Part 1: General Information

  • Business Name

  • Business address
  • Conducted on

  • Officer Name(s)

  • Inspection type

  • Business type

  • Where full inspection not undertaken, note target matters examined

  • Areas inspected/audited

  • Documents/records examined

  • Legislation considered/Scope of Inspection

  • Other Legislation considered

  • Does the business have a primary Authority?

  • Primary Authority name (where applicable)

Part 2 Inspection notes (aide-memoir)

  • Opening times

  • Business description (overview of the premises and the activities undertaken)

  • Food Safety Management documentation/records

  • Supplier details

  • Purchase/delivery checks

  • Dry goods storage

  • Chilled/frozen goods storage

  • Preparation/personal hygiene practices

  • Cooking

  • Cooling

  • Reheating

  • Hot holding (within kitchen)

  • Cleaning/disinfection methods and chemicals used

  • Staff training

  • E. Coli guidance consideration

  • Pest Control issues

  • Waste: Refuse and waste oil

  • Service/display: hot and cold (front of house)

  • Transport/delivery (where applicable)

  • Structural issues: Walls/floors/ceilings - cleanliness of structure/equipment, layout permits safe workflow, WHB provision, hot water provision, lighting ventilation etc

Health & Safety

  • Matters of evident concern

Summary of Contraventions / key points discussed

  • Contraventions found?

  • Action To be taken

  • Specify where other action to be taken

  • Your revisit will be undertaken in the following time period

  • If Notice to be served, specify type

  • Voluntary closure undertaken

  • Matters of non-compliance requiring attention

  • Recommendations - you are not legally obliged to implement the following matters. The advice has been provided to highlight best practice

  • Evidence Gathered

  • Add media

Risk Rating

Part 4(i): Risk Rating - Food Hygiene

  • Potential Hazard

  • Method of processing

  • Consumers at risk

  • Additional Score

  • Level of current compliance (Food Hygiene/Safety) Food Hygiene and safety assessment focuses on handling practices/procedures and temperature control. Cross contamination risk from procedures observed. The assessment should consider the practices undertaken by staff Although these matters can be eliminated by effective training, Staff training should be assessed under Confidence in Management.

  • Level of current compliance (Structural) Structural compliance assessment focuses on the layout/design, condition of the structure, cleanliness of the structure and equipment, ventilation facilities etc Other matters which are structural include: No WHB or position of, the provision of water (hot and cold), lighting etc. The assessment should consider the premises and equipment and how suitable they are as a food business and how they are being maintained.

  • Confidence in Management/Control systems This part of the assessment is concerned with whether or not suitable management of controls is in place. The presence of a documented FSMS

  • Significant Risk

  • Food Hygiene category

Part 4(ii): Risk Rating - Food Standards

  • Risk to Consumers and.or other Caterers

  • Activities of the business affecting any hazard

  • Ease of Compliance

  • Consumers at Risk

  • Level of Compliance

  • Confidence in Management/ Control Systems

  • Food standards category

Food Hygiene Rating Scheme

  • Food Hygiene Rating Scheme applicable?

  • Food Hygiene Rating Score

Food Hygiene Rating justification

  • Level of compliance: food hygiene/safety - score given

  • Food hygiene/safety - score justification

  • Level of compliance: Structural - score given

  • Structural - score justification

  • Confidence in Management - score given

  • Confidence in Management - score justification

Personal details

Part 5: Food Business Operator details - Sensitive

  • Type of ownership

  • Food Business Operator details: Name, Head Office/home address etc

  • Person spoken with during Inspection

  • Position

  • Signature of person spoken with

  • Telephone number, email address

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.