Food Investigation Response Manual
Appendix 6D - Example Recall Effectiveness Checks Summary Report

Upon completion of all recall effectiveness checks, please complete this form for each health unit and submit to the CFIA contact indicated below.

General Information

Recall information (indicate recall that form is pertaining to): space
Date report was prepared: space
Name of Health Unit: space

Contact Information for Person who Prepared the Report

Name: space
Telephone number: space
E-mail address: space

Recall Effectiveness Checks Information
Total number of effectiveness checks requested to complete (if provided a distribution list by the CFIA):
Total estimated number of effectiveness checks to complete (based on health units knowledge of potentially affected food premises, when no distribution list is available from the CFIA): If information is not available, please check one:
  • Box Cannot be estimated
  • Box Unavailable information
  • Box Other, please specify space
Total number of effectiveness checks (number of premises) completed:
Total number of effectiveness checks (number of premises) not completed:
If there are any effectiveness checks still outstanding, please indicate a) if they will be completed; and b) by what date the checks will be completed:
  1. Check one:
    • Box Outstanding checks will be completed
    • Box Outstanding checks will not be completed
  2. Estimated completion date:
Total number of inspectors involved in completing the effectiveness checks:
Total number of food premises at which product was found for sale:
Please add any additional comments on a separate page
CFIA Contact:
Date modified: