Record of visit (food hygiene / workplace health and safety)

• Premises

• Address
  Address

• Registered address if different

• Date of visit

  Date

• Food hygiene visit

• Workplace health and safety visit

• Reason for visit

  Revisit following inspection

  Complaint

  Other

• Details:

• Officer

• Contact details

  Select

• Buckinghamshire Council, Regulatory Services, Walton Street Offices, Walton Street, Aylesbury, HP20 1UA

Contact details

• Contact name

• Email address

• Head office email address (for multi-site businesses)

• Telephone number

• Type of business:

• Business operator/proprietor:

• Areas inspected:

  Whole

  Part of

• Please specify:

• Records/documents examined:

  Select Food Safety Management System (e.g. SFBB or equivalent) FSMS monitoring records (e.g. temperature logs, daily diary) Training records/certificates Pest control records Traceability records (e.g. supplier invoices) Waste transfer/contract records Allergen information Cleaning schedule Risk assessment/s H&S policy Gas safety certificate Electrical safety certificate Other

  • Food Safety Management System (e.g. SFBB or equivalent)
  • FSMS monitoring records (e.g. temperature logs, daily diary)
  • Training records/certificates
  • Pest control records
  • Traceability records (e.g. supplier invoices)
  • Waste transfer/contract records
  • Allergen information
  • Cleaning schedule
  • Risk assessment/s
  • H&S policy
  • Gas safety certificate
  • Electrical safety certificate
  • Other

• Details:

• Food or environmental samples taken?

  Yes

  No

  N/A

• Food

  Environmental

• Details of food sample(s) taken

• Click to add swab detail

Swab

• Swab description

• Date/time of swab

  Date

• undefined

  Select Ultrasnap (ATP Surface Test) Pro-clean (Rapid Protein Residue Test)

  • Ultrasnap (ATP Surface Test)
  • Pro-clean (Rapid Protein Residue Test)

• ATP is the energy molecule found in all living cells, such as bacteria, making it a good indicator to determine if a surface is clean or not. The higher the score, the dirtier the surface.

• Score

• Food contact surface (e.g. chopping board, food prep. surface, food utensil): 0-20=Pass, 21-49=Borderline, >50=Fail.
  Hand contact surface (e.g. tap handle, fridge handle): 0-50=Pass, 51-99=Borderline, >100=Fail.

• Pass

  Borderline

  Fail

• Advice - A borderline score can show a surface is trending towards unclean and may require additional attention during the next cleaning.

• Legal - You need to review your cleaning procedures to ensure surfaces are cleaned and disinfected using a two stage process. The manufacturers' instructions must be followed for the dilution, contact time, and drying method (SR).

• Protein is more difficult to remove from surfaces than other residues so it is a good indicator of cleanliness.

• Pass

  Fail

• Legal - You need to review your cleaning procedures to ensure surfaces are cleaned and disinfected using a two stage process. The manufacturers' instructions must be followed for the dilution, contact time, and drying method (SR).

• Persons interviewed:

  Select Business Operator Manager 1x Food Handler 2x Food Handlers 3x Food Handlers 4+ Food Handlers Kitchen porter Front of House Staff Head Chef Other

  • Business Operator
  • Manager
  • 1x Food Handler
  • 2x Food Handlers
  • 3x Food Handlers
  • 4+ Food Handlers
  • Kitchen porter
  • Front of House Staff
  • Head Chef
  • Other

• Details:

• Names of persons interviewed:

• Summary of action to be taken by the officer:

  Select No action necessary Report of legal requirements and/or advice (as below) Hygiene Improvement Notice Voluntary surrender/seizure of food Formal detention/seizure of food Voluntary Hygiene Emergency Prohibition Notice Hygiene Emergency Prohibition Notice Improvement notice Prohibition notice Other

  • No action necessary
  • Report of legal requirements and/or advice (as below)
  • Hygiene Improvement Notice
  • Voluntary surrender/seizure of food
  • Formal detention/seizure of food
  • Voluntary Hygiene Emergency Prohibition Notice
  • Hygiene Emergency Prohibition Notice
  • Improvement notice
  • Prohibition notice
  • Other

• Key Points Discussed

• Add media

  Media

• Revisit required:

  Yes

  None

• Date and time of revisit:

  Date

• Officer signature:

  Sign

• Signature of person report discussed with:

  Sign

Understanding your report and rating

• Understanding Your Inspection Report
  
  Items are listed as either Legal Requirements – these are considered to be breaches of the legislation and require action. The period of time allowed to comply is detailed against each item, or Advice – these are items which you are strongly advised to implement as they constitute good practice. Failure to action the legal requirements is a breach of the relevant legislation which may result in enforcement action in line with the Regulatory Services Enforcement Policy. Details of this policy can be viewed at :
  
  https://tinyurl.com/495xp8vj

• This report gives you information about the inspection of your premises. It only covers areas inspected at the time; and summarises matters discussed during the inspection. The information provided by you in respect of your business will be held on our database and may be used for the purposes authorised in the Council’s registration under the Data Protection Act 2018.

• This report, including photographs, may be disclosed in response to a Freedom of Information request apart from information of a personal or commercially confidential nature. If the food business operator has any concerns regarding this then they should contact Mr Ian Snudden, Environmental Health Manager at ian.snudden@buckinghamshire.gov.uk with the reasons why they would not want the information disclosed.