Horsham Rural City Council Food Safety Assessment

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

GENERAL INFORMATION

• Date and Time audit began

  Date

• Premises Number

• Name of Premises

• Address of Premises

• Phone Number

• Name of Proprietor or staff in attendance

• Name of proprietor or staff in attendance

• Name of Officer

  Select Luke Mitton Helene Wortley

  • Luke Mitton
  • Helene Wortley

ASSESSMENT TYPE

• Reason for assessment

  Scheduled assessment

  Follow up assessment

  Assessment following a complaint

  Other

RECEIVING

• Are food supplies obtained from a Reputable Supplier?<br>Approved Suppliers List

  Yes

  No

  N/A

• Is Potentially hazardous food delivered under temperature control? <br>Temperatures checked? <br>Goods Received Form

  Yes

  No

  N/A

• Is all food protected from contamination and checked upon receipt?<br>Goods Receival Form

  Yes

  No

  N/A

STORAGE

• Is food stored so that it is protected from contamination?<br>Is the Dry Storage area adequate?

  Yes

  No

  N/A

• Are Potentially hazardous foods stored under temperature control? <br>Cold Storage Log

  Yes

  No

  N/A

• Are the food storage, dry store, refrigerator and freezers clean and free from dirt grime and food particles?

  Yes

  No

  N/A

PROCESSING

• Are adequate procedures in place to prevent contamination during processing?

  Yes

  No

  N/A

• Are adequate processes being followed for thawing and washing of food?

  Yes

  No

  N/A

• Are potentially hazardous foods being cooked, chilled and reheated safely?

  Yes

  No

  N/A

• Shown sound knowledge of 2/4 hour rule?

  Yes

  No

  N/A

• Internal review records?

  Yes

  No

  N/A

DISPLAY

• Is food protected from contamination while on display?

  Yes

  No

  N/A

• Is potentially hazardous food under temperature control?<br>Hot/Cold Display Temperature Form

  Yes

  No

  N/A

PACKAGING

• Is appropriate packaging material used and single use utensils and packaging stored in safe manner?

  Yes

  No

  N/A

TRANSPORTATION AND DISTRIBUTION

• Is food protected from contamination during transport?

  Yes

  No

  N/A

• Is food kept under temperature control during transport?

  Yes

  No

  N/A

RECALLS/FOOD DISPOSAL

• Is there an adequate sytem in place to ensure that unsafe or unsuitable food is not sold or is recalled?<br>Food Recalls Support Program

  Yes

  No

  N/A

HEALTH, HYGIENE & KNOWLEDGE

• Are all food handlers following good personal hygiene?

  Yes

  No

  N/A

• Food handlers with illness or wounds taking appropriate measure to ensure food is protected?<br>Health of Food Handlers Support Program

  Yes

  No

  N/A

• Food Handlers using safe food handling procedures?

  Yes

  No

  N/A

• Do food handlers have the appropriate skills and knowledge in food safety?<br>Food handling skills and knowledge support program.

  Yes

  No

  N/A

PREMISES AND HYGIENE

• Adequate hand washing facilities?<br>Soap provided?<br>Paper Towel or drier provided?

  Yes

  No

  N/A

• Is sewerage and wastewater being disposed of safely?

  Yes

  No

  N/A

• Are the floors, walls & ceiling made from smooth and suitable materials?<br>Can clearly see when it is dirty and easily cleanable?

  Yes

  No

  N/A

• Is there an adequate supply of potable water?

  Yes

  No

  N/A

• Does the premises have adequate ventillation?<br>Clean and in working condition?

  Yes

  No

  N/A

• Is the premises being maintained in a good sate of repair?

  Yes

  No

  N/A

• Is the premises and equipment being maintained to a satisfactory standard of cleanliness?<br>Equipment Calibration Support Program<br>Cleaning and Sanitising Schedule Support Program

  Yes

  No

  N/A

• Are utensils/equipment/appliances adequate and in good state of repair?

  Yes

  No

  N/A

• Adequate storage of checmicals, clothing and personal items?

  Yes

  No

  N/A

• Are all food contact surfaces being effectively cleaned and sanitised?

  Yes

  No

  N/A

• Are cleaned appliances/utensils/food cotnact surfaces protected from contamination while not in use?

  Yes

  No

  N/A

• Adequate toilet facilities for food handlers

  Yes

  No

  N/A

• Does the premises have adequate light?<br>Shatter proof globes or covered?

  Yes

  No

  N/A

• Is waste being stored in a safe and suitable manner that prevents contamination of food?<br>Covers on receptacles, area is clean and tidy?

  Yes

  No

  N/A

• Are effective measure in place to control animals and pests?<br>Evidence of pests?<br>Pest Control Support Program

  Yes

  No

  N/A

• Is there an accurate suitable thermomenter on the premises?<br>Equipment Calibration Support Program

  Yes

  No

  N/A

COMMENTS/ACTIONS TO BE TAKEN

• Input additional comments and actions here

FURTHER ACTIONS

• Further Action?

  Nil

  Reinspection

  Letter

  Order/Notice

  Expiation Notice

REINSPECTION DATE

• Select date

  Date

SIGNATURE

• Signature of Officer

  Sign