Standard Food Safety Assessment Checklist-(Version 1.6)

• Authorised officer:

• Inspection Type:

  Select Renewal Follow up (unsatisfactory) Follow up (order) Renewal/Complaint Renewal/Poisoning Change of ownership Poisoning Other

  • Renewal
  • Follow up (unsatisfactory)
  • Follow up (order)
  • Renewal/Complaint
  • Renewal/Poisoning
  • Change of ownership
  • Poisoning
  • Other

• SR Number:

• Description of complaint:

• Nature of inspection:

• Food Registration and trading name:

• Food businesses location:

• Proprietor:

• Delegated contact person for correspondence (s) (e.g. director, manager):

• Contact phone number:

• Contact email address:

• Risk Class:

  1

  2

  3a

  3

  Not sure

• Food Safety Supervisor:

• Food Safety Program:

  Select Department Of Health Registered Food Safety Program Template VERSION 1 Department Of Health Registered Food Safety Program Template VERSION 2 Department Of Health Registered Food Safety Program Template VERSION 3 FoodSmart Non-standard FSP N/A Other:

  • Department Of Health Registered Food Safety Program Template VERSION 1
  • Department Of Health Registered Food Safety Program Template VERSION 2
  • Department Of Health Registered Food Safety Program Template VERSION 3
  • FoodSmart
  • Non-standard FSP
  • N/A
  • Other:

• Details of Food Safety Program

• Food Safety Supervisor:

• Is a food safety program required?

  Yes

  No

  Not Sure

• Food Safety Program:

  Select Department Of Health Registered Food Safety Program Template VERSION 1 Department Of Health Registered Food Safety Program Template VERSION 2 Department Of Health Registered Food Safety Program Template VERSION 3 FoodSmart Non-standard FSP N/A Other:

  • Department Of Health Registered Food Safety Program Template VERSION 1
  • Department Of Health Registered Food Safety Program Template VERSION 2
  • Department Of Health Registered Food Safety Program Template VERSION 3
  • FoodSmart
  • Non-standard FSP
  • N/A
  • Other:

• The following require a food safety program-
  
  a) sous vide cooking, (cooking at less than 75 degrees Celsius) where the food is cooked
  under controlled temperature and time conditions inside vacuum sealed packages in
  water baths or steam ovens;
  
  b) any potentially hazardous food that does not involve temperature control to minimise
  the growth of pathogenic or toxigenic organisms as described in Australia and New
  Zealand Food Standards Code, Standard 3.2.2;
  
  (c) preparation of acidified/fermented foods or drinks that are ready to eat and have a high
  level of acidity required to keep food safe, acid may be naturally present or added or
  produced by the food (due to microbial activity);
  
  (d) preparation of ready to eat foods containing raw unshelled eggs (unpasteurised);
  
  (e) preparation of ready to eat raw or rare minced/finely chopped red meats;
  
  (f) preparation of ready to eat raw and rare poultry and game meats;
  
  (g) off-site catering where ready to eat potentially hazardous food is prepared or partially
  prepared in one location, transported to another location, where the food is served at
  a catering event;
  
  (h) any other complex food process activity such as:
  
  (i) pasteurisation/thermal processing, where food is heated to a certain temperature
  for a specified time, to eliminate pathogenic organisms;
  
  (ii) packaging food where the oxygen has been removed and/or replaced with
  other gases for food safety or to increase shelf life of the food;
  
  (iii) any food processing activity which does not involve the use of temperature
  control, to minimise the growth of pathogenic or toxigenic organisms in food, as
  described in Australia and New Zealand Food Standards Code, Standard 3.2.2.

• Food Safety Supervisor:

• Class 1:
  Food premises are those that predominantly handle potentially hazardous food that is served to vulnerable groups.
  
  This includes businesses such as hospitals, childcare centres and aged care facilities such as nursing homes and hostels.
  
  Class 2:
  Food premises where any unpackaged, potentially hazardous food is handled are classified as class 2. The definition has been expanded to include food premises that manufacture potentially hazardous food and manufacturers of low-risk food where any allergen-free claim is made.
  
  A food premises at which:
  
  a) any unpackaged potentially hazardous food is handled or manufactured, or,
  b) (new) low-risk food is manufactured, for which any allergen-free claim is made, other than:
  I) a class 1 food premises, or
  II) a food premises at which the only handling of unpackaged potentially hazardous food is of a
  kind which renders the premises a class 3 food premises or a class 4 food premises, or
  III) (new) is a home-based business that produces low-risk packaged or unpackaged foods for
  which an allergen-free claim is made.
  
  Class 3A:
  A food premises at which one or more of the following food handling activities occurs:
  
  a) preparation and/or cooking of potentially hazardous foods which are served to guests for immediate consumption at an accommodation getaway premises; or
  b) food made using a hot-fill process resulting in a product such as chutney, relish, salsa, tomato sauce or any other similar food, that:
  I) is made at home-based business or temporary food premises (for example, a hired kitchen)
  has been heat treated to a temperature of not less than 85 °C and then filled and sealed hot into its
  II) packaging
  III) is acidic (pH of less than 4.6), and
  IV) has salt or sugar or any other preservative added
  
  Class 3:
  A food premises at which one or more of the following food handling activities occurs:
  
  a) the handling of unpackaged low-risk food
  b) the warehousing or distribution of pre-packaged foods
  c) the sale of pre-packaged potentially hazardous food
  d) the sale of shell eggs
  e) offering members of the public a free sample of a potentially hazardous food for immediate consumption if –
  I) that food is, or will be, available for sale at the premises in a packaged form
  f) the sale of ready-to-eat, potentially hazardous food by a community group if –
  I) all of the food is cooked on site with the intention of being served immediately
  II) the majority of persons involved in the handling of the food are volunteers, and
  III)this activity takes place at the premises for a maximum of two consecutive days at any one time g) (new) making of sweet or savory foods which do not require temperature control for safety, for a minimum period of 24 hours that are:
  I) uncooked and that may or may not contain dry nuts (whole or crushed), seeds, dry fruits, protein
  powder (or similar supplement), and other low risk ingredients; or
  II) after baking, are a low-risk food, include but not limited to cakes (including fruit cakes), cupcakes
  (with or without icing), bread, biscuits, crackers, muffins, croissants, and other pastry where all the
  ingredients are cooked; and
  III) have no potentially hazardous foods added to the product after baking (for example, fresh
  cream, custard)
  
  but does not include a food premises at which the only handling of food is of a kind which renders the premises a class 4 food premises.
  
  Class 4:
  A food premises at which the only food handling activities are one or more of the following:
  
  a) the sale to members of the public of:
  I) pre-packaged low-risk food
  II) sausages that are cooked and served immediately, with or without onions cooked at the same time, and bread and sauce – when cooked and sold at a temporary food premises or by a non-profit body
  III) packaged or covered cakes (other than cakes with a cream filling) at a temporary premises by a community group
  IV) biscuits, tea or coffee (with or without milk or soymilk) at a temporary premises by a community group
  b) a wine tasting for members of the public, which may include the serving of cheese or low risk food that has been prepared and is ready to eat
  c) the sale to members of the public or the wholesale of whole (uncut) fruit or vegetables
  d) (new) the handling of low-risk food or cut fruit or vegetables and the serving of that food to children at an education and care services facility within the meaning of the Education and Care Services National Law, and children’s services within the meaning of the Children’s Services Act 1996 (Victoria)
  e) (new) offering members of the public a free sample of a low-risk food for immediate consumption if that food is, or will be, available for sale at the premises in a packaged form
  f) (new) serving of coffee, tea (with or without milk, soy, almond or any other liquid), alcohol (including the addition of sliced fruit, pasteurised dairy products), water, soft drink (except fermented soft drinks containing a live culture) intended for immediate consumption but does not include unpasteurised processed fruit or vegetables (for example, fresh juice) or any drink which has any other potentially hazardous food added, such as unpasteurised egg.

• Registration current

  Major non-compliance

  Compliant

• Balance:

• Due date:

• Business response:

• Time of operations (mon-fri)

  Select Early - 12pm 12pm-3pm 9am-5pm 12pm - late 6am- 430pm early - late Can not determine suspected not operating / yet to be confirmed onsite other

  • Early - 12pm
  • 12pm-3pm
  • 9am-5pm
  • 12pm - late
  • 6am- 430pm
  • early - late
  • Can not determine
  • suspected not operating / yet to be confirmed onsite
  • other

• Other-

• Date of inspection:

  Date

• Time of inspection

  Date

• Proprietor’s name affixed to premises

  Yes

  No

  Could not determine

• Business is open:

  Yes

  No

  Could not determine

• Is the classification correct for the operations observed

  Yes

  No

  Not Sure

• 

• the premise needs to be re classed as-

  Class 1

  Class 2

  Class 3

  Class 4

• Person liaised on-site

• Role in business

  Select Owner General manager Duty manager Head Chef Sou chef (deputy chef) Commis chef (junior chef) Cook / Prep chef Food Safety Supervisor Wait staff General Kitchen / kitchen hand staff Office staff

  • Owner
  • General manager
  • Duty manager
  • Head Chef
  • Sou chef (deputy chef)
  • Commis chef (junior chef)
  • Cook / Prep chef
  • Food Safety Supervisor
  • Wait staff
  • General Kitchen / kitchen hand staff
  • Office staff

• Appropriate FSS nominated / qualified

  Minor non-compliance

  Major non-compliance

  Compliant

  Not Observed

  N/A

• Premises details correct:

  Yes

  No

  Could not determine

• Related changes

  Select Trading Name Proprietor Contact email Contact number Other-

  • Trading Name
  • Proprietor
  • Contact email
  • Contact number
  • Other-

• New details:

FOOD STORAGE AND DISPLAY

• PHF is under temperature control. Frozen solid, refrigerated, <5˚C or >60˚ C

  Select Critical non-compliance Major non-compliance Minor non-compliance Compliant Not observed N/A

  • Critical non-compliance
  • Major non-compliance
  • Minor non-compliance
  • Compliant
  • Not observed
  • N/A

• Temperature of foods and location:

• Photos

  Media

• Food is protected from contamination

  Select Critical non-compliance Major non-compliance Minor non-compliance Compliant Not observed N/A

  • Critical non-compliance
  • Major non-compliance
  • Minor non-compliance
  • Compliant
  • Not observed
  • N/A

• Nature of non compliance:

• Photos

  Media

• Food is date labelled and within use-by or best before date

  Select Critical non-compliance Major non-compliance Minor non-compliance Compliant Not observed N/A

  • Critical non-compliance
  • Major non-compliance
  • Minor non-compliance
  • Compliant
  • Not observed
  • N/A

• Nature of non compliance:

• Photos

  Media

• Food for disposal stored separately and labelled

  Select Critical non-compliance Major non-compliance Minor non-compliance Compliant Not observed N/A

  • Critical non-compliance
  • Major non-compliance
  • Minor non-compliance
  • Compliant
  • Not observed
  • N/A

• Nature of non compliance:

• Photos

  Media

• Self-serve display supervised and adequately controlled

  Select Critical non-compliance Major non-compliance Minor non-compliance Compliant Not observed N/A

  • Critical non-compliance
  • Major non-compliance
  • Minor non-compliance
  • Compliant
  • Not observed
  • N/A

• Nature of non compliance:

• Photos

  Media

SINK FACILITIES

• Designated hand basin(s) in each food handling area, warm water, single outlet, single use paper towel and soap

  Select Critical non-compliance Major non-compliance Minor non-compliance Compliant Not observed N/A

  • Critical non-compliance
  • Major non-compliance
  • Minor non-compliance
  • Compliant
  • Not observed
  • N/A

• Nature of issues

  Select Obstructed or otherwise cumbersome to use facilities Facilities not used for intended purpose of washing hands face and arms Facilities not present where hands are potential source of contamination Facilities not stocked with single use towels Facilities not stocked with soap Waste bins not provided at a reasonable distance for disposal of single use towels Sink undersized or otherwise cumbersome to use effectively Other:

  • Obstructed or otherwise cumbersome to use facilities
  • Facilities not used for intended purpose of washing hands face and arms
  • Facilities not present where hands are potential source of contamination
  • Facilities not stocked with single use towels
  • Facilities not stocked with soap
  • Waste bins not provided at a reasonable distance for disposal of single use towels
  • Sink undersized or otherwise cumbersome to use effectively
  • Other:

• Photos

  Media

• Other:

• Equipment washing facilities adequate

  Select Critical non-compliance Major non-compliance Minor non-compliance Compliant Not observed N/A

  • Critical non-compliance
  • Major non-compliance
  • Minor non-compliance
  • Compliant
  • Not observed
  • N/A

• Nature of non compliance:

• Photos

  Media

• Food prep sink adequate

  Select Critical non-compliance Major non-compliance Minor non-compliance Compliant Not observed N/A

  • Critical non-compliance
  • Major non-compliance
  • Minor non-compliance
  • Compliant
  • Not observed
  • N/A

• Nature of non compliance:

• Photos

  Media

• Cleaners sink and / or bin wash facilities adequate

  Select Critical non-compliance Major non-compliance Minor non-compliance Compliant Not observed N/A

  • Critical non-compliance
  • Major non-compliance
  • Minor non-compliance
  • Compliant
  • Not observed
  • N/A

• Nature of non compliance:

• Photos

  Media

• Adequate water supply and disposal (potable, temperature, pressure, volume, waste connected to sewer)

  Select Critical non-compliance Major non-compliance Minor non-compliance Compliant Not observed N/A

  • Critical non-compliance
  • Major non-compliance
  • Minor non-compliance
  • Compliant
  • Not observed
  • N/A

• Nature of non compliance:

• Photos

  Media

PREMISES AND EQUIPMENT

• Floors, walls, ceilings in a clean state

  Select Critical non-compliance Major non-compliance Minor non-compliance Compliant Not observed N/A

  • Critical non-compliance
  • Major non-compliance
  • Minor non-compliance
  • Compliant
  • Not observed
  • N/A

• Nature of non compliance:

• Photos

  Media

• FFE appropriately installed, fit for use, good state of repair and cleanliness

  Select Critical non-compliance Major non-compliance Minor non-compliance Compliant Not observed N/A

  • Critical non-compliance
  • Major non-compliance
  • Minor non-compliance
  • Compliant
  • Not observed
  • N/A

• Nature of non compliance:

• Photos

  Media

• Eating and drinking utensils clean and sanitary condition and in good state of repair

  Select Critical non-compliance Major non-compliance Minor non-compliance Compliant Not observed N/A

  • Critical non-compliance
  • Major non-compliance
  • Minor non-compliance
  • Compliant
  • Not observed
  • N/A

• Nature of non compliance:

• Photos

  Media

• Single use items and packaging fit for use and protected from contamination

  Select Critical non-compliance Major non-compliance Minor non-compliance Compliant Not observed N/A

  • Critical non-compliance
  • Major non-compliance
  • Minor non-compliance
  • Compliant
  • Not observed
  • N/A

• Nature of non compliance:

• Photos

  Media

• Lighting adequate (Lux levels / shatterproof covers)

  Select Critical non-compliance Major non-compliance Minor non-compliance Compliant Not observed N/A

  • Critical non-compliance
  • Major non-compliance
  • Minor non-compliance
  • Compliant
  • Not observed
  • N/A

• Nature of non compliance:

• Photos

  Media

• Ventilation sufficient, functional and clean

  Select Critical non-compliance Major non-compliance Minor non-compliance Compliant Not observed N/A

  • Critical non-compliance
  • Major non-compliance
  • Minor non-compliance
  • Compliant
  • Not observed
  • N/A

• Nature of non compliance:

• Photos

  Media

• All practicable measures taken to eradicate and prevent entry and harbourage of pests (pest activity present)

  Select Critical non-compliance Major non-compliance Minor non-compliance Compliant Not observed N/A

  • Critical non-compliance
  • Major non-compliance
  • Minor non-compliance
  • Compliant
  • Not observed
  • N/A

• Nature of non compliance:

• Photos

  Media

FOOD HANDLERS

• Adequate skills and knowledge. Personal hygiene, health and safe food practices

  Select Critical non-compliance Major non-compliance Minor non-compliance Compliant Not observed N/A

  • Critical non-compliance
  • Major non-compliance
  • Minor non-compliance
  • Compliant
  • Not observed
  • N/A

• Nature of non compliance:

• Photos

  Media

• Able to adequately prepare allergen free food and provide customers with information on the allergen status of their product.

  Select Critical non-compliance Major non-compliance Minor non-compliance Compliant Not observed N/A

  • Critical non-compliance
  • Major non-compliance
  • Minor non-compliance
  • Compliant
  • Not observed
  • N/A

• Nature of non compliance:

• Photos

  Media

• Adequate storage facilities for personal effects

  Select Critical non-compliance Major non-compliance Minor non-compliance Compliant Not observed N/A

  • Critical non-compliance
  • Major non-compliance
  • Minor non-compliance
  • Compliant
  • Not observed
  • N/A

• Nature of non compliance:

• Photos

  Media

CLEANING, WASTE and TOILETS

• All food contact surfaces are adequately cleaned and sanitised (type of sanitiser, dilution)

  Select Critical non-compliance Major non-compliance Minor non-compliance Compliant Not observed N/A

  • Critical non-compliance
  • Major non-compliance
  • Minor non-compliance
  • Compliant
  • Not observed
  • N/A

• Nature of non compliance:

• Photos

  Media

• Chemicals and cleaning equipment appropriately labelled and stored

  Select Critical non-compliance Major non-compliance Minor non-compliance Compliant Not observed N/A

  • Critical non-compliance
  • Major non-compliance
  • Minor non-compliance
  • Compliant
  • Not observed
  • N/A

• Nature of non compliance:

• Photos

  Media

• Adequate storage facilities for waste (internal and external)

  Compliant

  Minor non compliance

  Major non-compliance

  N/A

  Not observed

• Nature of non compliance:

• Photos

  Media

• Toilet facilities adequate (clean, hand basin, warm water, airlock or mechanical ventilation)

  Select Critical non-compliance Major non-compliance Minor non-compliance Compliant Not observed N/A

  • Critical non-compliance
  • Major non-compliance
  • Minor non-compliance
  • Compliant
  • Not observed
  • N/A

• Nature of non compliance:

• Photos

  Media

FOOD ACTIVITIES

• Business only accepts PHF temperature control and all food received is protected from contamination

  Select Critical non-compliance Major non-compliance Minor non-compliance Compliant Not observed N/A

  • Critical non-compliance
  • Major non-compliance
  • Minor non-compliance
  • Compliant
  • Not observed
  • N/A

• Nature of non compliance:

• Photos

  Media

• PHF adequately thawed

  Select Critical non-compliance Major non-compliance Minor non-compliance Compliant Not observed N/A

  • Critical non-compliance
  • Major non-compliance
  • Minor non-compliance
  • Compliant
  • Not observed
  • N/A

• Nature of non compliance:

• Photos

  Media

• Takes all practicable measures to prepare safe and suitable food (contamination, temperature issues).

  Select Critical non-compliance Major non-compliance Minor non-compliance Compliant Not observed N/A

  • Critical non-compliance
  • Major non-compliance
  • Minor non-compliance
  • Compliant
  • Not observed
  • N/A

• Nature of non compliance:

• Photos

  Media

• PHF is adequately cooked

  Select Critical non-compliance Major non-compliance Minor non-compliance Compliant Not observed N/A

  • Critical non-compliance
  • Major non-compliance
  • Minor non-compliance
  • Compliant
  • Not observed
  • N/A

• Nature of non compliance:

• Photos

  Media

• Cools PHF from 60˚C to 21˚C within 2 hours and from 21˚C to 5˚C within a further 4 hours.

  Select Critical non-compliance Major non-compliance Minor non-compliance Compliant Not observed N/A

  • Critical non-compliance
  • Major non-compliance
  • Minor non-compliance
  • Compliant
  • Not observed
  • N/A

• Nature of non compliance:

• Photos

  Media

• PHF is adequately reheated

  Select Critical non-compliance Major non-compliance Minor non-compliance Compliant Not observed N/A

  • Critical non-compliance
  • Major non-compliance
  • Minor non-compliance
  • Compliant
  • Not observed
  • N/A

• Nature of non compliance:

• Photos

  Media

• Adequate and documented process for recalled food (wholesale, manufacturing, importing businesses only)

  Select Critical non-compliance Major non-compliance Minor non-compliance Compliant Not observed N/A

  • Critical non-compliance
  • Major non-compliance
  • Minor non-compliance
  • Compliant
  • Not observed
  • N/A

• Nature of non compliance:

• Photos

  Media

FOOD SAFETY PROGRAM

• Food Safety Program applicable

  Yes

  No

• Food safety Program onsite and adequate for the business

  Select Critical non-compliance Major non-compliance Minor non-compliance Compliant Not observed N/A

  • Critical non-compliance
  • Major non-compliance
  • Minor non-compliance
  • Compliant
  • Not observed
  • N/A

• Nature of non compliance:

• Photos

  Media

• Non Standard FSP - 3rd party audit done, full / current copy of program submitted

  Select Critical non-compliance Major non-compliance Minor non-compliance Compliant Not observed N/A

  • Critical non-compliance
  • Major non-compliance
  • Minor non-compliance
  • Compliant
  • Not observed
  • N/A

• Nature of non compliance:

• Photos

  Media

• FSP type and template correct (check View Form to see/update)

  Yes

  No

  Could not determine

• Business only accepts food from approved food suppliers

  Select Critical non-compliance Major non-compliance Minor non-compliance Compliant Not observed N/A

  • Critical non-compliance
  • Major non-compliance
  • Minor non-compliance
  • Compliant
  • Not observed
  • N/A

• Nature of non compliance:

• Photos

  Media

• Adequate records (Suppliers, Delivery, Hot/Cold, Process, Calibration, Sushi prep/display, Chinese Meat, Sous Vide)

  Select Critical non-compliance Major non-compliance Minor non-compliance Compliant Not observed N/A

  • Critical non-compliance
  • Major non-compliance
  • Minor non-compliance
  • Compliant
  • Not observed
  • N/A

• Nature of non compliance:

• Photos

  Media

• Probe thermometer onsite, adequate and sanitised before use

  Select Critical non-compliance Major non-compliance Minor non-compliance Compliant Not observed N/A

  • Critical non-compliance
  • Major non-compliance
  • Minor non-compliance
  • Compliant
  • Not observed
  • N/A

• Nature of non compliance:

• Photos

  Media

ADDITIONAL

• Is tobacco applicable

  Yes

  No

  N/A

  Not observed

Tobacco – Enclosed Food/Drink

• Does the business have an indoor dining area

  Yes

  No

  N/A

  Not observed

• Are no smoking signs posted as required (licensed premises, shopping centre, bingo centre, casino, cafés and restaurants)?

  Yes

  No

  N/A

  Not observed

• Further notes:

• Photos:

  Media

• Inform On (Enclosed Workplace Eating Establishment)-
  • The need for Smoking status of an outdoor area can change if awning (or similar) are drawn the entire enclosed workplace to be smoke-free at all times
  • Smoking status of a workplace never changes even if doors and windows are opened
  • Occupier must not provide ashtrays, matches, lighters or other things designed to facilitate smoking
  • If occupier witnesses smoking they should request that the person extinguish the cigarette.
  • Where possible, designate an outside bin area as the area where smoking is permitted
  • A cigarette butt bin should be provided in designated outdoor smoking areas
  • Educating new staff regarding the smoke-free enclosed workplace
  

• Are there any signs that smoking may be occurring in an enclosed workplace eg ashtrays, butts, smell? (Refer to the Smoke Free Workplace Guide for calculating an enclosed workplace)

  Yes

  No

  N/A

  Not observed

• Further notes:

• Photos:

  Media

• Inform On (Enclosed Workplace Eating Establishment)-
  • The need for Smoking status of an outdoor area can change if awning (or similar) are drawn the entire enclosed workplace to be smoke-free at all times
  • Smoking status of a workplace never changes even if doors and windows are opened
  • Occupier must not provide ashtrays, matches, lighters or other things designed to facilitate smoking
  • If occupier witnesses smoking they should request that the person extinguish the cigarette.
  • Where possible, designate an outside bin area as the area where smoking is permitted
  • A cigarette butt bin should be provided in designated outdoor smoking areas
  • Educating new staff regarding the smoke-free enclosed workplace
  

Tobacco – Outdoor Food/Drink

• Does the premises have an outdoor dining area?

  Yes

  No

  N/A

  Not observed

• Is the outdoor dining area an enclosed area? (Refer to the Smoke Free Workplace Guide for calculating an enclosed workplace)

  Yes

  No

  Not Sure

• *****Calculating smoking permission*****
  
  Step1 Does area have roof?
  Does the roof impede airflow? If so, the area should be regarded as having a roof. As a guide, if half of the area is covered then the area may be considered to have a roof.
  
  Step 2 Total notational wall area
  Calculate the total wall surface area that is required to enclose all walls up to the lowest point of the roof along the perimeter of the roofline – this will give you the your “total notational wall area”
  
  Step 3 Total actual wall area
  Work out the actual wall area that exists. If a wall prevents or significantly impedes lateral airflow in an area, despite any openings or gaps in the wall, those openings should be disregarded in assessing the total actual area of the wall surface.
  
  Step 4 Compare your actual wall area as a percentage of your total notational wall area. If the amount is 75% or less, smoking is permitted. If the amount is more than 75%, smoking is not permitted.
  

• Is the outdoor dining area separated from an outdoor drinking area by a 4 metre buffer zone or a wall at least 2.1 metres high?

  Yes

  No

  N/A

  Not observed

• Is there a ‘No smoking in outdoor dining area’ sign displayed at the entry to, or within the outdoor dining area?

  Yes

  No

  N/A

  Not observed

• Is smoking occurring within the outdoor dining area?

  Yes

  No

  N/A

  Not observed

• Does the premises have an outdoor drinking area?

  Yes

  No

  Could not determine

• Is the outdoor drinking area an enclosed area? (Refer to the Smoke Free Workplace Guide for calculating an enclosed area)

  Yes

  No

  Not Sure

• *****Calculating smoking permission*****
  
  Step1 Does area have roof?
  Does the roof impede airflow? If so, the area should be regarded as having a roof. As a guide, if half of the area is covered then the area may be considered to have a roof.
  
  Step 2 Total notational wall area
  Calculate the total wall surface area that is required to enclose all walls up to the lowest point of the roof along the perimeter of the roofline – this will give you the your “total notational wall area”
  
  Step 3 Total actual wall area
  Work out the actual wall area that exists. If a wall prevents or significantly impedes lateral airflow in an area, despite any openings or gaps in the wall, those openings should be disregarded in assessing the total actual area of the wall surface.
  
  Step 4 Compare your actual wall area as a percentage of your total notational wall area. If the amount is 75% or less, smoking is permitted. If the amount is more than 75%, smoking is not permitted.
  

• Are only ‘snacks’ being served in the outdoor drinking area?

  Yes

  No

  N/A

  Not observed

Tobacco – Retailers

• Does the business sell tobacco?

  Yes

  No

  N/A

  Not observed

• Are tobacco products and packaging (cigarettes, cigars, loose tobacco, shisha tobacco and E-cigarette products ) covered and not visible to the public from anywhere inside or outside the retail premises?

  Yes

  No

  N/A

  Not observed

• Sells shisha without tobacco

  Yes

  No

  N/A

  Not observed

• Sells shisha with tobacco

  Yes

  No

  N/A

  Not observed

• Is the health warning sign displayed?

  Yes

  No

  N/A

  Not observed

• Is the “We don’t sell tobacco to u/18’s sign” displayed?

  Yes

  No

  N/A

  Not observed

• If a price board is displayed, is there a graphic health warning sign displayed on or immediately next to the price board?

  Yes

  No

  N/A

  Not observed

• Are staff being trained regarding cigarette sales to minors?

  Yes

  No

  N/A

  Not observed

• Is there any tobacco advertising within the store (Inc. non-branded tobacco advertising such as a backlit sign of lighters and/or matches)?

  Yes

  No

  N/A

  Not observed

• Are there any ‘discounted’ or ‘cheap’ cigarette signs?

  Yes

  No

  N/A

  Not observed

• Are cigarettes on sale in packs of less than 20 cigarettes?

  Yes

  No

  N/A

  Not observed

• Inform On Types of identification that should be sighted when purchasing cigarettes who may be under 25

  Yes

  No

  N/A

  Not observed

• Inform on Not selling single cigarettes or in a packet less than 20

  Yes

  No

  N/A

  Not observed

Tobacco – Vending Machines

• Does the premises have a vending machine?

  Yes

  No

  N/A

  Not observed

• Is the vending machine located in a correct position in the line of sight of the bar area not more than 5 meters from the outer edge of the bar area in a licensed premises, or in the line of sight of counter at a gaming venue or casino, or next the counter at a bottle shop?

  Yes

  No

  N/A

  Not observed

• Are tobacco products covered and not visible inside or outside of the vending machine?

  Yes

  No

  N/A

  Not observed

• Is the health warning sign displayed on or near the vending machine?

  Yes

  No

  N/A

  Not observed

• Is the ‘WE don’t sell tobacco to u/18’s’ sign displayed on or near the vending machine?

  Yes

  No

  N/A

  Not observed

• Yes

  No

  N/A

  Not observed

• Is the premises a transport vehicle

  Yes

  No

  N/A

  Not observed

FOOD TRANSPORT

• Food adequately transported – vehicle appropriate and clean, food protected and under temperature control.

  Select Critical non-compliance Major non-compliance Minor non-compliance Compliant Not observed N/A

  • Critical non-compliance
  • Major non-compliance
  • Minor non-compliance
  • Compliant
  • Not observed
  • N/A

• Nature of non compliance:

• Photos

  Media

• Does an abolishment need to be applied for?

  Yes

  No

  N/A

  Not observed

• Further notes or actions:

  Yes

  No

  N/A

  Not observed

• Further notes

• Further photos:

  Media