Title Page

  • Inspector

  • Contact details:

  • Date of inspection

  • Food Premises

  • Address

Business details

  • PERSONAL INFORMATION - please do not enter any personal information such as private contact details (names, addresses, telephone numbers, email addresses). This includes taking photographs that include personal information. NOTE: this form is NOT to be used for businesses located at private addresses such as home caterers.

Business Details

  • File History Checked?

  • Where applicable list the last three Food Hygiene Ratings List most recent first e.g. 5, 4, 5

  • Inspection:

  • Reason?

  • Is Food Hygiene Rating sticker displayed?

  • Is the food registration up-to-date?

  • Time limit:

  • Opening Times

  • Part of a Primary Authority? - Businesses can form a partnership with a local authority to provide advice other local regulators must respect. Check the Primary Authority website for information.

  • Who is supplied?

  • Where other business are supplied, provide detailed information:

  • Offsite/Outside Facilities

  • Details other functions, parties, outside catering, deliveries, manufacture, distribution, packing/wrapping

  • Scale of distribution (Select from the drop down)

  • Amount of food prepared served/number of covers per day

  • Examples of menu items:

  • Or photo menu:

Significant Risks

  • Menu analysis. Are there any high-risk methods of processing or high-risk dishes?

Food Suppliers

  • Common suppliers (select from list):

  • Other food suppliers: (Click "Add Food Supplier")

  • Food Supplier
  • Food Supplier

  • Delivered or collected?

  • Supplier audited

  • Scroll up and click +Add to add more.


  • Traceability records in place?

  • Legal - Traceability - you need to be able to identify the person or business that supplied you with food. As a minimum the 'system' should be able to provide: (1) Name, address of supplier, nature of products which were supplied and date of transaction/delivery; (2) Name, address of customer, nature of products which were supplied and date of transaction/delivery (only applicable if you do not supply the final consumer, i.e. delivers to retailers, caterers etc.). Depending upon the size and scale of your business, this can be as simple as keeping the receipts from all your food suppliers (CM).

  • Time limit:

  • Detail one example of 3rd country food product on premises

  • Add media

  • Please proceed to the next section.

Staff training

Training / Instruction / Supervision

  • Are all staff suitably trained in food hygiene?

  • Time limit

  • Do all staff receive suitable instruction / supervision in relation to food hygiene?

  • Legal - Conditions at the premises at the time of my visit indicate that staff were not suitably supervised and or instructed. Set up systems to ensure that all staff are adequately instructed and supervised in matters of food hygiene (CM).

  • Time limit:

  • Where staff are suitably trained/instructed; was the last training/ instruction session within three years?

  • Advice - It is recommended that staff handling high risk food receive refresher training at periods not exceeding three years. For details of taught and online training courses visit: www.chiltern.gov.uk/training or www.southbucks.gov.uk/training

Training in Food Safety Management Systems (FSMS)

  • Have all staff responsible for the development and maintenance of the FSMS received adequate training in its operation.

  • Time limit:

  • Please proceed to the next section.

Food Inspection - 1


  • Adequate delivery/collection checks being carried out?

  • Legal - Delivery/collection checks - You should carry out checks on all stock deliveries/collections (e.g. remaining shelf-life, condition of packaging), and in the case of chilled or frozen food deliveries, ensure that all products are received at the correct temperatures. Reject unfit food or products with an expired use-by date (FH).

  • Time limit:


  • Storage temperatures checked and at correct temperature (chilled and frozen)?

  • Time limit:

  • Adequate separation between raw and ready-to-eat food being stored?

  • Legal - Chilled storage (cross contamination) - ensure cooked/ready to eat foods are stored separately and above raw foods within the refrigerator. If possible, use separate refrigerators for raw and cooked/ready to eat foods (FH).

  • Time limit:

  • Food protected from contamination in storage?

  • Time limit:

  • Adequate stock rotation of food being stored?

  • Time limit:


  • Work Surfaces - adequate separation between raw and RTE preparation?

  • Time limit:

  • Equipment - adequate separation between raw and RTE preparation?

  • Time limit:

  • Staff - adequate separation between raw and RTE preparation?

  • Time limit:


  • Adequate cooking time-temperature and visual checks?

  • Time limit:

  • Adequate cross-contamination prevention during cooking?

  • Legal - Use of tongs/utensils (cross-contamination) - Separate tongs or other utensils need to be used to handle raw food and ready-to-eat/cooked food to prevent the risk of cross-contamination (FH). Advice – I recommend these are colour-coded.

  • Time limit:

  • Is the probe thermometer working, clean and being used correctly (including calibration)?

  • Time limit:


  • Adequate cooling methods used?

  • Time limit:

  • Food protected from contamination whilst cooling?

  • Legal - Protect food from contamination whilst cooling - cool food in suitable area and/or loosely covered (FH).

  • Time limit:


  • Cold food display time/temperatures checked and at correct temperature?

  • Time limit:

  • Hot food display time/temperatures checked and at correct temperature?

  • Time limit:

  • Open food on display protected from contamination?

  • Time limit:

  • Adequate stock rotation of food being displayed?

  • Time limit:


  • Adequate defrosting methods used?

  • Time limit:

  • Run-off liquid collected during defrosting?

  • Legal - Liquid from thawing of food – All run off liquid from the thawing of food may present a health risk and should be adequately drained/collected e.g. by placing on a tray or container (FH).

  • Time limit:


  • Adequate temperature control during transport?

  • Time limit:

  • Food protected against contamination during transport?

  • Time limit:

  • Please proceed to the next section.

Food Inspection - 2

Fitness to work

  • Adequate fitness to work arrangements in place (exclusion, reporting illness)?

  • Time limit:

Pest Control

  • Adequate pest control arrangements in place (no evidence of activity, good proofing, checks)?

  • Time limit:

  • Is a pest control contractor employed to carry out regular checks?

  • Name of contractor and details of contract (no. of visits, pests covered):

Washing equipment

  • Adequate equipment washing facilities (size, hot/cold water, clean, no x-contamination)?

  • Time limit:

Washing food

  • Adequate food washing facilities (size, hot/cold water, clean, no x-contamination)?

  • Time limit:

Hand washing facilities and practices

  • Adequate hand washing facilities (hot/cold water, soap, towels, accessible, other uses)?

  • Time limit:

  • Adequate handwashing practices (after certain tasks, good technique)?

  • Time limit:

Staff hygiene

  • Adequate staff hygiene (overclothing, jewellery, hands, hats)?

  • Time limit:


  • Adequate sanitary provision (clean and in good repair)?

  • Time limit:

Changing facilities

  • Adequate staff changing facilities available?

  • Legal - suitable provision must be made to allow staff to change at work without posing a risk of contamination. This will allow food handlers to change and to store clothes and personal items away from open foods (SR).

  • Time limit:

Water supply

  • Adequate water supply to premises?

  • Time limit:


  • Adequate ventilation (clean, working effectively)?

  • Time limit:


  • Adequate lighting?

  • Time limit:


  • Adequate drainage (clean, no blockages, grill/covers in place, no pooling water)?

  • Time limit:

Waste and refuse

  • Adequate waste facilities (clean, not accumulating, bins with lids)?

  • Time limit:

  • Suitable arrangements for the collection/disposal of waste in accordance with volume and type of food waste?

  • Time limit:


  • Can staff identify the 14 key allergens when used as ingredients in menu/food items?

  • Legal - Ensure that you can easily identify the 14 key allergens and know which allergens are used in which dishes. The information can be recorded upfront on your menu or on recipes or allergen charts of your dishes. The system must be robust enough to allow for recipe or supplier changes. Make sure the allergen information is accessible to all staff and that it is kept up-to-date (CM).

  • Advice - For further information visit:

  • Time limit:

  • Is allergen information available to customers (either provided upfront or available on request)?<br>

  • Legal - you must be able to provide correct allergen information about the ingredients that is in the food you
    make or serve, to your customer. You can do this by either (a) providing allergen information upfront e.g. on menus, or (b) you can to signpost to where it can be obtained, either in written or oral formats. If provided orally there must be away for: this information to be checked by others (verifiable); it to be confirmed as accurate; the same information to be given every time (consistent) (CM).

  • Advice - For further information visit:

  • Time limit:

Cleaning and structure


  • Adequate repair of general food premises?

  • Legal - General Maintenance - Repair / replace the areas of the premises shown. Ensure the food premises are maintained in a good condition (SR).

  • Time limit:

  • Equipment in contact with food in good repair/maintained?

  • Time limit:

  • Adequate repair and maintenance of surfaces, walls, floors, ceilings, windows and doors?

  • Legal - These surfaces need to be maintained in a sound condition and easy to clean and, where necessary, to disinfect. This will require the use of smooth, non-absorbent washable surfaces. Renew or repair these area(s) (SR).

  • Time limit:

  • Suitable materials/covering on surfaces, walls, floors, ceilings, windows and doors?

  • Time limit:


  • Is the food premises kept clean?

  • Time limit:

  • Are articles, fittings and equipment which come into contact with food clean?

  • Time limit:

Cleaning method

  • Is a 2 stage clean and disinfect method used (on equipment or surfaces that come in contact with food)?

  • Legal - 2 stage cleaning – Surfaces that are used for raw and ready to eat food, but are separated by time, must be cleaned and disinfected using a two stage process. The manufacturers' instructions must be followed for the dilution, contact time, and drying method (SR).

  • Time limit:

  • Is chemical disinfection used to disinfect surfaces or equipment used for raw and ready-to-eat food preparation?

  • Is the business using BS EN 1276 and/or EN 13697 compliant disinfectant /sanitiser?

  • Legal - Disinfectants and sanitisers must meet the requirements of one of the following standards: BS EN 1276 and/or BS EN 13697 when used to disinfect surfaces or equipment used for raw and ready-to-eat food preparation (SR).

  • Time limit:

  • When using disinfectants and sanitisers are contact times, dilution factor and drying methods understood/adhered to?

  • Time limit:

  • Are cleaning chemicals stored away from areas where open food is handled?

  • Time limit:

  • Cleaning chemicals used:

  • Or photo(s) of cleaning product(s):

  • Cloths used:

  • Is cloth cleaning method suitable?

  • Time limit:

  • Is a dishwasher used

Food Safety Management System (FSMS)


  • What FSMS is the Business using?

  • The officer has assessed that a documented FSMS based on HACCP Principles is not required for this business

  • All Hazards identified

  • Legal - Identify all the potential food safety hazards in your business (i.e. microbiological, physical and chemical) and then think about and decide the points in the food operation (e.g. delivery, storage, preparation, cooking, cooling, service etc.) at which things could actually go wrong (CM).

  • All Critical Control Points (CCPs) implemented

  • Legal - you need to decide which points are critical to making sure food is safe, and therefore must be properly controlled and checked (e.g. the through cooking of foods which must not be eaten raw) (CM).

  • Monitoring at CCP’s

  • Legal - You need to put in place procedures to stop these things going wrong (controls), and make sure that you/your staff always carry them out (e.g. cooking particular foods for a set time and temperature which is known to kill bacteria) (CM).

  • Corrective Actions Established

  • Legal - For each CCP you need to think what could go wrong and decide on corrective actions in each case (CM).

  • Verification Procedures in place

  • Legal - you need to check that the HACCP-based procedures are achieving the intended effect i.e. controlling food safety hazards. For example, this may be by regularly checking staff are following your procedures (CM).

  • All Documents and Records Available?

  • FSMS regularly reviewed?

  • Date of last review

  • Legal - You must routinely examine your food business to see if anything has changed which might need your control measures to change (e.g. new menu dishes may have new hazards and need new controls, or new equipment may require different thermostat settings) (CM).

  • Time limit for HACCP based procures section to be completed:

  • Does SFBB cover all Hazards?

  • Legal - The SFBB pack does not fully cover all the food safety hazards in your business. You need to complete a food safety management system to cover all your hazards (CM).

  • Time limit:

  • Has the 'Red' Cross Contamination Method been fully completed and implemented with no amendments required?

  • Time limit:

  • Has the 'Purple' Cleaning Method been fully completed and implemented with no amendments required?

  • Time limit:

  • Has the 'Blue' Chilling Method been fully completed and implemented with no amendments required?

  • Time limit:

  • Has the 'Orange' Cooking Method been fully completed and implemented with no amendments required?

  • Time limit:

  • Has the 'Dark Blue' Management Method been fully completed and implemented with no amendments required?

  • Time limit:

  • Is the daily diary signed and up-to-date?

  • Legal - You must complete the diary every day that you are trading. Each day, you need to confirm that your opening and closing checks have been done, and sign to say that your safe methods are being followed. If anything different happens, or something goes wrong, it is important to make a note of it in the diary, so you can show what happened and what you did to put it right. (CM)

  • Time limit:

  • Are the four weekly reviews being completed and implemented correctly?

  • Legal - You must regularly review the methods used in your business to check they are correct, up to date and still being followed by everyone in the business. You can do this by completing the 4 weekly review in the diary section of your SFBB pack (CM).

  • Time limit:

Your Food Hygiene Rating

  • New Food Hygiene Rating given?

  • How hygienically the food is handled (FH)

  • Condition of the structure (SR)

  • How you manage and document food safety (CM)

  • Total score

  • Highest (this means poorest) individual score


  • How Your Rating Is Calculated
    The inspector checks how well you are meeting the law on food hygiene. Three areas are assessed. These are:
    • how hygienically the food is handled – how it is prepared, cooked, cooled, stored, and what measures are taken to prevent food being contaminated with bacteria
    • the condition of the structure of the premises including cleanliness, layout, lighting, ventilation, equipment and other facilities
    • how you manage and record what you do to make sure food is safe using a system like Safer food, better business
    You are given a score for each area – see below. Food safety officers use guidance to determine how to score each of these areas.

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  • Reason for not re-assessing food hygiene rating?

Summary of action taken by officer

  • Type of intervention carried out:

  • Areas inspected:

  • Please specify:

  • Records/documents examined:

  • Food or environmental samples taken?

  • Details of sample(s) taken

  • Persons interviewed:

  • Summary of action to be taken by the officer:

  • Revisit required

  • Select date

Key points summary for Food Business Operator

  • Further work required around training

  • Details of training courses:

  • http://www.southbucks.gov.uk/training

  • Free online allergy training:

  • Watch the Food Standards Agency's food safety coaching videos:

  • Further work required around Food Safety Management System

  • See our Food Safety Management Factsheet for further guidance:

  • http://www.southbucks.gov.uk/foodfactsheets

  • Further work required around temperature control

  • See our Factsheets on chilled storage and cooling, and cooking, reheating and hot holding for further guidance:

  • http://www.southbucks.gov.uk/foodfactsheets

  • Watch the Food Standards Agency's food safety coaching videos:

  • Further work required around Cross Contamination

  • See our Factsheet on Cross-contamination for further guidance:

  • http://www.southbucks.gov.uk/foodfactsheets

  • Detailed information of cross contamination can be found at the FSA

  • Watch the Food Standards Agency's food safety coaching videos:

  • Further work required around Cleaning

  • A cleaning effectively video is available to help you reinforce the message:

  • See our Factsheet on Cleaning and disinfection for further guidance:

  • http://www.southbucks.gov.uk/foodfactsheets

  • Further work required around maintenance and structural improvements

Further information

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 Environmental Health Enforcement Policy. Details of this policy can be viewed at www.chiltern.gov.uk/inspections or www.southbucks.gov.uk/inspections

  • Food Hygiene Rating

    This is designed to help consumers choose where to eat out or shop for food by giving them information about the hygiene standards in food outlets at the time they are inspected to check compliance with legal requirements. You can tell your customers how good your hygiene standards are by putting the sticker up in the window or on the door. Your rating will also be published on the Food Standards Agency’s website at www.food.gov.uk/ratings between four to six weeks from receiving this report. Please remove any sticker showing your previous rating as only one rating – the most recent rating - should be displayed. To continue to display a previous rating may constitute an offence under the Consumer Protection from Unfair Trading Regulations 2008.

    See our ‘Improve My Food Rating Factsheets’ on our websites www.chiltern.gov.uk/foodfactsheets or www.southbucks.gov.uk/foodfactsheets
    If you make the improvements highlighted in your inspection report, you can request a re-inspection to re-assess your rating – this could go up but it could stay the same or it could go down. A £150 charge is made for a request to re-inspect. Visit www.chiltern.gov.uk/revisit or www.southbucks.gov.uk/revisit to apply.

  • Want to appeal your rating? Explain why you received the score you did to your customers?

    If you have improved hygiene standards since your inspection, or if there were unusual circumstances at the time of the inspection that might have affected your food hygiene rating, you have a ‘right to reply’ to explain this to potential customers that look up your rating online.
    If you think that the rating is wrong or unfair – in other words it does not reflect the hygiene standards at the time of your inspection – you have 21 days (from the date of this report) in which you can appeal against this. However you should contact the inspecting officer first so they can help you understand how your rating was worked out.
    All requests to reply, appeal or re-inspect must be made in writing by completing the appropriate form at www.chiltern.gov.uk/fhrssafeguards or www.southbucks.gov.uk/fhrssafeguards

Further information

  • 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 Data Protection Act 1998 legislation.

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