Title Page

  • Premises Name & (FILE REF):

  • Officer Name:

  • Date & Time:

  • Person Spoken to and (position):

Premises Infomation

Premises Details and Management

  • Business name & Address:

  • Type or Nature of business:

  • CAPS Uniform contact/FBO information correct?

  • Name of current Manager:

  • Manager's Telephone Contact:

  • Manager's Email Contact:

  • Current number of Food Handlers:

COVID-19 Specific:

  • Is the business currently closed due to the COVID-19 event?

  • Has there been a change of processes or service style as a result?

  • Outline of new arrangements and any related controls:

Previous Intervention

  • Key issues &/or contraventions raised in last RI:

  • Have the key issues &/or contraventions from the previous RI been addressed?

  • Have arrangements been made/planned for rectifying any outstanding issues? Note details and timeframes:

Additional Information

  • General Comments:

Food Safety Management

Documented Systems

  • Nature of the business' FSMS/HACCP

  • Is this satisfactory when considering the nature or risk of the business?

  • Do the controls adequately address any potential E. coli O157 risk? Make Notes to outline arrangements in the documentation, in addition to noting any deficiencies.

Allergen Control

  • Has the business identified allergens in its menu items and effectively communicates these to their customers?

COVID-19 Specific:

  • Has any new processes, service styles been reflected in FSMS?

Additional Information

  • General Comments:

General Prerequisite Systems

  • Are food handling staff appropriately trained or instructed?

  • Personal hygiene policies adequate; protective clothing, jewellery, exclusion?

  • Pests and domestic pets adequately controlled? No gaps, voids, evidence inside?

  • Appropriate waste receptacles internal and externally, waste cooking oil collected?

Additional Information

  • General Comments:

Food Room Structure

  • Are all wash basins served by both fresh running mains and hot water as required?

  • Materials for hand washing continue to be stocked?

  • Cleaning schedule in place, appropriate daily and specific cleaning items listed

  • Disinfection arrangements satisfactory? Chemicals and types of cloths used, method:

  • All structure readily cleansable – No broken tiles, exposed wood, etc?

  • General Comments:

Food Handling Practices

Food Handling Processes

  • Same suppliers since last RI? All reputable businesses, traceability satisfactory?

  • Delivery or transport to premises satisfactory with appropriate checks on receipt?

  • Arrangements for primary storage of food satisfactory, inc temperature control?

  • Workflow & layout of food rooms adequate to prevent C/C? Separate areas, equipment, etc.

  • Does the business ensure that food is thoroughly cooked before service?

  • Are any hazards around cooling, reheating and hot-holding of food controlled?

  • Is any food-contact packaging appropriately stored prior and during use?

COVID-19 Specific

  • Is Social Distancing achievable during food production and service?

  • Are food service/delivery to customer arrangements satisfactory?

Additional Information

  • General Comments:

Projected FHRS Score

  • Does this intervention require an updated FRHS Score?

  • The standards are judged on three key factors observed during the inspection: How hygienically the food is handled (how it is prepared, cooked, re-heated, cooled and stored); the condition of the structure of the buildings (the cleanliness, layout, lighting, ventilation and other facilities); and how the business manages and records what it does to make sure food is safe. The level of compliance with the food law found is rated on a scale. At the bottom of the scale is ‘0’ – this means urgent improvement is required. At the top of the scale is ‘5’ – this means the hygiene standards are very good.

Level of Current Compliance

  • Food Hygiene & Safety (food handling practices & procedures, temperature control)

  • Comments:

  • Structure & Facilities (Cleanliness, layout, condition of structure, facilities etc.)

  • Comments:

Confidence in Management and Control Systems

  • Confidence in Management (How much we have in the business, written systems, etc)

  • Comments:

TOTAL SCORES, RISK CATEGORY, & FHRS

  • The inspection scores are 'mapped' to the six Food Hygiene Rating Scheme bands or tiers as illustrated below. Where an individual score from the adjacent three score elements above exceeds the Additional Scoring factor, the position of the establishment will drop down the banding to the maximum level at which the Additional Scoring factor is permitted. For example, where there is an individual score of 15 (even if scoring 0, 15, 0), the establishment would drop down from 5 to 2 at least.

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  • TOTAL SCORE

  • Projected Food Hygiene Rating Scheme score

Additional Information

  • General Comments:

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. You should independently determine whether the template is suitable for your circumstances.