw and cooked or ready-to-eat foods

Food Processing & Hot Holding


  • Refrigerators keep foods below 5°C & freezers keep foods frozen hard/ at -15°C or below

  • Thawing foods safety stored separately from cooked/ ready-to-eat foods; foods appropriately protected from contamination


  • Food maintained at correct temperatures

  • Surfaces and equipment kept clean/sanitised

  • Raw fruits, vegetables appropriately washed, eggs clean/no cracks

  • No physical, microbiological or chemical contamination risk to food

Cooking and Reheating

  • Method of ensuring adequate cooking and re-heating processes (i.e. 75°C at centre of food)

  • Food not reheated more than once; foods rapidly reheated

Other Food Processing Methods

  • Other known processes are used to ensure foods produced are safe - such as pH control, fermentation, acidification etc.


  • Appropriate processes and method to ensure adequate cooling of food (from 60°C to 21°C within 2 hours, 21°C to 5°C within further 4 hours)

Hot Holding

  • Food maintained above 60°C, not overloaded, fresh tray used when replenishing, hot holding equipment cleaned and pre-heated prior to use

Serving, Packaging, Labelling & Transporting Food

Serving, Displaying and Self Serve

  • Clean and separate utensils for each item

  • Measures in place to prevent physical contamination, foods kept covered/ packaged, self-serve adequately supervised

  • Separation of raw/ ready-to-eat foods/ allergen-free foods

  • Food kept at proper temperatures within time limits and stock rotated correctly

Food Packaging

  • Packaging intact, clean and stored away from contaminants, packaging occurring in a suitable location and not likely to contaminate foods

  • Packaging/containers to be food grade

  • Appropriately labelled (including allergens, health claims, batch details, storage instructions, date, NIPs, address etc.)

Transporting Food from Premises

  • Verification of food at correct temperatures, protected from contamination, vehicles in clean condition and appropriate for use

Portable Component

  • Appropriate set-up for, processes undertaken appropriate, records kept

Food handling and Personal Hygiene

Food Handling Skills / Knowledge

  • Skills and knowledge of FSS adequate, regularly onsite to train and monitor staff

  • Skills and knowledge of food handlers adequate, knowledge and safe handling of foods, ingredients in foods available on request

  • Accurate thermometer available on site and in use, sanitised prior to/between use

Health and Personal Hygiene

  • Food handlers wearing appropriate and clean protective clothing, free of contamination risks (hair, jewellery, nail polish/fake nails etc)

  • Hand-washing facilities adequate, liquid soap & paper towel provided, easily accessible

  • Staff wash hands using dedicated hand-wash basin, and wash hands thoroughly, including before commencing work, and after: using toilet, smoking eating, cleaning, handling raw foods etc

  • Staff avoid unnecessary contact with ready-to-eat food, and preparation surfaces

  • Staff do not handle foods when ill/illness register kept

  • No evidence of smoking or unsafe personal habits

  • Separate storage area for staff belongings

Premises, Cleaning & Pest Control

Premises and Equipment Maintenance / Cleaning

  • Fit-out is suitable for size/scale of business, type/s of food being produced/handled onsite

  • Floors/walls/ceiling fit-for-purpose, well maintained and clean

  • Shelving/cupboards/benches fit-for-purpose, well maintained and clean

  • Cooking/refrigeration/freezer/display equipment fit-for-purpose, well maintained and clean

  • Canopy/filters/ventilation fit-for-purpose, well maintained and clean

  • Crockery, cutlery, glasses, utensils and equipment

  • Lighting/Fixtures/Other appropriate, well maintained and clean

  • Plumbing & hot water supply, adequate toilets, and wastewater disposal appropriate

  • Yard well maintained & garbage disposal suitable and adequate receptacles

Cleaning and Sanitising

  • Proper use of food safe approved sanitisers/cloths

  • Cleaning chemicals labelled and stored safely

  • Equipment/utensils air dried or dried using clean tea towels or paper towel

Food Safety Program, Records, Audit and Food Recall

Record Keeping

  • FSP onsite (if required), appropriate for business and records maintained

  • A recall/traceability process is in place – including documentation, and process for separating recalled foods

  • Audit conducted in last 12 months and report received by Council

  • Date conducted

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.