Information
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Stapleton Sausage Company #103 3950 191 Street Surrey, BC V3Z 0Y6
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INFORMATION
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Select date
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Employee/Assessor Name & Signature
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Supervisor Name & Signature
DOCUMENTATION & SIGNATURES
Pest Control Program
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Written Pest Control Policy In Place.
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Contracted to Pest Control Company
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Add Photo of Most Recent Service Report.
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Evidence of Pests.
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Building Restricts Access To Pests.
Traceability & Recall Program
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Traceability & Recall Programs In Place.
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List Recall Team (Name & Responsibility).
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Has a Product Withdrawal,Product Recall, or Mock Recall Occurred In The Past 30 Days?
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Add Photo of Recall Log Documenting Each Occurrence in the Past 30 Days.
Documentation & Inspections
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Inspection Report from Regulatory Authority In The Past 30 Days.
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Add photo of Inspection Report.
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Have All Infractions Been Addressed And Corrected (Corrective Action Plan Created And Implemented).
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Organic, Kosher, Gluten-Free or other Certification
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Add photo of most recent Certifications.
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Have All Infractions Been Addressed And Corrected (Corrective Action Plan Created And Implemented).
RECEIVING & SHIPPING
RECEIVING
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Loading Dock Clean, Well-Lit And Free of Debris.
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Food items are from Approved Source.
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Deliveries Received At Non-Peak Times, Not Left On The Dock.
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Sanitation of Trucks Checked and Logged.
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Deliveries Are Kept At Least 15cm/6in Off Floor.
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Pallets are Clean, Properly Labelled and Dated.
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Pallets Observed for Cleanliness & Potential Of Cross-Contamination.
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Food is Inspected Before Being Placed In Storage.
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Evidence of Cross Contamination.
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Policy In Place For Rejection Of Goods.
SHIPPING
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Pallets are Clean, Properly Labelled and Dated.
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Are Slip Sheets (or Similar) Used With Pallets (Should Cover Entire Pallet)?
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Sanitation of Trucks Checked and Logged.
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Is the Loading Dock Clean, Well-Lit and Free of Debris.
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Is there Evidence of Cross Contamination?
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Food is Inspected before being placed into Vehicle.
DRY STORAGE
Dry Storage
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Evidence temperatures are monitored and recorded.
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Adequate Air Cirulation
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Food And Supplies Are Maintained At 15cm/6in Off Floor.
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FIFO Product Rotation Maintained
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Food & Supplies Are Stored At Least 45cm/18in From Sprinkler Heads.
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Are storage areas well lit?
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Are protective light shields cover all light sources?
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Is all food is labelled and dated?
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Bulk Food Products Are Labeled & Dated If Not In Original Containers.
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Evidence of leaks and moisture.
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Is food protected from cross-contamination?
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Floors are clear of debris, boxes and hazards.
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All surfaces are clean.
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Chemicals are stored away from food products & supplies.
PRODUCTION
Warewashing
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Drying/Storage Areas For Small Wares Kept Clean And Organized.
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Only Clean & Sanitized Utensils Are Used For Production.
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List Sanitizing Method and Concentration.
SANITATION
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Sanitation Log Maintained.
Equipment And Building Maintenance
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Building meets local building codes.
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Floors, walls and ceiling meets local safety codes.
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Building, Storage Shelves, Counters and Work Surfaces In Good Repair<br>(No evidence of flaking paint).
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Food contact surfaces meet safety standards.
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Regular Maintenance on building.
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Water Quality meets Safety Standards.
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Regular Preventative Maintenance Performed.
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Inoperative equipment removed from production areas.
CHEMICALS
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Only Authorized Cleaning Compounds and Sanitizers In Use.
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Sanitizer Concentrations meet standards.
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Chemicals are properly labeled.
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Chemicals are properly stored.
Power Equipment
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Only approved equipment is used.
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Power Equipment is clean and maintained.
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Power equipment shows no signs of fluid leaks.
Utensils And Equipment
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Utensils are clean & sanitized.
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Drawers Are Clean & Sanitized.
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Racks are clean.
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Equipment is covered when clean and not in use.
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Pallets are maintained and clean.
DAILY CLEANING
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Daily Cleaning Schedule In Place.
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Floor and walls cleaned regularly.
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Deep cleaning schedule in place.
GARBAGE STORAGE and DISPOSAL
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Garbage containers are clean and covered.
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Garbage containers are emptied as necessary.
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Boxes and containers are removed.
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Dumpster is located Away From Points of Facility Entry.
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Dumpster area is clean.
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Dumpster lids are closed.
EMPLOYEE HYGEINE
EMPLOYEE HYGIENE
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Employee Health Poster available.
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Proper Hand Washing Observed.
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Staff only wash hands in designated handwash sink.
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Employees wear appropriate uniform including proper shoes.
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Hair restraints worn.
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Fingernails are trimmed.
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Jewelry is restricted.
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Disposable Glove Policy Maintained (minimized bare hand contact, cover cuts & sores, changed frequently).
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Open sores, cuts, or bandages on hands are completely covered while handling food.
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Staff beverages are covered with a lid and stored away from food prep areas.
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Eating, drinking or gum Allowed only in designated areas.
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Appropriate action when coughing or sneezing.
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Disposable tissues are used and disposed of when coughing or blowing nose.
FACILITIES
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Hand Washing signage displayed.
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Adequate hand wash stations available and are fully stocked (anti-microbial hand soap, disposable towels and hand sanitizer)
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Sanitizing solution available in critical areas.
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Staff lockers available away from food prep area.
