Title Page
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Company Name
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Conducted on
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Audited by
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Location
Scope and Personnel
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Designated an FSMA Qualified Individual, competent FSMA Auditor and competent Sanitation Manager
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Established roles for qualified individuals and delegated responsibility for every step of safety plan's implementation, verification, validation, and correction
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Qualified individuals have been trained in the application of risk-based preventive controls
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Determined which FSMA requirements are applicable to the facility
Hazard Analysis
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Are hazards evaluated based on the significance they pose?
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Are identified hazards likely to occur even with preventive measures taken?
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Do identified hazards pose severe threat to consumers?
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Are allergens evaluated on points which cross-contamination hazards could emerge?
Labeling
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Are raw ingredients containing allergens properly labeled?
Storage
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Are storage areas organized to minimize the chances of allergen contamination from a spill?
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Can storage areas be effectively cleaned in the event of an allergen spill?
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Are bulk storage containers and silos designated as allergen-free?
Staging
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Do ingredients containing allergens share staging areas with allergen-free areas?
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Are staging areas designed for thorough cleaning between production runs?
Utensils
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Are separate utensils used for preparing allergen-free foods?
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Are utensils for preparing allergen-free foods clearly marked?
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Do utensils share storage or cleaning areas?
Personnel
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Are workers able to move between areas preparing allergen and allergen-free products?
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Do personnel use PPE and sanitation procedures to prevent cross-contamination?
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Please specify what these are
Biological
Equipment
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Is processing equipment designed for sanitation?
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Are processing surfaces free of cracks that could harbor bacteria?
Transportation
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Are transportation containers routinely sterilized?
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Are ingredients transported at proper temperatures?
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Are containers designed to effectively seal out environmental contaminants?
Sanitation
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Are sanitation procedures in place to prevent cross-contamination from employees?
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Specify procedures
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Are processing areas designed for routine sanitation?
Raw Materials
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Are raw ingredients checked for spoilage and contamination prior to processing?
Facility
Grounds
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Are pests, dirt, and other potential contaminants present on the facility’s grounds?
Structure
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Are roofs and walls effectively sealing out environmental contaminants?
Non-contact surfaces
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Are the facility’s floors and fixtures free of cracks that could harbor bacteria or other contaminants?
Plumbing and HVAC
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Are drains and vents able to be sanitized?
Non-food chemicals
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Are potentially hazardous chemicals properly labeled and stored?
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Do routine maintenance tasks require introducing non-food chemicals into the processing area?
Supply Chain
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Are suppliers of potentially-hazardous ingredients routinely audited?
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Have the preventive controls of suppliers been documented and reviewed?
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Does your Food Safety Plan require taking action if a supplier fails to conform to your standards?
Intentional Adulteration
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Could a malicious employee or intruder intentionally contaminate products?
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What supervisory measures are in place to prevent and detect intentional contamination?
Preventive Controls
Monitoring
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Does your food safety plan identify Critical Control Points where contamination can be stopped at its source (ie, handwashing stations, pasteurization baths)?
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What oversight procedures are in place to ensure the Safety Plan is followed at these points?
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Do your food safety plan specify critical limits (e.g., temperature, or cooking time) which must not be exceeded?
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Is product testing to verify the effectiveness of controls routinely scheduled?
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Is the processing environment (e.g., condensation from pipes, accumulation of waste materials) constantly monitored to ensure conditions don't promote contamination?
Validation
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Do verification processes follow a regular schedule?
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Is verification performed by a designated Qualified Individual?
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Are implementation records regularly audited for compliance?
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Is testing equipment routinely calibrated to ensure accuracy corrections?
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If a critical limit is exceeded, what new testing protocols will be used to validate the effectiveness of new controls?
Re-anlaysis
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Has your Food Safety Plan been reanalyzed in the past three years?
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Is there a new process for revising the plan to mitigate new hazards?
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Does the plan reflect the latest food safety research?
Recalls
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Is there a documented plan in the event of a recall?
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Has a recall team been designated? Are the team members’ roles clear?
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Can at least 98% of the affected product be removed from the supply chain?
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Can all affected products be identified and located within four hours?
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Can the supply chain be traced to locate the source of contamination?
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Are there notification procedures in place to alert distributors in the event of a recall?
- Yes
- No
- N/A
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Are disposal procedures followed to ensure the removal of contaminated products and ingredients?
Completion
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Additional comments and recommendations
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Name & Signature of Assigned Auditor