Title Page

  • Premise Name

  • Conducted on

  • Inspected by

Hygiene

  • Employees wash their hands with soap and warm water before starting work, immediately after using washroom, any time needed to prevent cross-contamination

  • Employees wearing clean outer garments

  • Hair of employees is properly confined

  • Employees in good health with no open cuts or sores

  • Clothing and personal effects stored away from products in a proper manner

Sanitary Facilities

  • Toilet facilities are well maintained and in proper working order

  • Self closing doors for toilet and dressing room working properly

  • Toilet tissue dispensers full. Sanitary napkin disposal unit available.

  • Single service soap and towel dispensers operable and full

  • Ventilation provided and in proper working order

  • Separate hand washing basin in each area with required supplies

Water and Sewage

  • All sinks are fully operable with hot and cold water at each faucet

  • All sinks drain properly. Floor drains and sink in good order

  • Plumbing in good repair

Floors, Wall, Ceilings, Lighting and Ventilation

  • Floors clean, well maintained and in good repair

  • Walls, ceilings and windows clean. Well maintained and in good repair

  • Adequate lighting and ventilation provided throughout the facility

  • Light fixtures have approved safety covers

  • Exhaust ventilation filters are clean and well maintained

Equipment and Utensils

  • Food contact surfaces washed, rinsed and sanitised before using

  • Non-Food contact surfaces visibly clean and in good repair

  • All equipment (i.e.) Manta, Ullma, dips, tables, sinks, ect. cleaned and well maintained

  • Inoperable equipment has been repaired, replaced, locked/tagged out or removed from facility

  • Damaged or unapproved utensils have been repaired or replaced

Cleaning equipment

  • Wiping clothes clean, sanitized, stored and maintained properly

  • Chemicals buckets and equipment stored correctly

Garbage and Waste

  • Bins are lined with insect and vermin-proof disposable plastic bag at all times.

  • Plastic bags are tied before being placed in outside trash bin. Bin lids are kept closed.

  • Outside premises and refuse areas are clean, sanitized, illuminated by light and well maintained.

  • Frequency of garbage removal adequate to maintain premises in a sanitary condition.

Pest Control

  • Adequate protection against the entrance of insects, vermin, rodents, dust and fumes.

  • Outside doors and screen doors are self-closing and closures are in acceptable working order.

  • Keep all areas free of debris, moisture, and visable soil and well lit.

  • Working with a licensed pest control company.

Items Critical to Food Safety

  • Product is purchased ONLY from approved sources

  • Product is inspected when received and found to be free from contamination and spoilage.

  • All food is stored off the floor and away from the walls

  • All food is labeled, dated and stored in leak proof packaging or food grade containers

  • All food is protected from dirt, unnecessary handling, over-head leakage and other forms of contamination

  • 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)

  • An accurate thermometer, approved for measuring food temperatures, is readily available and is being used to verify internal food temperature on a daily basis

  • All paper products are stored in a manner so as to protect them from contamination

  • Food handlers use proper utensils to minimize direct hand contact with product

  • Hands are properly washed before and after handling food

  • Product that has been returned is inspected and discarded

  • Product is disposed of in an approved manner

  • All food is protected from potential contamination

  • Refrigerated food is received and stored at 5°C or colder

  • Signed off by

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