HACCP Plan Verification Summary - Annex 4, Section 2
FDA Procedures for Standardization of Retail Food Safety Inspection Officers
[For Subparagraph 3-302 (B)(3)]
|Establishment Name:||Type of Facility:|
|Physical Address:||Person in Charge:|
|Insp. Time In:||Insp.Time Out:||Date:||Candidate's Name:|
Indicate Person Filling Out Form: (circle one)
Candidate's Form / Standard's Form
|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:
- 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.
- 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.
- 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.