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U.S. Department of Health and Human Services

Food

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NCIMS HACCP Centralized Deviation Log

 

Return to Dairy Grade A Voluntary HACCP

 

SUBJECT

Centralized Deviation Log

 
PLANT NAME
ADDRESS

Deviation #1

TODAY'S DATE:DATE OF INCIDENT:
DATE REPORTED:REPORTED BY:
EXPLAIN CCP CRITICAL LIMIT DEVIATION:
 
PRODUCT / PROCESS INVOLVED
      • Product Name and Description:
      • Code Date(s):
      • Date(s) of Manufacture:
      • Production Line #:
CORRECTIVE ACTION:ACTION TAKEN
1. Segregate and hold the affected product until 2. and 3. are completedcheckbox YES  checkbox NO   Date:
Comments:
2. Perform or obtain a review to determine the acceptability of the affected product for distribution. The review shall be performed by an individual or individuals qualified by training or experience to perform such a review;checkbox YES  checkbox NO   Date:
Comments:
3. Take corrective action, when necessary, with respect to the affected product to ensure that no product is allowed to enter commerce that is either injurious to health or is otherwise adulterated as a result of the deviation;checkbox YES  checkbox NO   Date:
Comments:
4. Take corrective action, when necessary, to correct the cause of the deviation; andcheckbox YES  checkbox NO   Date:
Comments:
5. Perform or obtain timely validation by a qualified individual(s), as required in Appendix K, to determine whether modification of the HACCP Plan is required to reduce the risk of recurrence of the deviation, and modify the HACCP Plan as necessary.checkbox YES  checkbox NO   Date:
Comments:

 

DISPOSITION OF PRODUCT      ROOT CAUSE OF DEVIATION