• Decrease font size
  • Return font size to normal
  • Increase font size
U.S. Department of Health and Human Services

Food

  • Print
  • Share
  • E-mail

HACCP Plan Verification Summary - Annex 4, Section 2

FDA Procedures for Standardization of Retail Food Safety Inspection Officers

Table of Contents


[For Subparagraph 3-302 (B)(3)]

HACCP Plan Verification Summary
Establishment Name: Type of Facility:
Physical Address: Person in Charge:
City: State: Zip: County:
Insp. Time In: Insp.Time Out: Date: Candidate's Name:
Agency: Standard's Name:

Indicate Person Filling Out Form: (circle one)

Candidate's Form / Standard's Form

 

Chart 1: HACCP Plan Verification Summary
HACCP Plan Verification Summary (circle YES or NO)
  Record #1 Record #2 Record #3
Current Date if Possible 2nd Selected Date: 3rd Selected Date:
Required Monitoring Recorded 1 YES / NO YES / NO YES / NO
Accurate and Consistent 2 YES / NO YES / NO YES / NO
Corrective Action Documented 3 YES / NO YES / NO YES / NO

Total # of record answers that are in Disagreement with the Standard =________

(This box for Completion by Standard only)

The use of a HACCP plan by a food establishment can be verified through a review of food establishment records and investigating the following information:

  1. Does the food establishment's HACCP documentation indicate that the required monitoring procedures were followed (frequency, initials, dated, etc.) on the 3 selected dates? A "YES" answer would indicate that all required monitoring was documented. If any required monitoring was not documented, a "NO" answer would be circled in this section.
  2. Does the food establishment's HACCP documentation for the selected dates appear accurate and consistent with other observations? A "YES" answer would indicate that the record appears accurate and consistent. A "NO" answer would indicate that there is inaccurate or inconsistent HACCP documentation.
  3. Was corrective action documented in accordance with the HACCP plan when CLs were not met on each of the 3 selected dates? A "YES" answer would indicate that corrective action was documented for each CL not met for each of the 3 selected dates. A "Yes" can also mean that no corrective action was needed. A "NO" answer would indicate any missing or inaccurate documentation of corrective action.