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Food premises inspection form

1Officer

2Establishment information

3Business details

4Training

5Receipt of goods

6Chilled/Frozen storage

7Ambient storage/Stock control

8Defrosting

9Preparation and processes

10Cooking

11Cooling

12Reheating

13Cold display hot display

14Transport/delivery

15Personal hygiene/Washbasins /WC

16Pest control/Pest proofing

17Cleaning structure/repair equipment

18Ventilation

19Food waste/refuse

20Feed stuffs

21Food safety management system

22Records seen on site

23Food standards

24Non prepacked food

25Allergen information

26Pre-packed for direct sale (PPDS) - labelling

27Distance selling of PPDS

28Pre-packed for retail

29Traceability

30Imported foods on premises. POAO (N.B Caterers exempt)

31Health & safety

32Notes

33New food hygiene intervention rating

34Justification for food hygiene rating score

35Food Standards: Inherent Risk Factors

36Food Standards: Compliance Risk Factors

Officer's Details

Name of the officer(Required)

Officer's email address(Required)

Date of inspection(Required)

DD slash MM slash YYYY

New business - Food registration completed

Yes

No

Primary authority agreement

Yes

No

PA Inspection plan

Yes

No

N/A

Establishment information

Name of food business

Post code

Find addressSelected address

Please enter the Post code and click on Find address to pick an address

Phone numbers

Email address

Opening times

Number of staff

Food business operator

Ltd Co.

Plc.

Partner

Sole Trader

Other

If other, please specify(Required)

Business details

Registered business name

Post code of Registered office

Find addressSelected address

Please enter the Post code and click on Find address to pick an address

Person(s) In control E.g. Active Director, Manager

Person(s) interviewed

Business type (Description)

Vulnerable group ?

Yes

No

No. of meals served including snacks

0-50

51-100

101-150

151-200

200+

Languages

Does the food business undertake any of the following ?

Handle Raw + RTE foods

Pre-packed foodstuffs only

Lightly cooked meat products (burgers/steak tartare/carpaccio)

Vacuum Packing/MAP/Sous-vide

Distribute outside of area

Fish to be eaten raw/almost raw

Training

Training

Manager/Supervisor level

Level 2

Training in SFBB Safe Methods:

Training in HACCP-based procedures

N/A

Other (please state)

If other, please specify(Required)

Employees

Supervision

Instructed

Trained

Receipt of goods

Delivery details

Expiry dates checked

Yes

No

Visual checks : Quality

Yes

No

Temp checked

Yes

No

Chilled/Frozen storage

Chilled/Frozen storage details

Separation of raw/cooked

Yes

No

Food covered

Yes

No

Food dated/labelled

Yes

No

Temps – monitored

Yes

No

Recorded

Yes

No

Ambient storage/Stock control

Ambient storage/Stock control details

Covered/lidded

Yes

No

Off floor

Yes

No

Any off-site storage

Yes

No

Dates on own products?

Yes

No

FIFO used

Yes

No

Defrosting

Defrosting details

Food defrosted in refrigerator

Yes

No

Food defrosted at ambient

Yes

No

Food defrosted under cold running water

Yes

No

Food defrosted in microwave

Yes

No

Preparation and processes

Preparation and processes details

Vacuum packers; slicers; mincers not to be dual-used with rte.foods

Separation of raw/cooked during preparation

Yes

No

Coloured boards

Yes

No

Colour coded utensils

Yes

No

Clean & disinfect after raw meat preparation

Yes

No

Minimise times at ambient

Yes

No

Satisfactory handling practices

Yes

No

Cooking

Cooking details

Core temps – monitored

Yes

No

Recorded

Yes

No

Cooling

Cooling details

90 min rule explained

Yes

No

Adequate space for cooling

Yes

No

Protection against contamination

Yes

No

Reheating

Reheating details

Core temps – Monitored recorded

Yes

No

Cold display hot display

Cold display/hot display details

Temps – Monitored

Yes

No

Recorded

Yes

No

Transport/delivery

Transport/delivery details

Temp controlled delivery vehicle

Yes

No

Cool boxes/ice packs used

Yes

No

Temps monitoring

Yes

No

Recorded

Yes

No

Personal hygiene/Washbasins /WC

Clean PPE clothing

Yes

No

Disposable aprons used for raw prep

Yes

No

PPE laundered

Yes

No

Food handlers wearing jewellery

Yes

No

WHB

Hand drying

Hot water

Soap

Evidence of smoking

Food handlers washing hands

WC's

Clean

Soap

Hand drying

Hot Water

Ventilation and lobby if applicable

Pest control/Pest proofing

Pest control/Pest proofing

Evidence of pests

Yes

No

Contract

Yes

No

Cleaning structure/repair equipment

Cleaning structure/repair equipment condition lighting sinks/washing facilities

Cleaning schedule available and followed

Yes

No

Disposable cloths in use

Yes

No

Re-useable cloths used (how cleaned?)

Yes

No

Satisfactory standard of cleanliness

Yes

No

Separate food/HWB

Yes

No

Disinfectant/sanitiser used BS EN 1276 or BS EN 13697

Yes

No

Contact times known and followed

Yes

No

Ventilation

Mechanical/Natural cleanliness

Food waste/refuse

Trade waste/contracter

Waste Oil

Feed stuffs

Food goes to animal feed

Yes

No

Details of contactor/destination of feed

Food safety management system

Type of procedures

HACCP-based

SFBB

None

Other (state)

Compliance with pre-requisites will control food hazards / simple checks

If other, please specify

Assessment of what can go wrong & awareness of important areas to focus on to prevent hazards? (Adequate controls to prevent cross contamination/FSA guidance? Cooking? Cooling?)

Yes

No

If no, please specify(Required)

Physical checks in place to ensure hazards controlled?

Yes

No

If no, please specify(Required)

Actions in place if something goes wrong?

Yes

No

If no, please specify(Required)

Procedures verified/reviewed and kept up-to-date?

Yes

No

If no, please specify(Required)

Records & documents to demonstrate procedures in place and working?

Yes

No

If no, please specify(Required)

Review/update required?

Yes

No

Records seen on site

Please select records seen on site

Fridge/Freezer temperatures

Cooked food temperatures

Hot holding food temperatures

Food probe calibration checks

Cleaning schedule

Delivery checks

Maintenance

Internal audits

External audits

Training records

Pest control records

SFBB Diary opening/closing checks

Food standards

Person responsible for labelling

Person responsible for recipes

Non prepacked food

Nature of claim

Homemade

Yes

No

Organic

Yes

No

Fresh

Yes

No

Vegan

Yes

No

Vegetarian

Yes

No

Gluten - Free

Yes

No

Kosher/Halal

Yes

No

Health claims

Yes

No

Allergen information

How is allergen information provided?

Allergen matrix

Yes

No

Menu/ Chalkboard

Yes

No

Signposting

Yes

No

Verbally via staff

Yes

No

Is genetically modified oil used (requires a notice)

Yes

No

Pre-packed for direct sale (PPDS) - labelling

Labelling of PPDS food which falls under PPDS (please state):

Name of food

Yes

No

Description of food

Yes

No

List of full ingredients

Yes

No

Allergens highlighted in bold

Yes

No

Distance selling of PPDS

Via telephone

Yes

No

Via website

Yes

No

Is allergen information provided before purchase through

Website

Yes

No

Menu

Yes

No

Orally

Yes

No

When food is delivered, is allergen information provided in writing through

Allergen stickers on food containers

Yes

No

Leaflet

Yes

No

Pre-packed for retail

Does the shop sell food from outside the UK

Yes

No

Is the labelling in english

Yes

No

Are the labels over stickered in english

Yes

No

Is the business packing their own products

Yes

No

Comments (additives, supplements, health marks, nutrition information, QUID, training, public analyst, dates, instructions of use) :

Traceability

System in place

Yes

No

Receipts

Yes

No

Imported foods on premises. POAO (N.B Caterers exempt)

Do they import?

Yes

No

POAO details:

Yes

No

Samples taken

Yes

No

Number of samples taken

Raw fish / meat on site

Yes

No

Health & safety

Matters of Evident Concern?

Yes

No

If matters of evident concern, please specify(Required)

Possible areas to consider

Lifting Equipment – including FLT’s and hoists?

Electricity – Installation and equipment. Wiring is sound, damaged sockets or plugs, multi adaptors used?

Equipment Safe – guarding, CE marking, appropriate use and training given?

Gas – orange flame, smell of gas, non-mains gas suitable storage, CO risk?

Slips, trips and falls – trailing wires, inappropriate floor covering, mopping procedures, stair construction?

Working at Height – barriers or guarding required, ladder usage?

Manual Handling – safe accessibility, appropriate weight, lifting aids required?

Workplace transport – pedestrian and vehicle separation?

Asbestos – register and/or control?

Notes

Notes

Please upload photos (Maximum of 10)

Drop files here or

Max. file size: 10 MB, Max. files: 10.

New food hygiene intervention rating

Type and method of food handling (5:10:30:40)

Please enter a number less than or equal to 99.

Method of processing high risk foods (0:20)

Please enter a number less than or equal to 99.

Consumers at risk (0:5:10:15)

Vulnerable group (0:22)

Food hygiene and safety (0:5:10:15:20:25)

Structure including cleaning (0:5:10:15:20:25)

Confidence in management (0:5:10:20:30)

Please enter a number less than or equal to 99.

Significance of risk (0:20)

Please enter a number less than or equal to 99.

Total

Justification for food hygiene rating score

Food hygiene and safety

Structure including cleaning

Confidence in management

Actions required following inspection

HEPN

HIN

Warning Letter

Fire Authority referral

AES

Verbal advice

NFA

Do you need to revisit?

Yes

No

FHRS sticker left on site

Yes

No

Comments

Food Standards: Inherent Risk Factors

Scale of supply (1,2,3,4,5)(Required)

Ease of compliance (1,2,3,4,5)(Required)

Responsible for information (1,2,3,4,5)(Required)

Potential for product harm (1,2,3,4,5)(Required)

Average Score(Required)

Food Standards: Compliance Risk Factors

Management system and procedures (1,2,3,4,5)(Required)

Allergen Information (1,2,3,4,5)(Required)

Current level of compliance (1,2,3,4,5)(Required)

Confidence in management (1,2,3,4,5)(Required)

Average Score(Required)

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