Self Assessment Richmond Plastics Ltd. Certification # PKG1091112

• Employee/Assessor Name

• Enter Date & Time

  Date

• Supervisor Name & Signature

  Sign

PEST CONTROL

• Written integrated pest control policy in place

  Yes

  No

  N/A

• Contracted to Pest Control company

  Yes

  No

  N/A

• Evidence of pests?

  Yes

  No

  N/A

• Building restricts access to pests

  Yes

  No

  N/A

• Food Safety & Quality Systems The goal of this program is to ensure raw materials and finished products meet all local and federal food safety regulations as well as specification.  An assigned person/position responsible for maintaining program – HACCP Coordinator  Certificate of Analysis (COA) or Certificate of Conformance (COC) (CFIA Registration) • Facility should not allow chemicals, raw materials, or label material to be used in the process without being accompanied by a guarantee that specifications are met • A procedure addressing materials receipt and missing documentation (e.g. how to obtain the documentation, what to do with materials prior to receipt of COA, responsibilities and expectations of suppliers)  Letters of Guarantee (LOG) • An assurance letter shall be supplied stating that finished product meets regulatory compliance for specified packaging material DOCUMENT VERIFICATION PAPERS

• HACCP Plan in Place and Operational?

  Yes

  No

  N/A

• List HACCP Committee Members

• Design Control Policy In Place (Printing)

  Yes

  No

  N/A

• Line Clearance Policy In Place (Printing)

  Yes

  No

  N/A

RECEIVING

• Loading Dock Sanitation Condition

  Yes

  No

  N/A

• Food-grade materials are from an Approved Source

  Yes

  No

  N/A

• Deliveries are Received at non-peak times, not left on dock?

  Yes

  No

  N/A

• Sanitation of Delivery Vehicles Checked and Logged

  Witnessed Document

  No Document

• Pallets are Properly Labelled and Dated

  Yes

  No

  N/A

• Pallets Observed for Cleanliness and potential for cross contamination.

  Yes

  No

  N/A

• Slip Sheets are Used to Separate Product from Pallet

  Yes

  No

  N/A

• Evidence of Contamination

  Safe

  At Risk

  N/A

• Raw Materials Are Inspected Before Being Stored

  Yes

  No

  N/A

RECALL AND REJECTION OF GOODS

• Policy in place for RECALLS

  Yes

  No

  N/A

• Documentation Maintained for Recalls?

  Yes

  No

  N/A

• Segregated Area for Recalls?

  Yes

  No

  N/A

• Policy in place for Rejection of Goods

  Yes

  No

  N/A

• Documentation Maintained for Rejection of Goods?

  Yes

  No

  N/A

SHIPPING

• Loading Dock Sanitation Condition

  Yes

  No

  N/A

• Pallets are Properly Labelled and Dated

  Yes

  No

  N/A

• Slip Sheets Are In Use

  Yes

  No

  N/A

• Product is Inspected before being placed into Vehicle

  Yes

  No

  N/A

• Sanitation of Delivery Vehicles Checked and Logged

  Witnessed Document

  No Document

• Evidence of Contamination

  Safe

  At Risk

  N/A

• Product Is Kept 6 in Off Floor<br><br><br><br>

  Yes

  No

  N/A

• Evidence temperatures are monitored and recorded

  Yes

  No

  N/A

• Adequate Air Circulation

  Safe

  At Risk

  N/A

• Raw Material & Finished Product Kept At Least 6 in Off Floor

  Yes

  No

  N/A

• FIFO Product Rotation Maintained

  Yes

  No

  N/A

• Raw Materials & Finished Products Are Stored At Least 18 in From Sprinkler Heads

  Yes

  No

  N/A

• Storage area is well lit

  Yes

  No

  N/A

• Protective light shields cover all light sources

  Yes

  No

  N/A

• All Materials and Products Are Labeled And Dated

  Yes

  No

  N/A

• Evidence of leaks and moisture

  Safe

  At Risk

  N/A

• Raw Material & Finished Product Are Protected From Contamination

  Yes

  No

  N/A

• Floors are clear of debris, boxes and hazards

  Yes

  No

  N/A

• All surfaces are clean

  Safe

  At Risk

  N/A

• Chemicals Are Stored Separate From Raw Material & Finished Products

  Yes

  No

  N/A

EQUIPMENT and BUILDING MAINTENANCE

• Building meets local building codes

  Yes

  No

  N/A

• Floors, walls and ceiling meets local safety codes

  Yes

  No

  N/A

• No evidence of flaking paint

  Safe

  At Risk

  N/A

• Water Quality meets Safety Standards

  Yes

  No

  N/A

• Regular Maintenance on building

  Yes

  No

  N/A

• Regular Maintenance on critical equipment

  Yes

  No

  N/A

• Inoperative Equipment Tagged For Repair Or Removal From Production Areas

  Yes

  No

  N/A

CHEMICALS

• Cleaning compounds and sanitizers meet standards

  Yes

  No

  N/A

• Concentrations meet standards

  Yes

  No

  N/A

• Chemicals are properly labeled

  Yes

  No

  N/A

• Chemicals are properly stored

  Yes

  No

  N/A

POWER EQUIPMENT

• Only approved equipment is used

  Yes

  No

  N/A

• Power Equipment is clean and maintained

  Yes

  No

  N/A

• Power equipment shows no signs of excessive fluid leaks

  Yes

  No

  N/A

UTENSILS and EQUIPMENT

• Drawers are clean

  Yes

  No

  N/A

• Racks are clean

  Yes

  No

  N/A

• Pallets are maintained and clean

  Yes

  No

  N/A

DAILY CLEANING

• Daily Cleaning, Sanitizing and Preventative Maintenance Schedule In Place

  Yes

  No

  N/A

• Deep cleaning schedule in place

  Witnessed Document

  No Document

• Sanitary Condition of Facility

GARBAGE STORAGE and DISPOSAL

• Refuse and garbage containers are clean and emptied regularly (not overflowing)

  Yes

  No

  N/A

• Boxes and containers are removed as necessary

  Yes

  No

  N/A

• Recyclable Materials Removed From Production Areas Regularly

  Yes

  No

  N/A

• Dumpster is located away from facility access

  Yes

  No

  N/A

• Dumpster lids are closed

  Yes

  No

  N/A

• Dumpster area is clean

  Yes

  No

  N/A

EMPLOYEE HYGIENE

• Hands are washed at critical times and places

  Yes

  No

  N/A

• Staff only wash hands in handwash sink

  Yes

  No

  N/A

• Employee Health Poster available

  Yes

  No

  N/A

• Employees wear appropriate uniform including proper shoes

  Yes

  No

  N/A

• Hair restraints are worn

  Yes

  No

  N/A

• Fingernails are trimmed

  Yes

  No

  N/A

• Jewelry is restricted,

  Yes

  No

  N/A

• Gloves are changed at critical times and places

  Yes

  No

  N/A

• Open sores, cuts, or bandages completely covered

  Yes

  No

  N/A

• Staff beverages stored away from production areas

  Yes

  No

  N/A

• Eating, Drinking and Gum Prohibited

  Yes

  No

  N/A

• Staff take appropriate action when coughing or sneezing

  Yes

  No

  N/A

FACILITIES

• Hand wash stations available

  Yes

  No

  N/A

• Soap dispensers available with adequate supply

  Yes

  No

  N/A

• Paper towel dispensers with adequate supply

  Yes

  No

  N/A

• Sanitizing solution available in critical areas

  Yes

  No

  N/A

• Hand Washing signage displayed

  Yes

  No

  N/A