Information
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Document No.
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Audit Title
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Client / Site
-
Conducted on
-
Prepared by
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Location
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Personnel
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CORRECTIVE ACTION REPORT
PLEASE SELECT A NEW REPORT FOR EACH INCIDENCE.
NEW REPORT
-
DATE:
-
CLEANING FREQUENCY:<br>(Select only ONE.)
-
NOTES:
-
EQUIPMENT: (Select only ONE)
- ALL STAINLESS STEEL TABLE
- BASKET PROOFER & HANDLES (EXTERIOR)
- BLAST FREEZER 2, 3 INCL ROOF BLAST
- BLUE LADDER
- BOWL MIXER 1 2 3
- BOWL MIXER 2 5
- BREAD (BAGUETTE) MOULDER
- CEMENT BASE OF BLAST FREEZERS 1 2 3
- CINELLI EXPERIA MULTI ROLLER
- CLEANING TOOLS
- CROSS SHEETER (EXTERIOR & BELT)
- CROSS SHEETER LINE
- DIES
- DIVIDERS 1 2 3 4 5
- DOORS
- DOORS & HANDLES OF ALL FREEZERS
- ELEVATOR (HOIST)
- ELEVATOR (HOIST) & DUMPER
- FLOORS IN THE PLANT
- FLOORS IN THE PLANT
- FLOORS OF NEW PLANT
- FREEZER 1 WHEN OFF
- GARBAGE CONTAINERS
- METAL DETECTORS (CINELLI)
- METAL DETECTORS (FORTRESS)
- OVERHEAD (BASKET) PROOFER
- ROOF OF BLAST FREEZER 1
- ROOF OF COLD STORAGE
- ROUNDER 1 2 3 4 5 6
- SEQUENTIAL OVENS (OUTSIDE/CONVEYOR/EXHAUST)
- SIFTER AND FLOUR CHUTE (EXTERIOR)
- SINKS 1 2 3
- STORAGE COOLER (SWEEPING)
- STORAGE COOLER HANDLES & DOOR
- STORAGE FREEZER (SWEEPING)
- SUPER SIX MACHINE
- TOP OF WATER TREATMENT INSTRUMENT
- TOP OF WHITE BINS
- UNDER OIL BINS
- UV LIGHT
- WALK IN PROOFER INCL ROOF
- WALK-IN PROOFER (FLOORS & HANDLES)
- WALLS IN MIXING AREA
- WALLS TO 5 FEET
- WATER HEATER
-
NOTES:
-
ISSUES WITH EQUIPMENT: (Select all that apply.)
- DIRTY AFTER CLEANING
- WAS NOT CLEANED
- REPORT FILLED INCORRECTLY
- ITEM WAS NOT USED / CLEAN
- EQUIPMENT FAULTY / BROKEN
- EQUIPMENT NOT DISMANTLED
- OTHER - SEE ADDITIONAL NOTES
-
NOTES:
-
PLEASE SELECT CORRECTIVE ACTION TAKEN: (Select all that apply.)
- CLEANER INSTRUCTED IN PROPER PROCEDURES
- ITEM REWASHED
- NO ACTION REQUIRED AT THIS TIME
- INCIDENCE ADDRESSED WITH CLEANER IN QUESTION
- APPROPRIATE STAFF NOTIFIED OF DEFECT / BREAKAGE
- EQUIPMENT DISMANTLED
- RINSED AND SANITIZED
- SANITIZED ONLY
- FULL WASH AND SANITIZED
- OTHER - SEE ADDITIONAL NOTES
-
ADDITIONAL DETAILS: (Please provide any additional information that was not mentioned above, ex: name of person who re cleaned, further action needed etc...)
-
NAME OF CLEANER(S) INVOLVED:
-
SIGNATURE OF PCI SUPERVISOR ON DUTY:
-
CORRECTIVE ACTION REPORT
PLEASE SELECT A NEW REPORT FOR EACH INCIDENCE.
NEW REPORT
-
DATE:
-
CLEANING FREQUENCY:<br>(Select only ONE.)
-
NOTES:
-
EQUIPMENT: (Select only ONE)
- ALL STAINLESS STEEL TABLE
- BASKET PROOFER & HANDLES (EXTERIOR)
- BLAST FREEZER 2, 3 INCL ROOF BLAST
- BLUE LADDER
- BOWL MIXER 1 2 3
- BOWL MIXER 2 5
- BREAD (BAGUETTE) MOULDER
- CEMENT BASE OF BLAST FREEZERS 1 2 3
- CINELLI EXPERIA MULTI ROLLER
- CLEANING TOOLS
- CROSS SHEETER (EXTERIOR & BELT)
- CROSS SHEETER LINE
- DIES
- DIVIDERS 1 2 3 4 5
- DOORS
- DOORS & HANDLES OF ALL FREEZERS
- ELEVATOR (HOIST)
- ELEVATOR (HOIST) & DUMPER
- FLOORS IN THE PLANT
- FLOORS IN THE PLANT
- FLOORS OF NEW PLANT
- FREEZER 1 WHEN OFF
- GARBAGE CONTAINERS
- METAL DETECTORS (CINELLI)
- METAL DETECTORS (FORTRESS)
- OVERHEAD (BASKET) PROOFER
- ROOF OF BLAST FREEZER 1
- ROOF OF COLD STORAGE
- ROUNDER 1 2 3 4 5 6
- SEQUENTIAL OVENS (OUTSIDE/CONVEYOR/EXHAUST)
- SIFTER AND FLOUR CHUTE (EXTERIOR)
- SINKS 1 2 3
- STORAGE COOLER (SWEEPING)
- STORAGE COOLER HANDLES & DOOR
- STORAGE FREEZER (SWEEPING)
- SUPER SIX MACHINE
- TOP OF WATER TREATMENT INSTRUMENT
- TOP OF WHITE BINS
- UNDER OIL BINS
- UV LIGHT
- WALK IN PROOFER INCL ROOF
- WALK-IN PROOFER (FLOORS & HANDLES)
- WALLS IN MIXING AREA
- WALLS TO 5 FEET
- WATER HEATER
-
NOTES:
-
ISSUES WITH EQUIPMENT: (Select all that apply.)
- DIRTY AFTER CLEANING
- WAS NOT CLEANED
- REPORT FILLED INCORRECTLY
- ITEM WAS NOT USED / CLEAN
- EQUIPMENT FAULTY / BROKEN
- EQUIPMENT NOT DISMANTLED
- OTHER - SEE ADDITIONAL NOTES
-
NOTES:
-
PLEASE SELECT CORRECTIVE ACTION TAKEN: (Select all that apply.)
- CLEANER INSTRUCTED IN PROPER PROCEDURES
- ITEM REWASHED
- NO ACTION REQUIRED AT THIS TIME
- INCIDENCE ADDRESSED WITH CLEANER IN QUESTION
- APPROPRIATE STAFF NOTIFIED OF DEFECT / BREAKAGE
- EQUIPMENT DISMANTLED
- RINSED AND SANITIZED
- SANITIZED ONLY
- FULL WASH AND SANITIZED
- OTHER - SEE ADDITIONAL NOTES
-
ADDITIONAL DETAILS: (Please provide any additional information that was not mentioned above, ex: name of person who re cleaned, further action needed etc...)
-
NAME OF CLEANER(S) INVOLVED:
-
SIGNATURE OF PCI SUPERVISOR ON DUTY:
-
CORRECTIVE ACTION REPORT
PLEASE SELECT A NEW REPORT FOR EACH INCIDENCE.
NEW REPORT
-
DATE:
-
CLEANING FREQUENCY:<br>(Select only ONE.)
-
NOTES:
-
EQUIPMENT: (Select only ONE)
- ALL STAINLESS STEEL TABLE
- BASKET PROOFER & HANDLES (EXTERIOR)
- BLAST FREEZER 2, 3 INCL ROOF BLAST
- BLUE LADDER
- BOWL MIXER 1 2 3
- BOWL MIXER 2 5
- BREAD (BAGUETTE) MOULDER
- CEMENT BASE OF BLAST FREEZERS 1 2 3
- CINELLI EXPERIA MULTI ROLLER
- CLEANING TOOLS
- CROSS SHEETER (EXTERIOR & BELT)
- CROSS SHEETER LINE
- DIES
- DIVIDERS 1 2 3 4 5
- DOORS
- DOORS & HANDLES OF ALL FREEZERS
- ELEVATOR (HOIST)
- ELEVATOR (HOIST) & DUMPER
- FLOORS IN THE PLANT
- FLOORS IN THE PLANT
- FLOORS OF NEW PLANT
- FREEZER 1 WHEN OFF
- GARBAGE CONTAINERS
- METAL DETECTORS (CINELLI)
- METAL DETECTORS (FORTRESS)
- OVERHEAD (BASKET) PROOFER
- ROOF OF BLAST FREEZER 1
- ROOF OF COLD STORAGE
- ROUNDER 1 2 3 4 5 6
- SEQUENTIAL OVENS (OUTSIDE/CONVEYOR/EXHAUST)
- SIFTER AND FLOUR CHUTE (EXTERIOR)
- SINKS 1 2 3
- STORAGE COOLER (SWEEPING)
- STORAGE COOLER HANDLES & DOOR
- STORAGE FREEZER (SWEEPING)
- SUPER SIX MACHINE
- TOP OF WATER TREATMENT INSTRUMENT
- TOP OF WHITE BINS
- UNDER OIL BINS
- UV LIGHT
- WALK IN PROOFER INCL ROOF
- WALK-IN PROOFER (FLOORS & HANDLES)
- WALLS IN MIXING AREA
- WALLS TO 5 FEET
- WATER HEATER
-
NOTES:
-
ISSUES WITH EQUIPMENT: (Select all that apply.)
- DIRTY AFTER CLEANING
- WAS NOT CLEANED
- REPORT FILLED INCORRECTLY
- ITEM WAS NOT USED / CLEAN
- EQUIPMENT FAULTY / BROKEN
- EQUIPMENT NOT DISMANTLED
- OTHER - SEE ADDITIONAL NOTES
-
NOTES:
-
PLEASE SELECT CORRECTIVE ACTION TAKEN: (Select all that apply.)
- CLEANER INSTRUCTED IN PROPER PROCEDURES
- ITEM REWASHED
- NO ACTION REQUIRED AT THIS TIME
- INCIDENCE ADDRESSED WITH CLEANER IN QUESTION
- APPROPRIATE STAFF NOTIFIED OF DEFECT / BREAKAGE
- EQUIPMENT DISMANTLED
- RINSED AND SANITIZED
- SANITIZED ONLY
- FULL WASH AND SANITIZED
- OTHER - SEE ADDITIONAL NOTES
-
ADDITIONAL DETAILS: (Please provide any additional information that was not mentioned above, ex: name of person who re cleaned, further action needed etc...)
-
NAME OF CLEANER(S) INVOLVED:
-
SIGNATURE OF PCI SUPERVISOR ON DUTY:
-
CORRECTIVE ACTION REPORT
PLEASE SELECT A NEW REPORT FOR EACH INCIDENCE.
NEW REPORT
-
DATE:
-
CLEANING FREQUENCY:<br>(Select only ONE.)
-
NOTES:
-
EQUIPMENT: (Select only ONE)
- ALL STAINLESS STEEL TABLE
- BASKET PROOFER & HANDLES (EXTERIOR)
- BLAST FREEZER 2, 3 INCL ROOF BLAST
- BLUE LADDER
- BOWL MIXER 1 2 3
- BOWL MIXER 2 5
- BREAD (BAGUETTE) MOULDER
- CEMENT BASE OF BLAST FREEZERS 1 2 3
- CINELLI EXPERIA MULTI ROLLER
- CLEANING TOOLS
- CROSS SHEETER (EXTERIOR & BELT)
- CROSS SHEETER LINE
- DIES
- DIVIDERS 1 2 3 4 5
- DOORS
- DOORS & HANDLES OF ALL FREEZERS
- ELEVATOR (HOIST)
- ELEVATOR (HOIST) & DUMPER
- FLOORS IN THE PLANT
- FLOORS IN THE PLANT
- FLOORS OF NEW PLANT
- FREEZER 1 WHEN OFF
- GARBAGE CONTAINERS
- METAL DETECTORS (CINELLI)
- METAL DETECTORS (FORTRESS)
- OVERHEAD (BASKET) PROOFER
- ROOF OF BLAST FREEZER 1
- ROOF OF COLD STORAGE
- ROUNDER 1 2 3 4 5 6
- SEQUENTIAL OVENS (OUTSIDE/CONVEYOR/EXHAUST)
- SIFTER AND FLOUR CHUTE (EXTERIOR)
- SINKS 1 2 3
- STORAGE COOLER (SWEEPING)
- STORAGE COOLER HANDLES & DOOR
- STORAGE FREEZER (SWEEPING)
- SUPER SIX MACHINE
- TOP OF WATER TREATMENT INSTRUMENT
- TOP OF WHITE BINS
- UNDER OIL BINS
- UV LIGHT
- WALK IN PROOFER INCL ROOF
- WALK-IN PROOFER (FLOORS & HANDLES)
- WALLS IN MIXING AREA
- WALLS TO 5 FEET
- WATER HEATER
-
NOTES:
-
ISSUES WITH EQUIPMENT: (Select all that apply.)
- DIRTY AFTER CLEANING
- WAS NOT CLEANED
- REPORT FILLED INCORRECTLY
- ITEM WAS NOT USED / CLEAN
- EQUIPMENT FAULTY / BROKEN
- EQUIPMENT NOT DISMANTLED
- OTHER - SEE ADDITIONAL NOTES
-
NOTES:
-
PLEASE SELECT CORRECTIVE ACTION TAKEN: (Select all that apply.)
- CLEANER INSTRUCTED IN PROPER PROCEDURES
- ITEM REWASHED
- NO ACTION REQUIRED AT THIS TIME
- INCIDENCE ADDRESSED WITH CLEANER IN QUESTION
- APPROPRIATE STAFF NOTIFIED OF DEFECT / BREAKAGE
- EQUIPMENT DISMANTLED
- RINSED AND SANITIZED
- SANITIZED ONLY
- FULL WASH AND SANITIZED
- OTHER - SEE ADDITIONAL NOTES
-
ADDITIONAL DETAILS: (Please provide any additional information that was not mentioned above, ex: name of person who re cleaned, further action needed etc...)
-
NAME OF CLEANER(S) INVOLVED:
-
SIGNATURE OF PCI SUPERVISOR ON DUTY:
-
CORRECTIVE ACTION REPORT
PLEASE SELECT A NEW REPORT FOR EACH INCIDENCE.
NEW REPORT
-
DATE:
-
CLEANING FREQUENCY:<br>(Select only ONE.)
-
NOTES:
-
EQUIPMENT: (Select only ONE)
- ALL STAINLESS STEEL TABLE
- BASKET PROOFER & HANDLES (EXTERIOR)
- BLAST FREEZER 2, 3 INCL ROOF BLAST
- BLUE LADDER
- BOWL MIXER 1 2 3
- BOWL MIXER 2 5
- BREAD (BAGUETTE) MOULDER
- CEMENT BASE OF BLAST FREEZERS 1 2 3
- CINELLI EXPERIA MULTI ROLLER
- CLEANING TOOLS
- CROSS SHEETER (EXTERIOR & BELT)
- CROSS SHEETER LINE
- DIES
- DIVIDERS 1 2 3 4 5
- DOORS
- DOORS & HANDLES OF ALL FREEZERS
- ELEVATOR (HOIST)
- ELEVATOR (HOIST) & DUMPER
- FLOORS IN THE PLANT
- FLOORS IN THE PLANT
- FLOORS OF NEW PLANT
- FREEZER 1 WHEN OFF
- GARBAGE CONTAINERS
- METAL DETECTORS (CINELLI)
- METAL DETECTORS (FORTRESS)
- OVERHEAD (BASKET) PROOFER
- ROOF OF BLAST FREEZER 1
- ROOF OF COLD STORAGE
- ROUNDER 1 2 3 4 5 6
- SEQUENTIAL OVENS (OUTSIDE/CONVEYOR/EXHAUST)
- SIFTER AND FLOUR CHUTE (EXTERIOR)
- SINKS 1 2 3
- STORAGE COOLER (SWEEPING)
- STORAGE COOLER HANDLES & DOOR
- STORAGE FREEZER (SWEEPING)
- SUPER SIX MACHINE
- TOP OF WATER TREATMENT INSTRUMENT
- TOP OF WHITE BINS
- UNDER OIL BINS
- UV LIGHT
- WALK IN PROOFER INCL ROOF
- WALK-IN PROOFER (FLOORS & HANDLES)
- WALLS IN MIXING AREA
- WALLS TO 5 FEET
- WATER HEATER
-
NOTES:
-
ISSUES WITH EQUIPMENT: (Select all that apply.)
- DIRTY AFTER CLEANING
- WAS NOT CLEANED
- REPORT FILLED INCORRECTLY
- ITEM WAS NOT USED / CLEAN
- EQUIPMENT FAULTY / BROKEN
- EQUIPMENT NOT DISMANTLED
- OTHER - SEE ADDITIONAL NOTES
-
NOTES:
-
PLEASE SELECT CORRECTIVE ACTION TAKEN: (Select all that apply.)
- CLEANER INSTRUCTED IN PROPER PROCEDURES
- ITEM REWASHED
- NO ACTION REQUIRED AT THIS TIME
- INCIDENCE ADDRESSED WITH CLEANER IN QUESTION
- APPROPRIATE STAFF NOTIFIED OF DEFECT / BREAKAGE
- EQUIPMENT DISMANTLED
- RINSED AND SANITIZED
- SANITIZED ONLY
- FULL WASH AND SANITIZED
- OTHER - SEE ADDITIONAL NOTES
-
ADDITIONAL DETAILS: (Please provide any additional information that was not mentioned above, ex: name of person who re cleaned, further action needed etc...)
-
NAME OF CLEANER(S) INVOLVED:
-
SIGNATURE OF PCI SUPERVISOR ON DUTY:
-
CORRECTIVE ACTION REPORT
PLEASE SELECT A NEW REPORT FOR EACH INCIDENCE.
NEW REPORT
-
DATE:
-
CLEANING FREQUENCY:<br>(Select only ONE.)
-
NOTES:
-
EQUIPMENT: (Select only ONE)
- ALL STAINLESS STEEL TABLE
- BASKET PROOFER & HANDLES (EXTERIOR)
- BLAST FREEZER 2, 3 INCL ROOF BLAST
- BLUE LADDER
- BOWL MIXER 1 2 3
- BOWL MIXER 2 5
- BREAD (BAGUETTE) MOULDER
- CEMENT BASE OF BLAST FREEZERS 1 2 3
- CINELLI EXPERIA MULTI ROLLER
- CLEANING TOOLS
- CROSS SHEETER (EXTERIOR & BELT)
- CROSS SHEETER LINE
- DIES
- DIVIDERS 1 2 3 4 5
- DOORS
- DOORS & HANDLES OF ALL FREEZERS
- ELEVATOR (HOIST)
- ELEVATOR (HOIST) & DUMPER
- FLOORS IN THE PLANT
- FLOORS IN THE PLANT
- FLOORS OF NEW PLANT
- FREEZER 1 WHEN OFF
- GARBAGE CONTAINERS
- METAL DETECTORS (CINELLI)
- METAL DETECTORS (FORTRESS)
- OVERHEAD (BASKET) PROOFER
- ROOF OF BLAST FREEZER 1
- ROOF OF COLD STORAGE
- ROUNDER 1 2 3 4 5 6
- SEQUENTIAL OVENS (OUTSIDE/CONVEYOR/EXHAUST)
- SIFTER AND FLOUR CHUTE (EXTERIOR)
- SINKS 1 2 3
- STORAGE COOLER (SWEEPING)
- STORAGE COOLER HANDLES & DOOR
- STORAGE FREEZER (SWEEPING)
- SUPER SIX MACHINE
- TOP OF WATER TREATMENT INSTRUMENT
- TOP OF WHITE BINS
- UNDER OIL BINS
- UV LIGHT
- WALK IN PROOFER INCL ROOF
- WALK-IN PROOFER (FLOORS & HANDLES)
- WALLS IN MIXING AREA
- WALLS TO 5 FEET
- WATER HEATER
-
NOTES:
-
ISSUES WITH EQUIPMENT: (Select all that apply.)
- DIRTY AFTER CLEANING
- WAS NOT CLEANED
- REPORT FILLED INCORRECTLY
- ITEM WAS NOT USED / CLEAN
- EQUIPMENT FAULTY / BROKEN
- EQUIPMENT NOT DISMANTLED
- OTHER - SEE ADDITIONAL NOTES
-
NOTES:
-
PLEASE SELECT CORRECTIVE ACTION TAKEN: (Select all that apply.)
- CLEANER INSTRUCTED IN PROPER PROCEDURES
- ITEM REWASHED
- NO ACTION REQUIRED AT THIS TIME
- INCIDENCE ADDRESSED WITH CLEANER IN QUESTION
- APPROPRIATE STAFF NOTIFIED OF DEFECT / BREAKAGE
- EQUIPMENT DISMANTLED
- RINSED AND SANITIZED
- SANITIZED ONLY
- FULL WASH AND SANITIZED
- OTHER - SEE ADDITIONAL NOTES
-
ADDITIONAL DETAILS: (Please provide any additional information that was not mentioned above, ex: name of person who re cleaned, further action needed etc...)
-
NAME OF CLEANER(S) INVOLVED:
-
SIGNATURE OF PCI SUPERVISOR ON DUTY:
-
CORRECTIVE ACTION REPORT
PLEASE SELECT A NEW REPORT FOR EACH INCIDENCE.
NEW REPORT
-
DATE:
-
CLEANING FREQUENCY:<br>(Select only ONE.)
-
NOTES:
-
EQUIPMENT: (Select only ONE)
- ALL STAINLESS STEEL TABLE
- BASKET PROOFER & HANDLES (EXTERIOR)
- BLAST FREEZER 2, 3 INCL ROOF BLAST
- BLUE LADDER
- BOWL MIXER 1 2 3
- BOWL MIXER 2 5
- BREAD (BAGUETTE) MOULDER
- CEMENT BASE OF BLAST FREEZERS 1 2 3
- CINELLI EXPERIA MULTI ROLLER
- CLEANING TOOLS
- CROSS SHEETER (EXTERIOR & BELT)
- CROSS SHEETER LINE
- DIES
- DIVIDERS 1 2 3 4 5
- DOORS
- DOORS & HANDLES OF ALL FREEZERS
- ELEVATOR (HOIST)
- ELEVATOR (HOIST) & DUMPER
- FLOORS IN THE PLANT
- FLOORS IN THE PLANT
- FLOORS OF NEW PLANT
- FREEZER 1 WHEN OFF
- GARBAGE CONTAINERS
- METAL DETECTORS (CINELLI)
- METAL DETECTORS (FORTRESS)
- OVERHEAD (BASKET) PROOFER
- ROOF OF BLAST FREEZER 1
- ROOF OF COLD STORAGE
- ROUNDER 1 2 3 4 5 6
- SEQUENTIAL OVENS (OUTSIDE/CONVEYOR/EXHAUST)
- SIFTER AND FLOUR CHUTE (EXTERIOR)
- SINKS 1 2 3
- STORAGE COOLER (SWEEPING)
- STORAGE COOLER HANDLES & DOOR
- STORAGE FREEZER (SWEEPING)
- SUPER SIX MACHINE
- TOP OF WATER TREATMENT INSTRUMENT
- TOP OF WHITE BINS
- UNDER OIL BINS
- UV LIGHT
- WALK IN PROOFER INCL ROOF
- WALK-IN PROOFER (FLOORS & HANDLES)
- WALLS IN MIXING AREA
- WALLS TO 5 FEET
- WATER HEATER
-
NOTES:
-
ISSUES WITH EQUIPMENT: (Select all that apply.)
- DIRTY AFTER CLEANING
- WAS NOT CLEANED
- REPORT FILLED INCORRECTLY
- ITEM WAS NOT USED / CLEAN
- EQUIPMENT FAULTY / BROKEN
- EQUIPMENT NOT DISMANTLED
- OTHER - SEE ADDITIONAL NOTES
-
NOTES:
-
PLEASE SELECT CORRECTIVE ACTION TAKEN: (Select all that apply.)
- CLEANER INSTRUCTED IN PROPER PROCEDURES
- ITEM REWASHED
- NO ACTION REQUIRED AT THIS TIME
- INCIDENCE ADDRESSED WITH CLEANER IN QUESTION
- APPROPRIATE STAFF NOTIFIED OF DEFECT / BREAKAGE
- EQUIPMENT DISMANTLED
- RINSED AND SANITIZED
- SANITIZED ONLY
- FULL WASH AND SANITIZED
- OTHER - SEE ADDITIONAL NOTES
-
ADDITIONAL DETAILS: (Please provide any additional information that was not mentioned above, ex: name of person who re cleaned, further action needed etc...)
-
NAME OF CLEANER(S) INVOLVED:
-
SIGNATURE OF PCI SUPERVISOR ON DUTY:
-
CORRECTIVE ACTION REPORT
PLEASE SELECT A NEW REPORT FOR EACH INCIDENCE.
NEW REPORT
-
DATE:
-
CLEANING FREQUENCY:<br>(Select only ONE.)
-
NOTES:
-
EQUIPMENT: (Select only ONE)
- ALL STAINLESS STEEL TABLE
- BASKET PROOFER & HANDLES (EXTERIOR)
- BLAST FREEZER 2, 3 INCL ROOF BLAST
- BLUE LADDER
- BOWL MIXER 1 2 3
- BOWL MIXER 2 5
- BREAD (BAGUETTE) MOULDER
- CEMENT BASE OF BLAST FREEZERS 1 2 3
- CINELLI EXPERIA MULTI ROLLER
- CLEANING TOOLS
- CROSS SHEETER (EXTERIOR & BELT)
- CROSS SHEETER LINE
- DIES
- DIVIDERS 1 2 3 4 5
- DOORS
- DOORS & HANDLES OF ALL FREEZERS
- ELEVATOR (HOIST)
- ELEVATOR (HOIST) & DUMPER
- FLOORS IN THE PLANT
- FLOORS IN THE PLANT
- FLOORS OF NEW PLANT
- FREEZER 1 WHEN OFF
- GARBAGE CONTAINERS
- METAL DETECTORS (CINELLI)
- METAL DETECTORS (FORTRESS)
- OVERHEAD (BASKET) PROOFER
- ROOF OF BLAST FREEZER 1
- ROOF OF COLD STORAGE
- ROUNDER 1 2 3 4 5 6
- SEQUENTIAL OVENS (OUTSIDE/CONVEYOR/EXHAUST)
- SIFTER AND FLOUR CHUTE (EXTERIOR)
- SINKS 1 2 3
- STORAGE COOLER (SWEEPING)
- STORAGE COOLER HANDLES & DOOR
- STORAGE FREEZER (SWEEPING)
- SUPER SIX MACHINE
- TOP OF WATER TREATMENT INSTRUMENT
- TOP OF WHITE BINS
- UNDER OIL BINS
- UV LIGHT
- WALK IN PROOFER INCL ROOF
- WALK-IN PROOFER (FLOORS & HANDLES)
- WALLS IN MIXING AREA
- WALLS TO 5 FEET
- WATER HEATER
-
NOTES:
-
ISSUES WITH EQUIPMENT: (Select all that apply.)
- DIRTY AFTER CLEANING
- WAS NOT CLEANED
- REPORT FILLED INCORRECTLY
- ITEM WAS NOT USED / CLEAN
- EQUIPMENT FAULTY / BROKEN
- EQUIPMENT NOT DISMANTLED
- OTHER - SEE ADDITIONAL NOTES
-
NOTES:
-
PLEASE SELECT CORRECTIVE ACTION TAKEN: (Select all that apply.)
- CLEANER INSTRUCTED IN PROPER PROCEDURES
- ITEM REWASHED
- NO ACTION REQUIRED AT THIS TIME
- INCIDENCE ADDRESSED WITH CLEANER IN QUESTION
- APPROPRIATE STAFF NOTIFIED OF DEFECT / BREAKAGE
- EQUIPMENT DISMANTLED
- RINSED AND SANITIZED
- SANITIZED ONLY
- FULL WASH AND SANITIZED
- OTHER - SEE ADDITIONAL NOTES
-
ADDITIONAL DETAILS: (Please provide any additional information that was not mentioned above, ex: name of person who re cleaned, further action needed etc...)
-
NAME OF CLEANER(S) INVOLVED:
-
SIGNATURE OF PCI SUPERVISOR ON DUTY:
-
CORRECTIVE ACTION REPORT
PLEASE SELECT A NEW REPORT FOR EACH INCIDENCE.
NEW REPORT
-
DATE:
-
CLEANING FREQUENCY:<br>(Select only ONE.)
-
NOTES:
-
EQUIPMENT: (Select only ONE)
- ALL STAINLESS STEEL TABLE
- BASKET PROOFER & HANDLES (EXTERIOR)
- BLAST FREEZER 2, 3 INCL ROOF BLAST
- BLUE LADDER
- BOWL MIXER 1 2 3
- BOWL MIXER 2 5
- BREAD (BAGUETTE) MOULDER
- CEMENT BASE OF BLAST FREEZERS 1 2 3
- CINELLI EXPERIA MULTI ROLLER
- CLEANING TOOLS
- CROSS SHEETER (EXTERIOR & BELT)
- CROSS SHEETER LINE
- DIES
- DIVIDERS 1 2 3 4 5
- DOORS
- DOORS & HANDLES OF ALL FREEZERS
- ELEVATOR (HOIST)
- ELEVATOR (HOIST) & DUMPER
- FLOORS IN THE PLANT
- FLOORS IN THE PLANT
- FLOORS OF NEW PLANT
- FREEZER 1 WHEN OFF
- GARBAGE CONTAINERS
- METAL DETECTORS (CINELLI)
- METAL DETECTORS (FORTRESS)
- OVERHEAD (BASKET) PROOFER
- ROOF OF BLAST FREEZER 1
- ROOF OF COLD STORAGE
- ROUNDER 1 2 3 4 5 6
- SEQUENTIAL OVENS (OUTSIDE/CONVEYOR/EXHAUST)
- SIFTER AND FLOUR CHUTE (EXTERIOR)
- SINKS 1 2 3
- STORAGE COOLER (SWEEPING)
- STORAGE COOLER HANDLES & DOOR
- STORAGE FREEZER (SWEEPING)
- SUPER SIX MACHINE
- TOP OF WATER TREATMENT INSTRUMENT
- TOP OF WHITE BINS
- UNDER OIL BINS
- UV LIGHT
- WALK IN PROOFER INCL ROOF
- WALK-IN PROOFER (FLOORS & HANDLES)
- WALLS IN MIXING AREA
- WALLS TO 5 FEET
- WATER HEATER
-
NOTES:
-
ISSUES WITH EQUIPMENT: (Select all that apply.)
- DIRTY AFTER CLEANING
- WAS NOT CLEANED
- REPORT FILLED INCORRECTLY
- ITEM WAS NOT USED / CLEAN
- EQUIPMENT FAULTY / BROKEN
- EQUIPMENT NOT DISMANTLED
- OTHER - SEE ADDITIONAL NOTES
-
NOTES:
-
PLEASE SELECT CORRECTIVE ACTION TAKEN: (Select all that apply.)
- CLEANER INSTRUCTED IN PROPER PROCEDURES
- ITEM REWASHED
- NO ACTION REQUIRED AT THIS TIME
- INCIDENCE ADDRESSED WITH CLEANER IN QUESTION
- APPROPRIATE STAFF NOTIFIED OF DEFECT / BREAKAGE
- EQUIPMENT DISMANTLED
- RINSED AND SANITIZED
- SANITIZED ONLY
- FULL WASH AND SANITIZED
- OTHER - SEE ADDITIONAL NOTES
-
ADDITIONAL DETAILS: (Please provide any additional information that was not mentioned above, ex: name of person who re cleaned, further action needed etc...)
-
NAME OF CLEANER(S) INVOLVED:
-
SIGNATURE OF PCI SUPERVISOR ON DUTY:
-
CORRECTIVE ACTION REPORT
PLEASE SELECT A NEW REPORT FOR EACH INCIDENCE.
NEW REPORT
-
DATE:
-
CLEANING FREQUENCY:<br>(Select only ONE.)
-
NOTES:
-
EQUIPMENT: (Select only ONE)
- ALL STAINLESS STEEL TABLE
- BASKET PROOFER & HANDLES (EXTERIOR)
- BLAST FREEZER 2, 3 INCL ROOF BLAST
- BLUE LADDER
- BOWL MIXER 1 2 3
- BOWL MIXER 2 5
- BREAD (BAGUETTE) MOULDER
- CEMENT BASE OF BLAST FREEZERS 1 2 3
- CINELLI EXPERIA MULTI ROLLER
- CLEANING TOOLS
- CROSS SHEETER (EXTERIOR & BELT)
- CROSS SHEETER LINE
- DIES
- DIVIDERS 1 2 3 4 5
- DOORS
- DOORS & HANDLES OF ALL FREEZERS
- ELEVATOR (HOIST)
- ELEVATOR (HOIST) & DUMPER
- FLOORS IN THE PLANT
- FLOORS IN THE PLANT
- FLOORS OF NEW PLANT
- FREEZER 1 WHEN OFF
- GARBAGE CONTAINERS
- METAL DETECTORS (CINELLI)
- METAL DETECTORS (FORTRESS)
- OVERHEAD (BASKET) PROOFER
- ROOF OF BLAST FREEZER 1
- ROOF OF COLD STORAGE
- ROUNDER 1 2 3 4 5 6
- SEQUENTIAL OVENS (OUTSIDE/CONVEYOR/EXHAUST)
- SIFTER AND FLOUR CHUTE (EXTERIOR)
- SINKS 1 2 3
- STORAGE COOLER (SWEEPING)
- STORAGE COOLER HANDLES & DOOR
- STORAGE FREEZER (SWEEPING)
- SUPER SIX MACHINE
- TOP OF WATER TREATMENT INSTRUMENT
- TOP OF WHITE BINS
- UNDER OIL BINS
- UV LIGHT
- WALK IN PROOFER INCL ROOF
- WALK-IN PROOFER (FLOORS & HANDLES)
- WALLS IN MIXING AREA
- WALLS TO 5 FEET
- WATER HEATER
-
NOTES:
-
ISSUES WITH EQUIPMENT: (Select all that apply.)
- DIRTY AFTER CLEANING
- WAS NOT CLEANED
- REPORT FILLED INCORRECTLY
- ITEM WAS NOT USED / CLEAN
- EQUIPMENT FAULTY / BROKEN
- EQUIPMENT NOT DISMANTLED
- OTHER - SEE ADDITIONAL NOTES
-
NOTES:
-
PLEASE SELECT CORRECTIVE ACTION TAKEN: (Select all that apply.)
- CLEANER INSTRUCTED IN PROPER PROCEDURES
- ITEM REWASHED
- NO ACTION REQUIRED AT THIS TIME
- INCIDENCE ADDRESSED WITH CLEANER IN QUESTION
- APPROPRIATE STAFF NOTIFIED OF DEFECT / BREAKAGE
- EQUIPMENT DISMANTLED
- RINSED AND SANITIZED
- SANITIZED ONLY
- FULL WASH AND SANITIZED
- OTHER - SEE ADDITIONAL NOTES
-
ADDITIONAL DETAILS: (Please provide any additional information that was not mentioned above, ex: name of person who re cleaned, further action needed etc...)
-
NAME OF CLEANER(S) INVOLVED:
-
SIGNATURE OF PCI SUPERVISOR ON DUTY:
