• Date of Assessment.


  • Is There a HACCP Committee

  • List HACCP Committee Members

  • Scan Minutes from Last Meeting

  • Are Biological Hazards Minimized

  • Are Chemical Hazards Minimized

  • Are Physical Hazards Minimized

  • Are Allergenic Hazards Minimized


  • Written integrated pest control policy in place.

  • No evidence of insects or pests present.

  • Building restricts access to pests.

  • Scan most recent Pest Control Service Report.


  • Traceability & Recall Program in place.

  • Has a Mock Recall or Recall Incident Been Performed During the Past 30-days?

  • Scan All Pertinent Documents (Notifications, Logs, etc).


  • Date of most recent inspection.

  • Scan Most Recent Regulatory Inspection.

  • Have All Infractions Been Corrected?

  • List Corrective Action(s) taken.


  • Pallets are properly labelled and dated.

  • Loading Dock sanitation condition.

  • Pallets are checked for cleanliness and potential for contamination.

  • Food deliveries are kept 6" off the floor before being stored.

  • Policy in place for rejection of goods.


  • Pallets are properly labeled & dated.

  • Delivery Vehicle sanitation is observed and logged.

  • Evidence of cross contamination.

  • Food is inspected before being placed in delivery vehicles.


    Ambient Warehousing Condtions
  • Adequate air circulation.

  • All food and paper supplies are 6" off the floor.

  • Product Rotation Maintained (first in first out).

  • Is storage area well lit.

  • Protective light shields cover all light sources.

  • All food is labeled & dated.

  • No evidence of leaks and moisture.

  • Food is protected from cross contamination.

  • Floors are clean an free of debris, boxes and hazards.

  • All surfaces are clean.

  • Chemicals are stored away from food and other food related supplies.

  • Refrigerated Warehousing Conditions
  • Thermometer is conspicuous and accurate.

  • FIFO Maintained (first in first out).

  • Monitored for cross contamination.

  • Food is stored 6" off floor.

  • Record ambient air temperature.


  • Building meets local building codes for food hygiene.

  • Floors, walls and ceiling meets local safety codes.

  • No evidence of peeling or flaking paint.

  • Regular maintenance performed on building.

  • Regular preventative maintenance performed on critical equipment.

  • No evidence of leaking pipes.


  • Cleaning compounds and sanitizers meet standards.

  • Concentrations meet standards.

  • Chemicals are all properly labelled.

  • Chemicals are all properly stored.


  • Refuse and garbage cans are clean and covered when not in use.

  • Garbage containers are emptied as necessary.

  • Boxes and containers are removed from site.

  • Dumpster is located away from facility access points.

  • Dumpster area is clean.

  • Dumpster lid(s) are closed.


  • Employee health poster available.

  • Staff only use wash hands in hand wash sinks.

  • Employees wear proper uniform including proper shoes.

  • Fingernails are short, unpolished and clean.

  • Hair restraint is worn.

  • Jewelry is limited , no watches, earrings.

  • Open sores, cuts, or splints and bandages on hands are covered.

  • Staff beverages are covered with a lid and straw and stored away from food preparation area.

  • Staff take appropriate action when coughing or sneezing.

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


  • Hand washing signage is displayed.

  • Hand sinks accessible and stocked with soap and paper towels.

  • Hand sanitizing solution is available at all hand washing stations and wash rooms.

  • Staff lockers provided away from food production and storage areas.


  • Assessor's Name & Signature.

  • Supervisor's Name & Signature.

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