INFORMATION

  • Enter Date

  • Employee/Assessor Name & Signature

  • Supervisor Name & Signature

DOCUMENTATION & SIGNATURES

Pest Control Program

  • Written Pest Control Policy In Place.

  • Contracted to Pest Control Company

  • Add Photo of Most Recent Service Report.

  • Evidence of Pests.

  • Building Restricts Access To Pests.

Traceability & Recall Program

  • Traceability & Recall Programs In Place.

  • List Recall Team (Name & Responsibility).

  • Has a Product Withdrawal,Product Recall, or Mock Recall Occurred In The Past 30 Days?

  • Add Photo of Recall Log Documenting Each Occurrence in the Past 30 Days.

Documentation & Inspections

  • % Of Production Staff With Food Safety Training (Goal Is 100% After 90 Days Employment).

  • Inspection Report from Regulatory Authority In The Past 30 Days.

  • Add photo of Inspection Report.

  • Have All Infractions Been Addressed And Corrected (Corrective Action Plan Created And Implemented).

  • Organic, Kosher, Fairtrade or other Certification

  • Add photo of most recent Certifications.

  • Have All Infractions Been Addressed And Corrected (Corrective Action Plan Created And Implemented).

RECEIVING & SHIPPING

RECEIVING

  • Loading Dock Clean, Well-Lit And Free of Debris.

  • Food items are from Approved Source.

  • Deliveries Received At Non-Peak Times, Not Left On The Dock.

  • Sanitation of Trucks Checked and Logged.

  • Deliveries Are Kept At Least 15cm/6in Off Floor.

  • Pallets are Clean, Properly Labelled and Dated.

  • Pallets Observed for Cleanliness & Potential Of Cross-Contamination.

  • Food is Inspected Before Being Placed In Storage.

  • Evidence of Cross Contamination.

  • Policy In Place For Rejection Of Goods.

SHIPPING

  • Pallets are Clean, Properly Labelled and Dated.

  • Is the Loading Dock Clean, Well-Lit and Free of Debris.

  • Is there Evidence of Cross Contamination?

  • Food is Inspected before being placed into Vehicle.

DRY STORAGE

Dry Storage

  • Adequate Air Circulation

  • Food & Supplies Are Stored At Least 45cm/18in From Sprinkler Heads.

  • Enter Ambient Air Temperature.

  • Are storage areas well lit?

  • Food And Supplies Are Maintained At 15cm/6in Off Floor.

  • Evidence temperatures are monitored and recorded.

  • Are protective light shields cover all light sources?

  • FIFO Product Rotation Maintained

  • Is all food is labelled and dated?

  • Bulk Food Products Are Labeled & Dated If Not In Original Containers.

  • No evidence of leaks and moisture.

  • Is food protected from cross-contamination?

  • Floors are clear of debris, boxes and hazards.

  • All surfaces are clean.

  • Chemicals are stored away from food products & supplies.

  • Is there evidence of sewage back-up?

PRODUCTION

Baking

  • Oven Temperature Calibrated Per Scheduled Maintenance.

  • Enter Date Of Most Recent Calibration.

  • Baking Logs Maintained (Including Batch/Lot Tracing).

  • Fresh Oil Used For Baking Forms.

  • Production Area, Equipment, Utensils and Racks Clean & Sanitized Before Use.

Warewashing

  • Drying/Storage Areas For Small Wares Kept Clean And Organized.

  • Only Clean & Sanitized Utensils Are Used For Production.

  • List Sanitizing Method and Concentration.

SANITATION

  • Sanitation Log Maintained.

Equipment And Building Maintenance

  • Building meets local building codes.

  • Floors, walls and ceiling meets local safety codes.

  • Building, Storage Shelves, Counters and Work Surfaces In Good Repair
    (No evidence of flaking paint).

  • Food contact surfaces meet safety standards.

  • Regular Maintenance on building.

  • Water Quality meets Safety Standards.

  • Regular Preventative Maintenance Performed.

  • Inoperative equipment removed from production areas.

CHEMICALS

  • Only Authorized Cleaning Compounds and Sanitizers In Use.

  • Sanitizer Concentrations meet standards.

  • Chemicals are properly labeled.

  • Chemicals are properly stored.

Power Equipment

  • Only approved equipment is used.

  • Power Equipment is clean and maintained.

  • Power equipment shows no signs of fluid leaks.

Utensils And Equipment

  • Utensils are clean & sanitized.

  • Drawers Are Clean & Sanitized.

  • Racks are clean.

  • Equipment is covered when clean and not in use.

  • Pallets are maintained and clean.

DAILY CLEANING

  • Daily Cleaning Schedule In Place.

  • Floor and walls cleaned regularly.

  • Deep cleaning schedule in place.

GARBAGE STORAGE and DISPOSAL

  • Garbage containers are clean and covered.

  • Garbage containers are emptied as necessary.

  • Boxes and containers are removed.

  • Dumpster is located Away From Points of Facility Entry.

  • Dumpster area is clean.

  • Dumpster lids are closed.

EMPLOYEE HYGEINE

EMPLOYEE HYGIENE

  • Employee Health Poster available.

  • Proper Hand Washing Observed.

  • Staff only wash hands in designated handwash sink.

  • Employees wear appropriate uniform including proper shoes.

  • Hair restraints worn.

  • Fingernails are trimmed.

  • Jewelry is restricted.

  • Disposable Glove Policy Maintained (minimized bare hand contact, cover cuts & sores, changed frequently).

  • Open sores, cuts, or bandages on hands are completely covered while handling food.

  • Staff beverages are covered with a lid and stored away from food prep areas.

  • Eating, drinking or gum Allowed only in designated areas.

  • Appropriate action when coughing or sneezing.

  • Disposable tissues are used and disposed of when coughing or blowing nose.

FACILITIES

  • Hand Washing signage displayed.

  • Adequate hand wash stations available and are fully stocked (anti-microbial hand soap, disposable towels and hand sanitizer)

  • Sanitizing solution available in critical areas.

  • Staff lockers available away from food prep area.

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