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Annex D - Establishment inspection report

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Note:
This Establishment Inspection Report is to be used by establishments applying for initial C-PIQ registration, as part of the company self-assessment required prior to proceeding to Pre-Validation

Establishment name:space

Address:space

SFC licence number:space

Establishment representative:space

Date of inspection:space

Establishment inspection report

S= Satisfactory
U= Unsatisfactory
Surroundings
S U Comments Correction dates
Land free of debris and refuse.
Land permits good drainage.
Not close to any source of pollution.
Establishment
S U Comments Correction dates
Separate from and has no direct access to areas where operations are carried out which are incompatible with the handling of food.
Protected against entrance of insects, birds, rodents etc.
No room in the establishment used for storage or manufacture of anything that is likely to emit an odour that could affect flavour of the produce.
Of sound construction and in good repair.
Constructed of materials that are durable and free of noxious constituents.
Has areas with temperature, light and ventilation suitable for the preservation of produce.
Adequate means of drainage, waste removal and waste disposal.
Physical facilities are maintained in a sanitary manner.
Equipped with shatter proof light bulbs and fixtures in areas where produce or packaging materials are exposed.
Adequate supply of potable hot and cold water to serve the water needs of the establishment.
There is no connection between the non-potable and potable water systems.
Chemical storage
S U Comments Correction dates
Detergent, sanitizer, food contact lubricant or other chemical agent is properly labelled, stored and used in a manner that prevents contamination of produce or a surface with which produce comes in contact.
Lavatories
S U Comments Correction dates
Clean and kept in a sanitary manner.
Adequate in size and equipment for the number of people.
Well lighted and ventilated.
Separate from and do not lead directly into any room used to handle produce.
"Wash Hands" sign is clearly posted.
Product handling
S U Comments Correction dates
Lighting over the grading equipment must be appropriate for the activity being conducted.
No stagnant or polluted water used in the washing or fluming of the product.
Final rinse water is potable.
If final rinse water is reused, it is only used for initial washing or fluming of the produce.
Produce is handled with equipment that is cleaned regularly and maintained in a sanitary condition.
Adequate facilities and means for cleaning of equipment.
Operations in relation to the preparation of produce are carried out in a sanitary manner.
Inspection facilities
S U Comments Correction dates
Lighting over the grading equipment must be appropriate for the activity being conducted.
The location is free from vehicular traffic or other hazards.
There is a suitable grading table.
An electrical outlet is available to facilitate the use of electronic equipment necessary to carry out a full inspection.
The inspection room or area is a suitable environment with adequate temperature to allow the inspector to determine the condition of produce.
Establishment is willing to provide assistance as required to obtain samples and open and close containers and provide other assistance as the inspector requires.
Waste disposal is provided for the inspector.
Records
S U Comments Correction dates
Accurate records are maintained of produce shipments from the establishment by kind and grade of produce, size of container, date of shipment and number of containers shipped.
Annual water test records are maintained and available.
Pest control records are maintained and available.

Name of Establishment
Representative:
space

Signature:space

Date:space

Date modified: