Hinckley and Bosworth Borough Council Food Safety Inspection Form

• Comm Uniform Ref

• Conducted on

  Date

• Officer

  Select Simon Matthews Alexis Wiggins Kayleigh Brown Sarah Marriner Paula Kelly

  • Simon Matthews
  • Alexis Wiggins
  • Kayleigh Brown
  • Sarah Marriner
  • Paula Kelly

• Premises Name/ Trading as

• Contact Number

• Premises Address
  Address

• Email address

• Registered Address
  Address

• Food Business Operator

• Registration details correct

  Yes

  No

• Opening Times

• Type, size, nature and scale of business

• Changes in activities

• Approval necessary:

• No. of employees

• Primary Authority

  Yes

  No

  N/A

• Inspection Plan

  Yes

  No

• Number of Covers/ Customer Base

  Select <20 20-50 50-100 101 - 200 200-300 301-500 500+

  • <20
  • 20-50
  • 50-100
  • 101 - 200
  • 200-300
  • 301-500
  • 500+

• Type of Intervention

  Select Inspection Partial Inspection Audit Sampling Visit Monitoring Visit Surveillance Visit Verification Visit Other Intervention

  • Inspection
  • Partial Inspection
  • Audit
  • Sampling Visit
  • Monitoring Visit
  • Surveillance Visit
  • Verification Visit
  • Other Intervention

• Vulnerable groups

  Hospital

  Nursery

  Elderly

  None

• Person seen

• Local/ National/International

  Local

  National

  International

• Language

  Select Chinese English Bengali Polish Punjabi Urdu Arabic Turkish Mandarin

  • Chinese
  • English
  • Bengali
  • Polish
  • Punjabi
  • Urdu
  • Arabic
  • Turkish
  • Mandarin

• Area Inspected

Article 5 – Procedures based on the HACCP principles

• Satisfactory

  Yes

  No

  N/A

CHAPTER I - General requirements for food premises (other than those specified in chapter iii)

• Satisfactory

  Yes

  No

  N/A

CHAPTER II - Specific requirements in rooms where foodstuffs are prepared, treated or processed (excluding dining areas and those premises specified in chapter III)

• Satisfactory

  Yes

  No

  N/A

CHAPTER III - Requirements for movable and/or temporary premises (such as marquees, market stalls, mobile sales vehicles), premises used primarily as a private dwelling-house but where foods are regularly prepared for placing on the market and vending machines

• Satisfactory

  Yes

  No

  N/A

CHAPTER IV – Transport

• Satisfactory

  Yes

  No

  N/A

CHAPTER V - Equipment requirements

• Satisfactory

  Yes

  No

  N/A

CHAPTER VI - Food waste

• Satisfactory

  Yes

  No

  N/A

CHAPTER VII - Water supply

• Satisfactory

  Yes

  No

  N/A

CHAPTER VIII - Personal hygiene

• Satisfactory

  Yes

  No

  N/A

CHAPTER IX - Provisions applicable to foodstuffs

• Satisfactory

  Yes

  No

  N/A

Traceability

• Satisfactory

  Yes

  No

  N/A

Imports

• Satisfactory

  Yes

  No

  N/A

Delivery

• Satisfactory

  Yes

  No

  N/A

Storage / Stock control

• Satisfactory

  Yes

  No

  N/A

Temperature Control

• Satisfactory

  Yes

  No

  N/A

Pest Control

• Satisfactory

  Yes

  No

  N/A

Compliance with FSA E.coli guidance assessed

• Assessment

  Yes

  No

  N/A

Sampling

• Sampling undertaken

  Yes

  No

CHAPTER X - Provisions applicable to the wrapping and packaging of foodstuffs

• Satisfactory

  Yes

  No

  N/A

CHAPTER XI - Heat treatment – food in hermetically sealed containers

• Satisfactory

  Yes

  No

  N/A

CHAPTER XII - Training

• Satisfactory

  Yes

  No

  N/A

Food Information Regulations

• Customer notification

  Yes

  No

• Allergen Matrix/Equivalent System

  Yes

  No

• Cross Contamination/Allergen Issues

Additonal Information

• Referrals

• Documents seen

• Information Provided

• Further Notes

• H+S Hazard Spotting

RECOMMENDED INTERVENTION FOR NEXT VISIT AND REASONS

• Category A or B

  Inspection

  Partial Inspection

  Audit

• Category C - Broadly compliant

  Select Inspection Partial Inspection Audit Sampling Visit Monitoring Visit Surveillance Visit Verification Visit Other Intervention

  • Inspection
  • Partial Inspection
  • Audit
  • Sampling Visit
  • Monitoring Visit
  • Surveillance Visit
  • Verification Visit
  • Other Intervention

• Category C – Not broadly complaint:

  Inspection

  Partial Inspection

  Audit

• Category D - Alternate between official controls and other interventions

  Select Inspection Partial Inspection Audit Sampling Visit Monitoring Visit Surveillance Visit Verification Visit Other Intervention

  • Inspection
  • Partial Inspection
  • Audit
  • Sampling Visit
  • Monitoring Visit
  • Surveillance Visit
  • Verification Visit
  • Other Intervention

• Category E

  AES