Food
FDA 1999 Food Code - Annex 7: Model Forms, Guides, and Other Aids
Return to 1999 Food Code Table of Contents
U. S. Department of Health and Human Services
Public Health Service
Food and Drug Administration
1999 Food Code
| Annex 7 and Other Aids |
- Form 1 APPLICANT AND FOOD EMPLOYEE INTERVIEW
- Form 2 FOOD EMPLOYEE REPORTING AGREEMENT
- Form 3 APPLICANT AND FOOD EMPLOYEE MEDICAL REFERRAL
- Form 4 ADOPTION BY REFERENCE
- Form 5 ADOPTION BY SECTION-BY-SECTION REFERENCE
- Form 6 HACCP INSPECTION DATA
- Form 7 FOOD ESTABLISHMENT INSPECTION REPORT
- Guide 1 EXCLUSIONS AND RESTRICTIONS
- Guide 2 REMOVAL OF EXCLUSIONS AND RESTRICTIONS
- Guide 3 INSPECTIONAL GUIDE
- List WORLDWIDE STATUS OF SALMONELLA TYPHI, SHIGELLA SPP., ESCHERICHIA COLI O157:H7, AND HEPATITIS A VIRUS BY GEOGRAPHICAL AREA
- Chart 1 SUMMARY CHART FOR MINIMUM COOKING FOOD TEMPERATURES AND HOLDING TIMES REQUIRED BY CHAPTER 3
- Chart 2 SUMMARY CHART FOR MINIMUM FOOD TEMPERATURES AND HOLDING TIMES REQUIRED BY CHAPTER 3 FOR REHEATING FOODS FOR HOT HOLDING
- Chart 3 SUMMARY CHART - DATE MARKING AND DISPOSING READY-TO-EAT, POTENTIALLY HAZARDOUS FOOD
- Chart 4 FDA FOOD CODE MOBILE FOOD ESTABLISHMENT MATRIX
- Summary SUMMARY OF CHANGES IN THE FDA FOOD CODE
The documents provided in this Annex are intended to facilitate adoption of the Food Code and the application of its provisions as they relate to applicants' and food employees' health and to food establishment inspections.
Forms 1-3, Guides 1 and 2, and the List are designed to assist those responsible for preventing foodborne disease. The Food Code specifies that the permit holder is responsible for requiring applicants and food employees to report certain symptoms, diagnoses, past illnesses, high-risk conditions, and foreign travel as they relate to diseases transmitted through food by infected workers. The food employee is personally responsible for reporting this information to the person in charge.
Forms 4 and 5 can be used for the Code adoption process and Forms 6 and 7 are provided for use in recording HACCP information and inspectional observations. Guide 3 is a compressed outline of the Code to use as a tool in locating and citing Code provisions.
| Form 1
|
The purpose of this form is to ensure that Applicants to whom a conditional offer of employment has been made and Food Employees advise the Person in Charge of past and current conditions described so that the Person in Charge can take appropriate steps to preclude the transmission of foodborne illness.
Applicant or Employee name (print) _______________________________________________________ Address __________________________________________________________________________________ __________________________________________________________________________________________ Telephone Daytime:____________________________ Evening:_______________________________ |
TODAY:Are you suffering from any of the following: |
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| 1. Symptoms | |
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Diarrhea?
Fever? Vomiting? Jaundice? Sore throat with fever? |
YES/NO YES/NO YES/NO YES/NO YES/NO |
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2. Lesions containing pus on the hand, wrist or an exposed body part?
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YES/NO |
PAST:
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Have you ever been diagnosed as being ill with typhoid fever (Salmonella Typhi), shigellosis (Shigella spp.), Escherichia coli O157:H7 infection (E. coli O157:H7), or hepatitis A (hepatitis A virus)? If you have, what was the date of the diagnosis? ______________________
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YES/NO |
HIGH-RISK CONDITIONS |
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| 1. Have you been exposed to or suspected of causing a confirmed outbreak of typhoid fever, shigellosis, E. coli O157:H7 infection, or hepatitis A? | YES/NO |
| 2. Do you live in the same household as a person diagnosed with typhoid fever, shigellosis, hepatitis A, or illness due to E. coli O157:H7? | YES/NO |
| 3. Do you have a household member attending or working in a setting where there is a confirmed outbreak of typhoid fever, shigellosis, E. coli O157:H7 infection, or hepatitis A? | YES/NO |
Name, Address, and Telephone Number of your Doctor:
Name _________________________________________________________________
Address _________________________________________________________________
_________________________________________________________________________
Telephone Daytime:_____________________ Evening:_______________________
Signature of Applicant or Food Employee __________________________________ Date ________
Signature of Permit Holder's Representative ______________________________ Date ________
| Form 2
|
The purpose of this agreement is to ensure that Food Employees notify the Person in Charge when they experience any of the conditions listed so that the Person in Charge can take appropriate steps to preclude the transmission of foodborne illness.
I AGREE TO REPORT TO THE PERSON IN CHARGE:
FUTURE SYMPTOMS and PUSTULAR LESIONS:
- Diarrhea
- Fever
- Vomiting
- Jaundice
- Sore throat with fever
- Lesions containing pus on the hand, wrist, or an exposed body part
(such as boils and infected wounds, however small)
FUTURE MEDICAL DIAGNOSIS
Whenever diagnosed as being ill with typhoid fever (Salmonella Typhi), shigellosis (Shigella spp.), Escherichia coli O157:H7 infection (E. coli O157:H7), or hepatitis A (hepatitis A virus)
FUTURE HIGH-RISK CONDITIONS:
- Exposure to or suspicion of causing any confirmed outbreak of typhoid fever, shigellosis, E. coli O157:H7 infection, or hepatitis A
- A household member diagnosed with typhoid fever, shigellosis, illness due to E. coli O157:H7, or hepatitis A
- A household member attending or working in a setting experiencing a confirmed outbreak of typhoid fever, shigellosis, E. coli O157:H7 infection, or hepatitis A
I have read (or had explained to me) and understand the requirements concerning my responsibilities under the Food Code and this agreement to comply with:
- Reporting requirements specified above involving symptoms, diagnoses, and high-risk conditions specified;
- Work restrictions or exclusions that are imposed upon me; and
- Good hygienic practices.
I understand that failure to comply with the terms of this agreement could lead to action by the food establishment or the food regulatory authority that may jeopardize my employment and may involve legal action against me.
Applicant or Food Employee Name (please print) _________________________________________ Signature of Applicant or Food Employee __________________________________ Date ________ Signature of Permit Holder's Representative ______________________________ Date ________
| Form 3
|
The Food Code specifies, under Part 2-2 Employee Health Subpart 2-201 Disease or Medical Condition, that Applicants to whom a conditional offer of employment has been made and Food Employees obtain medical clearance from a physician licensed to practice medicine whenever the individual:
- Is chronically suffering from a symptom such as diarrhea; or
- Meets one of the high-risk conditions specified under Paragraph 2-201.11(D) and is suffering from any symptom specified under Subparagraph 2-201.11(B)(1).
- Has a current illness involving Salmonella Typhi (typhoid fever), Shigella spp. (shigellosis), Escherichia coli O157:H7 (E. coli O157:H7 infection), or hepatitis A virus (hepatitis A), or
- Reports past illness involving S. Typhi (typhoid fever), Shigella spp. (shigellosis), E. coli O157:H7, or hepatitis A virus (hepatitis A), if the establishment is a facility serving a highly susceptible population such as preschool age children, immunocompromised persons, or older adults.
| Applicant or Food Employee being referred: (___________________ (Name, please print)___________________ ) Serving a highly susceptible population YES /_/ NO /_/ |
REASON FOR MEDICAL REFERRAL: The reason for this referral is checked below:
/_/ Chronic diarrhea or other chronic symptom ______________(specify)_______________ .
/_/ Meets a high-risk condition specified under Paragraph 2-201.11(D) ______________(specify)_______________ and suffers from a symptom specified under Subparagraph 2-201.11(B)(1). ______________(specify)_______________ .
/_/ Diagnosed or suspected typhoid fever, shigellosis, E. coli O157:H7 infection, or hepatitis A.
/_/ Reported past illness from typhoid fever, shigellosis, E. coli O157:H7 infection, or hepatitis A.
/_/ Other medical condition of concern per the following description: _________________________________
PHYSICIAN'S CONCLUSION:
/_/ Applicant or food employee is free of S. Typhi, Shigella spp., E. coli O157:H7, or hepatitis A virus and may work as a food employee without restrictions.
/_/ Applicant or food employee is an asymptomatic shedder of ____(pathogen)____ and is restricted from working with exposed food; clean equipment, utensils, and linens; and unwrapped single-service and single-use articles in establishments that do not serve highly susceptible populations.
/_/ Applicant or food employee is not ill but continues as an asymptomatic shedder of ____(pathogen)____ and should be excluded from working with exposed food; clean equipment, utensils, and linens; and unwrapped single-service and single-use articles in food establishments that serve highly susceptible populations such as those who are preschool age, immunocompromised, or older adults and in a facility that provides preschool custodial care, health care, or assisted living.
/_/ Applicant or food employee is suffering from typhoid fever, Shigellosis, E. coli O157:H7 infection, or hepatitis A and should be excluded from working with exposed food; clean equipment, utensils, and linens; and unwrapped single-service and single-use articles.
COMMENTS: (In accordance with Title I of the Americans with Disabilities Act (ADA) and to provide only the information necessary to assist the food establishment operator in preventing foodborne disease transmission, please confine comments to explaining your conclusion and estimating when the employee may be reinstated.)
___________________________________________________________________________________
Signature of Physician ___________________________________________________ Date ________
Paraphrased from the FDA Food Code for Physician's Reference
From §2-201.11(A) Organisms of Concern:
Any foodborne pathogen, with special emphasis on these 4 organisms:
| S. Typhi | Shigella spp. | E. coli O157:H7 | Hepatitis A virus |
From §2-201.11(B)(1) Symptoms:
Symptoms associated with an acute gastrointestinal illness such as:
| Diarrhea | Fever | Vomiting | Jaundice | Sore throat with fever |
From §2-201.11(D) High-Risk Conditions Related to a Person's Activities:
- Suspected of causing a foodborne outbreak or being exposed to an outbreak caused by 1 of the 4 organisms above, at an event such as a family meal, church supper, or festival because the person:
Prepared or consumed an implicated food; or
Consumed food prepared by a person who is infected or ill with the organism that caused the outbreak or who is suspected of being a carrier; - Lives with a person who is diagnosed with illness caused by 1 of the 4 organisms; or
- Lives with a person who works where there is an outbreak caused by 1 of the 4 organisms.
From §2-201.12 Exclusion and Restriction:
Decisions to exclude or restrict a food employee are made considering the available evidence about the person's role in actual or potential foodborne illness transmission. Evidence includes:
| Symptoms | Diagnosis | High-risk conditions | Past illnesses | Stool/blood tests |
- In facilities serving highly susceptible populations such as day care centers and health care facilities, a person for whom there is evidence of foodborne illness is almost always excluded from the food establishment.
- In other establishments that offer food to typically healthy consumers, a person might only be restricted from certain duties, based on the evidence of foodborne illness.
- Exclusion from any food establishment is required when the person is:
-
Diagnosed with illness caused by 1 of the 4 organisms of concern; or
Jaundiced within the last 7 days.
From §8-501.40 Release of Employee from Exclusion or Restriction:
In addition to local law, these requirements must be met in the situations specified:
- For infection with S. Typhi, the person's stools must be negative for 3 consecutive cultures taken at least 1 month after onset, no earlier than 48 hours after antibiotics are discontinued, and at least 24 hours apart.
- For Shigella spp. or E. coli O157:H7 infections, the person's stools must be negative for 2 consecutive cultures taken no earlier than 48 hours after antibiotics are discontinued and at least 24 hours apart.
- For hepatitis A virus infection, the symptoms must cease or at least 2 blood tests must show falling liver enzymes.
| Form 4
|
This "short form" may be used by governmental bodies adopting the Food Code where authorized by law. Use of the adoption by reference form may substantially reduce the cost of publishing and printing.
The description of the Food Code, below, includes Chapter 8 and the Chapter 8 annex (Annex 1). Modifications to the description may be necessary, based on what provisions are being adopted and whether they are being adopted as law or regulation.
Section 2 lists provisions that may require modifications to be consistent with existing law or that require insertion of dollar amounts.
__(JURISDICTION)__ FOOD CODE
___(statute/regulation/ordinance)_____ Number __________
ADOPTING THE 1999 EDITION OF THE "FOOD CODE" REGULATING THE RETAIL SALE, COMMERCIAL AND INSTITUTIONAL SERVICE, AND VENDING OF FOOD; DEFINING PERMIT HOLDER, PERSON IN CHARGE, EMPLOYEE, FOOD, POTENTIALLY HAZARDOUS FOOD, FOOD ESTABLISHMENT, SAFE MATERIAL, SANITIZATION, AND OTHER TERMS; AND PROVIDING STANDARDS FOR EMPLOYEE FOOD SAFETY KNOWLEDGE, HEALTH, AND PRACTICES; FOOD SOURCES, PREPARATION, HOLDING TEMPERATURES, AND PROTECTION; EQUIPMENT DESIGN, CONSTRUCTION, INSTALLATION, CLEANING, AND SANITIZATION; WATER, AND LIQUID AND SOLID WASTES; FACILITIES CONSTRUCTION AND MAINTENANCE, AND STORAGE AND USE OF POISONOUS AND TOXIC MATERIALS; REQUIRING A PERMIT TO OPERATE A FOOD ESTABLISHMENT; AND PROVIDING FOR THE RESTRICTION OR EXCLUSION OF EMPLOYEES, THE EXAMINATION AND CONDEMNATION OF FOOD, AND THE ENFORCEMENT OF THIS CODE INCLUDING THE SETTING OF PENALTIES.
The __(governing body)__ of the __(jurisdiction)__ does ordain as follows:
SECTION 1. ADOPTION OF FOOD CODE
That a certain document, three copies of which are on file in the office of the __(jurisdiction's keeper of records)__ of the __(type of jurisdiction)__ of __(name of jurisdiction)__ being marked and designated as the Food Code, 1999 Recommendations of the United States Public Health Service/Food and Drug Administration as published by the U.S. Department of Health and Human Services, Public Health Service, Food and Drug Administration be, and is hereby adopted as, the Food Code of __(type of jurisdiction)__ of __(name of jurisdiction)__ in the State of __(state name)__; for regulating the design, construction, management and operation of food establishments, and providing for plans submission and approval and the issuance of permits and collection of fees therefore.
SECTION 2. INSERTIONS AND CHANGES
That the following provisions are hereby revised as follows:
Paragraph 8-811.10(B) Insert (Dollar Amount)
Paragraph 8-813.10(B) Insert (Dollar Amounts)
Subparagraph 8-811.10(B)(2) Insert (Number of Year(s))
SECTION 3. INCONSISTENT CODES REPEALED
That __(statute/regulation/ordinance)__ number __(present code number)__ of the __(jurisdiction)__ titled, __(complete title of the food code(s) in effect at the present time so they will be repealed by definite mention)__ and all other codes or portions of codes in conflict herewith are hereby repealed in that respect only.
SECTION 4. CERTIFICATION OF ADOPTION AND PUBLISHING
That the __(jurisdiction's keeper of records)__ shall certify the adoption of this __(statute/regulation/ordinance__ and cause the same to be published as required by law.
SECTION 5. EFFECTIVE DATE
That this Code and the rules, regulations, provisions, requirements, orders, and matters established and adopted hereby shall take effect and be in full force and effect __(time period)__ from and after the date of its final passage and approval.
PASSED AND APPROVED BY __(name of adopting authority)__ on this __(day)__ of __(month, year)__.
BY:____________________________________
Examples of how some jurisdictions have set fines, sentences, and penalties:
- California law provides:
-
- A. For Food Manufacturing Violations:
Criminal fines and sentence for violations of up to $10,000 and one year imprisonment if there is shown an intent to defraud or mislead, and
Civil penalties of up to $5,000 per day for certain violations.
-
- B. For Retail Food Violations:
Criminal fines and sentence for violations of not less than twenty-five dollars ($25) or more than one thousand dollars ($1000) for each offense, or by imprisonment in the county jail for a term not exceeding six months, or by both such fine and imprisonment.
-
- Maryland law provides:
-
- Criminal fines and sentence for certain violations of up to $10,000 and one year imprisonment, and in the case of repeat code violation convictions, up to $25,000 and three years imprisonment; and
- Civil penalties of up to $5,000 for each violation and for each day the violation continues.
-
- Texas law provides:
-
- Criminal fines and sentence for certain violations of up to $10,000 and two years imprisonment; and
-
- Assessment of five "severity" levels of administrative or civil penalties with base amounts ranging from $1,250 through $10,000. Base amounts can be decreased or increased by as much as 50% considering factors such as past performance, good faith, direct impact on health and safety, high-risk populations involved, etc.
Federal law provides under the Criminal Fine Enforcement Act of 1984 for a fine up to $100,000 for a misdemeanor by a corporation or individual not resulting in death and, for misdemeanors resulting in death, a fine of up to $250,000 for individuals and $500,000 for corporations.
| Form 5
|
This "long form" may be used by governmental bodies adopting the Food Code section-by-section.
The description of the "Food Code," below, includes Chapter 8 and the Chapter 8 annex (Annex 1). Modifications to the description may be necessary, based on what provisions are being adopted and whether they are being adopted as law or regulation.
Section 2 lists provisions that may require modifications to be consistent with existing law or that require insertion of dollar amounts.
__(JURISDICTION)__ FOOD CODE
__(statute/regulation/ordinance)__ Number _________
ADOPTING A CODE REGULATING THE RETAIL SALE, COMMERCIAL AND INSTITUTIONAL SERVICE, AND VENDING OF FOOD; DEFINING PERMIT HOLDER, PERSON IN CHARGE, EMPLOYEE, FOOD, POTENTIALLY HAZARDOUS FOOD, FOOD ESTABLISHMENT, SAFE MATERIAL, SANITIZATION, AND OTHER TERMS; AND PROVIDING STANDARDS FOR EMPLOYEE FOOD SAFETY KNOWLEDGE, HEALTH, AND PRACTICES; FOOD SOURCES, PREPARATION, HOLDING TEMPERATURES, AND PROTECTION; EQUIPMENT DESIGN, CONSTRUCTION, INSTALLATION, CLEANING AND SANITIZATION; WATER, AND LIQUID AND SOLID WASTES; FACILITIES CONSTRUCTION AND MAINTENANCE, AND STORAGE AND USE OF POISONOUS AND TOXIC MATERIALS; REQUIRING A PERMIT TO OPERATE A FOOD ESTABLISHMENT; AND PROVIDING FOR THE RESTRICTION OR EXCLUSION OF EMPLOYEES, THE EXAMINATION AND CONDEMNATION OF FOOD, AND THE ENFORCEMENT OF THIS CODE INCLUDING THE SETTING OF PENALTIES.
The __(governing body)__ of the __(jurisdiction)__ does ordain as follows:
(REPRINT THE FOOD CODE, 1999 RECOMMENDATIONS OF THE UNITED STATES PUBLIC HEALTH SERVICE/FOOD AND DRUG ADMINISTRATION, SECTION-BY-SECTION)
SECTION 2. INSERTIONS AND CHANGES
That the following provisions may need to be completed as follows:
Paragraph 8-811.10(B) Insert (Dollar Amount)
Paragraph 8-813.10(B) Insert (Dollar Amounts)
Subparagraph 8-811.10(B)(2) Insert (Number of Year(s))
SECTION 3. INCONSISTENT CODES REPEALED
That __(statute/regulation/ordinance)__ number __(present code number)__ of the __(jurisdiction)__ titled, __(complete title of the food code›s| in effect at the present time so they will be repealed by definite mention)__and all other codes or portions of codes in conflict herewith are hereby repealed in that respect only.
SECTION 4. CERTIFICATION OF ADOPTION AND PUBLISHING
That the __(jurisdiction's keeper of records)__ shall certify the adoption of this __(statute/regulation/ordinance__ and cause the same to be published as required by law.
SECTION 5. EFFECTIVE DATE
That this Code and the rules, regulations, provisions, requirements, orders, and matters established and adopted hereby shall take effect and be in full force and effect __(time period)__from and after the date of its final passage and approval.
PASSED AND APPROVED BY __(name of adopting authority)__ on this __(day)__ of __(month, year)__.
BY:____________________________________
Examples of how some jurisdictions have set fines, sentences, and penalties:
- California law provides:
-
- A. For Food Manufacturing Violations:
Criminal fines and sentence for violations of up to $10,000 and one year imprisonment if there is shown an intent to defraud or mislead, and
-
- Civil penalties of up to $5,000 per day for certain violations.
-
- B. For Food Retail Violations:
- Maryland law provides:
-
- Criminal fines and sentence for certain violations of up to $10,000 and one year imprisonment, and in the case of repeat code violation convictions, up to $25,000 and three years imprisonment; and
-
- Civil penalties of up to $5,000 for each violation and for each day the violation continues.
-
- Texas law provides:
-
- Criminal fines and sentence for certain violations of up to $10,000 and two years imprisonment; and
-
- Assessment of five "severity" levels of administrative or civil penalties with base amounts ranging from $1,250 through $10,000. Base amounts can be decreased or increased by as much as 50% considering factors such as past performance, good faith, direct impact on health and safety, high-risk populations involved, etc.
Federal law provides under the Criminal Fine Enforcement Act of 1984 for a fine up to $100,000 for a misdemeanor by a corporation or individual not resulting in death and, for misdemeanors resulting in death, a fine of up to $250,000 for individuals and $500,000 for corporations.
| Form 6
|
The HACCP Inspection Data form is designed to accommodate the recording of observations during an inspection. The design of the form focuses on information related to the flow of potentially hazardous foods being prepared, displayed, sold, and served within the establishment. The form is intended as a worksheet for use in noting food temperatures/times at each step and other pertinent data as they compare to the established critical limits. This juxtaposition of the observations and the critical limits highlights the violative steps. The information then is transferred to the Establishment Inspection Report form.
Refer to Annex 4, Food Establishment Inspection, Sections 5 and 10, for further discussion regarding the use of the form.
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DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC HEALTH SERVICE FOOD AND DRUG ADMINISTRATION |
HACCP INSPECTION DATA
| EST. NAME: | PERMIT NO. | INSPECTOR: | ||
| DATE: | TIME IN: | :AM / PM | TIME OUT: | :AM/ PM |
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Use Additional Forms If Necessary |
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FOOD STEP |
1.
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LIMIT |
2.
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LIMIT |
3.
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LIMIT |
4.
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LIMIT |
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A. SOURCE
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B. STORAGE
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| C. PREP BEFORE COOK |
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D. COOK
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| E. PREP AFTER COOK |
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F. HOT/COLD
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G. DISPLAY/
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H. COOL
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I. REHEAT
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| OTHER FOOD TEMPERATURES OBSERVED Use steps from above for location | ||||||||
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°C/°F |
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°C/°F |
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°C/°F |
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MANAGEMENT / PERSONNEL OBSERVATIONS |
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OTHER FOOD OBSERVATIONS |
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EQUIPMENT, UTENSILS, AND LINEN OBSERVATIONS |
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WATER, PLUMBING, AND WASTE OBSERVATIONS |
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PHYSICAL FACILITIES |
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POISONOUS OR TOXIC MATERIALS OBSERVATIONS |
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| Form 7
|
The food establishment inspection report is the official agency document regarding compliance of the establishment with agency requirements. The goal of the report is to clearly, concisely, and fairly present the compliance status of the establishment and to convey compliance information to the permit holder or person in charge at the conclusion of the inspection. The Food Establishment Inspection Report form is provided as a model for use during routine, follow-up, and investigative inspections.
Refer to Annex 4, Food Establishment Inspection, Sections 6, 11, and 12, for further discussion.
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DEPARTMENT OF HEALTH AND HUMAN SERVICES PUBLIC HEALTH SERVICE FOOD AND DRUG ADMINISTRATION |
FOOD ESTABLISHMENT INSPECTION REPORT
Violations cited in this report shall be corrected within the time frames specified below, but within a period not to exceed 10 calendar days for critical items (§ 8-405.11) or 90 days for noncritical items (§ 8-406.11).
| VIOLATIONS: | CRITICAL _____ | NONCRITICAL_____ |
ESTABLISHMENT: PERMIT NUMBER: DATE: |
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ADDRESS: CITY: STATE: ZIP: |
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PERSON IN CHARGE / TITLE: TELEPHONE: |
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INSPECTOR / TITLE: |
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INSPECTION TYPE: ROUTINE FOLLOW-UP COMPLAINT OTHER: TIME: |
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| Critical (X) | Repeat (X) | Code Reference | Violation Description / Remarks / Corrections |
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| Food Establishment Inspection Report Page ___ of ___ |
FOOD ESTABLISHMENT INSPECTION REPORT
ESTABLISHMENT: PERMIT NUMBER: DATE: |
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| Critical (X) | Repeat (X) | Code Reference | Violation Description / Remarks / Corrections |
| Food Establishment Inspection Report Page ___ of ___ |
| Guide 1
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| 1. Diagnosed with illness due to Salmonella Typhi, Shigella spp., Escherichia coli O157:H7, or hepatitis A virus | Exclude 2-201.12(A) |
Exclude 2-201.12(A) |
| 2. Experiencing a symptom listed in 2-201.11(B) | Restrict 2-201.12(B) |
Restrict 2-201.12(B) |
| 3. Experiencing a symptom listed in 2-201.11(B)(1) and meets a high-risk condition* of 2-201.11(D)(1)-(3) | Exclude 2-201.12(C)(1)* |
Restrict 2-201.12(B)(1) |
| 4. Asymptomatic but stools positive for S. Typhi, Shigella spp., or E. coli O157:H7 | Exclude 2-201.12(C)(2) |
Restrict 2-201.12(B)(2) |
| 5. Past illness from Salmonella Typhi within the last 3 months | Exclude 2-201.12(C)(3) |
|
| 6. Past illness from Shigella spp. or E. coli O157:H7 within the last month | Exclude 2-201.12(C)(4) |
No Restrictions |
| 7. Onset of jaundice within the last 7 days | Exclude 2-201.12(D)(1) |
Exclude 2-201.12(D)(1) |
| 8. Onset of jaundice more than 7 days ago | Exclude 2-201.12(D)(2)(a) |
Restrict 2-201.12(D)(2)(b) |
* High-risk conditions apply only to exclusions under this Subparagraph.
| Guide 2
|
| Health Status 2-201.11 and .12 |
Facilities Serving Highly Susceptible Population 2-201.13 |
Facilities Not Serving Highly Susceptible Population 2-201.13 |
| 1. Diagnosed with illness due to Salmonella Typhi, Shigella spp., Escherichia coli O157:H7, or hepatitis A virus 2-201.11(A) | 1. RA Approval + 2. Doctor*: Stool free or Blood free or symptom-free (A)(1) |
1. RA Approval + 2. Doctor*: Stool free or Blood free or symptom-free (A)(2) |
| 2. Experiencing a symptom listed in 2-201.11(B) | 1. No illness results + no symptoms or 2. Suspect cause of illness + no symptoms + Doctor*: stool or blood free or 3. Doctor*: Noninfectious condition (B)(1) |
1. No illness results + no symptoms or 2. Suspect cause of illness + no symptoms + Doctor*: stool or blood free or 3. Doctor*: Noninfectious condition (B)(1) |
| 3. Experiencing a symptom listed in 2-201.11(B)(1) and meets a high-risk condition 2-201.11(D)(1)-(3) 2-201.12(C)(1) |
Doctor*: 1. Stools or blood free or 2. No jaundice per .13(D) 3..12 (C)(1) Noninfectious condition (C) |
1. No illness results + no symptoms or 2. Suspect cause of illness + no symptoms + Doctor*: stool or blood free or 3. Doctor*: Noninfectious condition (B)(1) |
| 4. Asymptomatic but stools positive for S. Typhi, Shigella spp., or E. coli O157:H7 2-201.12(B)(2) & (C)(2) |
Doctor* - stools free (C) |
Doctor* - stools free (B)(2) |
| 5. Past illness from Salmonella Typhi within the last 3 months 2-201.11(C) | Doctor* - stools free (C) |
NA |
| 6. Past illness from Shigella spp., or E. coli O157:H7 within last month 2-201.11(C) | Doctor* - stools free (C) |
NA |
| 7. Onset of jaundice within last 7 days 2-201.12(D)(1) | 1. No illness results + Doctor* - blood free or Doctor* - no jaundice or 2. Suspect cause of illness + both satisfied (D) |
1. No illness results + Doctor* - blood free or Doctor* - no jaundice or 2. Suspect cause of illness + both satisfied (D) |
| 8. Onset of jaundice more than 7 days ago 2-201.12(D)(1) | 1. No illness results + Doctor* - blood free or Doctor* - no jaundice or 2. Suspect cause of illness + both satisfied (D) |
1. No illness results + Doctor* - blood free or Doctor* - no jaundice or 2. Suspect cause of illness + both satisfied (D) |
*Where "doctor" is indicated, nurse practitioner or physician assistant, if allowed by law, may provide documentation.
| Guide 3
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The major headings from each of the Code chapters have been extracted and condensed in this Guide to key word phrases to assist the person conducting inspections in locating the Code citation that corresponds to a given violation. The Guide is intended to be used during inspections as an aid in referencing Code provisions, ensuring that provisions of the Code are not overlooked during the inspection, and accurately completing the Food Establishment Inspection Report form.
INSPECTIONAL GUIDE
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Management and Personnel Food |
Contamination from Consumers Equipment, Utensils, and Linens |
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4-204.14 Vending Machine, Stage Closure 4-204.15 Bearings and Gear Boxes, Leakproof 4-204.16 Beverage Tubing, Separation 4-204.17 Ice Units, Separation of Drains 4-204.18 Condenser Unit, Separation 4-204.19 Can Openers on Vending Machines 4-204.110 Molluscan Shellfish Tanks 4-204.111 Vending Machines, Automatic Shutoff* 4-204.112 Temperature Measuring Devices 4-204.113 Warewasher, Data Plate Operat.Spec. 4-204.114 Warewasher, Internal Baffles 4-204.115 Warewasher, Temp. Measuring Devices 4-204.116 Manual Warewashing, Heaters/Baskets 4-204.117 Warewasher, Sanitizer Indicator 4-204.118 Warewasher, Flow Pressure Device 4-204.119 Sinks and Drainboards/Self-Draining 4-204.120 Equipment Compartments, Drainage 4-204.121 Vending Mach./Liquid Waste Products 4-204.122 Case Lot Handling Equip/Moveability 4-204.123 Vending Machine Doors and Openings NUMBERS AND CAPACITIES Equipment 4-301.11 Cooling/Heating/Holding Capacities 4-301.12 Warewashing, Sink Requirements 4-301.13 Drainboards 4-301.14 Ventilation Hood Systems, Adequacy 4-301.15 Clothes Washers and Dryers Utensils and Measuring/Testing Devices 4-302.11 Utensils for Consumer Self-Service 4-302.12 Food Temperature Measuring Devices 4-302.13 Wash/San. Temp. Measuring Devices 4-302.14 Sanitizing Solution Testing Devices LOCATION AND INSTALLATION 4-401.11 Equip. Location/Preventing Contam. Installation 4-402.11 Fixed Equipment, Spacing/Sealing 4-402.12 Fixed Equipment, Elevation/Sealing MAINTENANCE AND OPERATION Equipment 4-501.11 Good Repair and Proper Adjustment 4-501.12 Cutting Surfaces 4-501.13 Microwave Ovens 4-501.14 Equipment, Cleaning Frequency 4-501.15 Warewasher, Operating Instructions 4-501.16 Warewashing Sinks, Use Limitation 4-501.17 Warewashing, Cleaning Agents 4-501.18 Warewashing, Clean Solutions 4-501.19 Warewashing, Wash Sol. Temperature 4-501.110 Warewasher, Wash Sol. Temperature 4-501.111 Warewashing, San. Water Temp.* 4-501.112 Warewasher, San. Water Temp. 4-501.113 Warewasher, Sanitization Pressure 4-501.114 Chem.San., Temp./pH/Concentr./Hard.* 4-501.115 Chem.San., Detergent-Sanitizers 4-501.116 Determining Chem.San. Concentration Utensil/Temperature/Pressure Measuring Device 4-502.11 Good Repair and Calibration 4-502.12 Single-Ser./Use Art., Required Use 4-502.13 Single-Ser./Use Art., Use Limitation 4-502.14 Shells, Use Limitation CLEANING OF EQUIPMENT AND UTENSILS Objective 4-601.11 Clean Sight/Touch-No Accum/Encrust.* Frequency 4-602.11 Food-Contact Surfaces and Utensils* 4-602.12 Cooking and Baking Equipment 4-602.13 Nonfood-Contact Surfaces Methods 4-603.11 Dry Cleaning 4-603.12 Precleaning 4-603.13 Loading of Soiled Items, Warewasher 4-603.14 Wet Cleaning 4-603.15 Washing, Alternative Manual Equipment 4-603.16 Rinsing Procedures 4-603.17 Returnables, Cleaning for Refilling* SANITIZATION OF EQUIPMENT AND UTENSILS Objective 4-702.11 Frequency-Before Use After Cleaning* 4-703.11 Methods-Hot Water and Chemical* LAUNDERING 4-801.11 Objective, Clean Linens 4-802.11 Frequency, Specifications |
Water, Plumbing, and Waste |
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Physical Facilities |
Poisonous or Toxic Materials Compliance and Enforcement |
| List
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The following list of countries shows where typhoid fever, hepatitis A, and various diarrheal diseases commonly occur or are epidemic as reported to the Centers for Disease Control and Prevention (CDC) by the World Health Organization (WHO). CDC publishes this information annually in what is referred to as the "Yellow Book," Health Information for International Travel. Statistics cited were adapted from CDC's 1996-97 edition in the section entitled "Geographical Distribution of Potential Health Hazards to Travelers." The list is not comprehensive. Reporting to WHO is voluntary and is based on mortality, not morbidity. Where the Yellow Book refers to nonspecific "diarrheal disease," E. coli O157:H7 has been denoted as a possible cause.
This list is intended to be used as an aid to increase awareness of the person in charge that travel to some points outside the U.S. may increase the risk of acquiring foodborne illness. The person in charge can use the list to educate food employees about the need to be vigilant in the protection of their health during travel and the importance of informing the person in charge if symptoms occur or if there is a diagnosis of an illness (due to one of the four pathogens listed above) during or following travel.
Northern Africa ![]()
Algeria, Egypt, Libyan Arab Jamahiriya, Morocco, and Tunisia
Sub-Saharan Africa ![]()
Angola, Benin, Burkina Faso, Burundi, Cameroon, Cape Verde, Central African Republic, Chad, Comoros, Congo, Côte D'Ivoire, Djiouti, Equatorial Guinea, Eritrea, Ethiopia, Gabon, Gambia, Ghana, Guinea, Guinea-Bissau, Kenya, Liberia, Madagascar, Malawi, Mali, Mauritania, Mauritius, Mozambique, Niger, Nigeria, Réunion, Rwanda, Sao Tome and Principe, Senegal, Seychelles, Sierra Leone, Somalia, Sudan, Togo, Uganda, United Republic of Tanzania, Zaire, Zambia, and Zimbabwe.
Southern Africa ![]()
Botswana, Lesotho, Namibia, St. Helena, South Africa, and Swaziland.
North America ![]()
Bermuda, Canada, Greenland, St. Pierre and Miquelon and the United States of America.
Mainland Middle America ![]()
Belize, Costa Rica, El Salvador, Guatemala, Honduras, Mexico, Nicaragua, and Panama.
Caribbean Middle America ![]()
Antigua and Barbuda, Aruba, Bahamas, Barbados, British Virgin Islands, Cayman Islands, Cuba, Dominica, Dominican Republic, Grenada, Guadeloupe, Haiti, Jamaica, Martinique, Montserrat, Netherlands Antilles, Puerto Rico, St. Christopher and Nevis, Saint Lucia, Saint Vincent, and the Grenadines, Trinidad and Tobago, Turks and Caicos Islands, and the Virgin Islands (USA).
Tropical South America ![]()
Bolivia, Brazil, Colombia, Ecuador, French Guiana, Guyana, Paraguay, Peru, Suriname, and Venezuela.
Temperate South America ![]()
Argentina, Chile, Falkland Islands (Malvinas), and Uruguay.
East Asia ![]()
China, the Democratic People's Republic of Korea, Hong Kong, Japan, Macao, Mongolia, and the Republic of Korea.
Eastern South Asia ![]()
Brunei Darussalam, Cambodia, Indonesia, Lao People's Democratic Republic, Malaysia, Myanmar (formerly Burma), the Philippines, Singapore, Thailand, and Viet Nam.
Middle South Asia ![]()
Afghanistan, Armenia, Azerbaijan, Bangladesh, Bhutan, India, Islamic Republic of Iran, Kazakhstan, Kyrgyzstan, Maldives, Nepal, Pakistan, Sri Lanka, Tajikistan, Turkmenistan, and Uzbekistan.
Western South Asia ![]()
Bahrain, Cyprus, Iraq, Israel, Jordan, Kuwait, Lebanon, Oman, Qatar, Saudi Arabia, Syrian Arab Republic, Turkey, the United Arab Emirates, and Yemen.
Northern Europe ![]()
Belarus, Belgium, Czech Republic, Denmark (with the Faroe Islands), Estonia, Finland, Germany, Iceland, Ireland, Latvia, Lithuania, Luxembourg, Netherlands, Norway, Poland, Republic of Moldova, Russian Federation, Slovakia, Sweden, Ukraine, and the United Kingdom (with the Channel Islands and the Isle of Man).
Southern Europe ![]()
Albania, Andorra, Austria, Bosnia, and Herzegovina, Bulgaria, Croatia, France, Gibraltar, Greece, Hungary, Italy, Liechtenstein, Malta, Monaco, Portugal (with the Azores and Madeira), Romania, San Marino, Slovenia, Spain (with the Canary Islands), Switzerland, and the former Yugoslav Republic of Macedonia, and Yugoslavia.
Australia, New Zealand & Antarctic ![]()
Melanesia & Micronesia (Polynesia) ![]()
American Samoa, Cook Islands, Easter Island, Federated States of Micronesia, Fiji, French Polynesia, Guam, Kiribati, Marshall Islands, Nauru, New Caledonia, Niue, Palau, Papua New Guinea, Pitcairn, Samoa, Solomon Islands, Tokelau, Tonga, Trust Territory of the Pacific Islands, Tuvalu, Vanuata, Wake Island (U.S.) and the Wallis and Futuna Islands.
| Chart 1
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| Unpasteurized Shell Eggs prepared for immediate service Commercially Raised Game Animals Fish, Pork, and Meat Not Otherwise Specified in this Chart or in in ¶ 3-401.11(B) |
63°C (145°F) | 15 seconds |
| Unpasteurized Shell Eggs not prepared for immediate service Exotic Species of Game Animals Comminuted Fish and Meats Injected Meats |
70°C (158°F) 68°C (155°F) 66°C (150°F) 63°C (145°F) |
<1 second 15 seconds 1 minute 3 minutes |
| Poultry Stuffed Fish; Stuffed Meat; Stuffed Pasta; Stuffed Poultry Stuffing Containing Fish, Meat, or Poultry Wild Game Animals |
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| Food Cooked in a Microwave Oven |
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and hold for 2 minutes after removing from microwave oven |
| Chart 2
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| ¶ 3-403.11(A) Food that is cooked, cooled, and reheated |
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| ¶ 3-403.11(B) Food that is reheated in a microwave oven |
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| ¶ 3-403.11(C) Food that is taken from a commercially processed, hermetically sealed container or intact package |
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| ¶ 3-403.11(E) Unsliced portions of roasts of beef and roasts of pork cooked as specified under Subparagraph 3-401.11(B) |
Same oven parameters and minimum time and temperature conditions as specified under Subparagraph 3-401.11(B) |
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| Minimum time and temperature conditions listed in this chart for ¶ 3-403.11(A) or ¶ 3-403.11(B). | |||
| Chart 3
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C = T - F
C = consume- or dispose-by date
T = days allowed based on storage temperature
F = days before freezing
Example: The morning of October 1, a chicken was cooked, then cooled, refrigerated for 2 days at 41°F and then frozen. If the chicken is thawed October 10, the food must be consumed or discarded no later than midnight of October 15.
| Chart 4
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This table is a plan review and inspectional guide for mobile food establishments based on the mobile unit's menu and operation. Mobile units range in type from push carts to food preparation catering vehicles.
To use the table, read down the columns based on the menu and operation in use. For example, if only prepackaged potentially hazardous food is served, then requirements listed in the Potentially Hazardous Menu - Prepackaged column apply. Likewise, if only food that is not potentially hazardous is prepared on board, then requirements listed in the Not Potentially Hazardous Menu - Food Preparation column apply. Note that if a mobile food establishment has available for sale to the consumer both prepackaged potentially hazardous food and potentially hazardous food prepared on board, then the more stringent requirements of the Potentially Hazardous Menu - Food Preparation column apply.
It is important to remember that mobile units may also be subject to all Food Code provisions that apply to food establishments. Consult the local regulatory authority for specific local requirements.
The local regulatory authority's decision to require auxiliary support services such as a commissary or servicing area should be based on the menu, type of operation and availability of on-board or on-site equipment.
NOTE: The Food Code definition of "Food Establishment" does not include an establishment that offers only prepackaged foods that are not potentially hazardous.
FDA FOOD CODE MOBILE FOOD ESTABLISHMENT MATRIX |
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| Food Code | Potentially Hazardous Menu | Not Potentially Hazardous Menu | |
| Areas/Chapter |
Food Preparation |
Prepackaged |
Food Preparation |
| Personnel | Applicable Sections of Parts 2-2 - 2-4 5-203.11 (B) |
Applicable Sections of Parts 2-2 - 2-4 5-203.11 (B) |
Applicable Sections of Parts 2-2 - 2-4 5-203.11 (B) |
| Food | 3-101.11 3-201.11-.16 3-202.16; Applicable Sections of Part 3-3; 3-501.16 3-501.18(A) &(C) |
3-101.11 3-201.11-.16 3-303.12(A) 3-305.11; 3-305.12 (Applicable to Service Area or Commissary) |
3-101.11; 3-201.11 3-202.16; Applicable Sections of Part 3-3 |
| Temperature Requirements | 3-202.11; Applicable Sections of Parts 3-4 & 3-5 |
3-202.11 3-501.16 |
NONE |
| Equipment Requirements | Applicable Sections of Parts 4-1 - 4-9 and 5-5 | Applicable Sections of Parts 4-1 - 4-2; 4-6 and 5-5 | Applicable Sections of Parts 4-1 - 4-2; 4-5 - 4-6 and 5-5 |
| Water & Sewage | 5-104.12 5-203.11(A) & (B) Part 5-3; 5-401.11 5-402.13-.15 |
5-203.11(B) | 5-104.12 5-203.11(A) & (B) Part 5-3; 5-401.11 5-402.13-.15 |
| Physical Facility | 6-101.11; 6-201.11 6-102.11(A) & (B) 6-202.15; 6-501.11 6-501.12; 6-501.111 |
6-101.11 6-102.11(A) & (B) 6-202.15 6-501.111 |
6-101.11; 6-201.11 6-102.11(A) & (B) 6-202.15; 6-501.11 6-501.12; 6-501.111 |
| Toxic Materials | Applicable Sections of Chapter 7 | Applicable Sections of Chapter 7 | Applicable Sections of Chapter 7 |
| Servicing | 6-202.18 / As necessary to comply with the Food Code | 6-202.18 / As necessary to comply with the Food Code | 6-202.18 / As necessary to comply with the Food Code |
| Compliance and Enforcement | Applicable Sections of Chapter 8 and Annex 1 | Applicable Sections of Chapter 8 and Annex 1 | Applicable Sections of Chapter 8 and Annex 1 |


