Title Page
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Premise Name
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Conducted on
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Inspected by
Hygiene
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Employees wash their hands with soap and warm water before starting work, immediately after using washroom, any time needed to prevent cross-contamination
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Employees wearing clean outer garments
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Hair of employees is properly confined
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Employees in good health with no open cuts or sores
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Clothing and personal effects stored away from products in a proper manner
Sanitary Facilities
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Toilet facilities are well maintained and in proper working order
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Self closing doors for toilet and dressing room working properly
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Toilet tissue dispensers full. Sanitary napkin disposal unit available.
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Single service soap and towel dispensers operable and full
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Ventilation provided and in proper working order
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Separate hand washing basin in each area with required supplies
Water and Sewage
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All sinks are fully operable with hot and cold water at each faucet
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All sinks drain properly. Floor drains and sink in good order
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Plumbing in good repair
Floors, Wall, Ceilings, Lighting and Ventilation
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Floors clean, well maintained and in good repair
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Walls, ceilings and windows clean. Well maintained and in good repair
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Adequate lighting and ventilation provided throughout the facility
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Light fixtures have approved safety covers
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Exhaust ventilation filters are clean and well maintained
Equipment and Utensils
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Food contact surfaces washed, rinsed and sanitised before using
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Non-Food contact surfaces visibly clean and in good repair
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All equipment (i.e.) Manta, Ullma, dips, tables, sinks, ect. cleaned and well maintained
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Inoperable equipment has been repaired, replaced, locked/tagged out or removed from facility
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Damaged or unapproved utensils have been repaired or replaced
Cleaning equipment
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Wiping clothes clean, sanitized, stored and maintained properly
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Chemicals buckets and equipment stored correctly
Garbage and Waste
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Bins are lined with insect and vermin-proof disposable plastic bag at all times.
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Plastic bags are tied before being placed in outside trash bin. Bin lids are kept closed.
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Outside premises and refuse areas are clean, sanitized, illuminated by light and well maintained.
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Frequency of garbage removal adequate to maintain premises in a sanitary condition.
Pest Control
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Adequate protection against the entrance of insects, vermin, rodents, dust and fumes.
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Outside doors and screen doors are self-closing and closures are in acceptable working order.
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Keep all areas free of debris, moisture, and visable soil and well lit.
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Working with a licensed pest control company.
Items Critical to Food Safety
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Product is purchased ONLY from approved sources
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Product is inspected when received and found to be free from contamination and spoilage.
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All food is stored off the floor and away from the walls
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All food is labeled, dated and stored in leak proof packaging or food grade containers
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All food is protected from dirt, unnecessary handling, over-head leakage and other forms of contamination
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A thermometer, accurate to 1 °C is provided either as an integral part of the refrigerator / freezer (outside dial) or is located inside each unit at its warmest spot (usually at the point of access)
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An accurate thermometer, approved for measuring food temperatures, is readily available and is being used to verify internal food temperature on a daily basis
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All paper products are stored in a manner so as to protect them from contamination
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Food handlers use proper utensils to minimize direct hand contact with product
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Hands are properly washed before and after handling food
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Product that has been returned is inspected and discarded
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Product is disposed of in an approved manner
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All food is protected from potential contamination
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Refrigerated food is received and stored at 5°C or colder
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Signed off by