Food Premises Information

  • Food Shop Reference Number

  • Proprietor / Company Name

  • Email

  • Person Interviewed

  • Phone Number(s)

General Requirements

  • Establishment has valid certificate of acceptability with council

  • Is the certificate displayed in a conspicuous place?

  • 3. Food handlers have skills and knowledge to handle food safely

  • 4. No sale of food that is damaged, deteriorated or perished; no use of cracked or dirty eggs or food past use by date

  • Food handled on premises or handled / prepared elsewhere?

Food Handling Controls FSS 3.2.2 cl 5 - 12

  • 5. Food protected from the possibility of contamination; food receipt, storage, display and transport

  • 6. Names and addresses are available for manufacturer, supplier or importer of food

  • 7. Potentially hazardous food (PHF) is under temperature control: food receipt, storage, display and transport; less than 5 degrees, above 60 degrees Celsius . Frozen food is hard frozen

  • 8. Processing of foods; items thawed correctly; processed quickly; no contamination risk

  • 9. Cooked PHF is cooled rapidly

  • 11. Self serve food bar is supervised, has separate utensils and sneeze guard

  • 12. Food wraps and containers will not cause contamination

  • 13. Food for disposal is separated from normal stock

  • Surface of table and any equipment (utensil,basin, any other surface) used where food is handled is smooth, non-toxic, non-absorbent and is free of open joints or seams

  • Surfaces,crockery, cutlery, utensils or basins use for handling food clean, not chipped, split or cracked

  • Food handling surface cleaned before food preparation and after food is prepared

  • No remains of cleaning materials or disinfectants which may pollute the food

Health and Hygiene FSS 3.2.2 cl 13-18

  • 14. Food handlers wash and dry hands thoroughly using hand wash facilities

  • 15. Food handlers avoid unnecessary contact with ready to eat food or food contact surfaces by use of utensils, a gloved hand, food wraps etc

  • 16. Food handlers do not spit or smoke in food handling areas or eat over exposed food or food contact surfaces

  • 17. Food handlers have clean clothing, waterproof covering on bandages

  • 18. Food handlers wash hands before commencing/recommencing work and after: using the toilet, coughing, sneezing, smoking, handling raw mead, cleaning, etc

  • 19. Food handlers do not handle food if ill (eg vomiting, gastro)

  • 20. Hand washing facilities easily accessible and used only for washing of hands, arms and face

  • 21. Hand washing facilities have warm running water through single spout, single use towels and soap

  • Food stored not in contact with floor

  • Food stored on shelf kept clean,dust-free and free from impurity

  • Ready to consume food shall be protected against droplets contamination, dust and insects

  • Required protective equipment been used

  • Wearing of jewelry while preparing not allowed

  • Food handled using protective gloves when preparing food

  • Food handler hands, fingernails clean

  • Food handler clean, free from cuts, abscess (unprotected)

  • Food handler suspected of having a contagious disease

  • No smoking in food handling area

Cleaning and Sanitising FSS 3.2.2 cl 19-20

  • 22. Premises, fixtures, fittings and equipment maintained to an appropriate standard of cleanliness

  • 23. Food contact surfaces, eating and drinking utensils in a clean and sanitary condition/appropriate sanitising method in use (eg chemicals or dishwasher)

Miscellaneous FSS 3.2.2 cl 22-23

  • 24. Accurate temperature measuring device readily accessible (eg digital probe thermometer) Accurate to +/- 1 degree Celsius

  • 25. Single use items protected from contamination and not reuse (eg drinking straws, disposable utensils)

Animal and Pests FSS 3.2.2 cl 24

  • 26. Live animals not permitted in areas in which food is handled

  • 27. Practical pest exclusion measures used (eg screens, door seals)

  • 28. Practicable measures to eradicate and prevent harbourage of pests (eg housekeeping, stock rotation, pest controller)

  • 29. No signs of insect infestation or rodent activity in premises

  • Provided with effective means of preventing flies to the area where food is handled?

Design and Construction FSS 3.2.3

  • 30. General design and construction of premises appropriate

  • Adequate illumination provided - minimum 200lux on food handling surfaces

  • Adequate natural ventilation opening directly to natural air

  • Ventilation facilitate addition of adequate fresh air and effective removal polluted or stale air from food handling area

  • 31. Adequate supply of potable water available

  • 32. Premises has adequate sewage and waste water disposal system

  • 33. Premises has adequate storage facilities for garbage and recyclable matter

  • 35. Floors are able to be effectively cleaned

  • 36. Walls and ceilings are sealed and able to be effectively cleaned

  • 37. Fixtures, fittings and equipment are able to be effectively cleaned and where necessary sanitised

  • 39. Premises has adequate storage facilities (eg chemicals)

  • Establishment has certificate for gas installation?

  • Toilets, hand washbasins, provided as per regulation C of the regulations

Maintenance FSS 3.2.2 cl 21

  • 40. Premises, fixtures, fittings and equipment in a good state of repair and working order

  • 41. No chipped, broken or cracked eating or drinking utensils observed

Labelling FSC Chapter 1

  • 42. Food Labelling complies with the Food Standards Code


  • Further action required

  • Summary of report

  • Regulations /by-laws used for inspection:

I have read this report and understand the contents.

  • Owner / Employee signature

  • SHEQ Auditors signature

  • NB: Assessment report contains findings from date/time of inspection only

  • Select date

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. Any ratings or scores displayed in our Public Library have not been verified by SafetyCulture for accuracy. Users of our platform may provide a rating or score that is incorrect or misleading. You should independently determine whether the template is suitable for your circumstances. You can use our Public Library to search based on criteria such as industry and subject matter. Search results are based on their relevance to your search and other criteria. We may feature checklists based on subject matters we think may be of interest to our customers.