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PAGE 1 OF 2 |
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FORM APPROVED OMB NO. 0580-0013: According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0580-0013. The time required is estimated to average 1.5 hours per response and 1 minute of recordkeeping, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. |
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SANITATION INSPECTION REPORT |
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(PROCESSED PRODUCTS) |
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SANITATION INSPECTION OF (Name and Address of Plant) |
INSPECTOR |
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DATE INSPECTED |
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PLANT OWNED BY (Company or Individual) |
INSPECTOR ACCOMPANIED BY (Name and Title) |
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Assigned |
Inspr's |
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Assigned |
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Inspr's |
SANITARY DEFECTS |
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Defect |
Defect |
SANITARY DEFECTS |
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Defect |
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Defect |
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Points |
Points |
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Points |
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Points |
I. |
PREMISES |
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A. |
Outside premises not well drained. |
3 |
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B. |
Outside premises not free of weeds, clutter, |
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VII. |
DISPOSAL OF WASTES |
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unused equipment or other materials. |
3 |
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A. |
Garbage, trash, and dry waste materials, inside or |
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C. |
Waste not properly stored or contained. |
3 |
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outside the building, not satisfactorily contained. |
4 |
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D. |
Outside premises not free of harborage or breeding |
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B. |
Waste is not disposed of frequently enough |
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places for insects, rodents, birds, or other animals. |
4 |
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to prevent unsightliness or undesirable odors. |
4 |
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E. |
Approaches to docks not clean or treated to minimize |
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dust. |
3 |
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VIII. |
TOILET, HAND-WASHING, AND DRESSING ROOM |
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FACILITIES |
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II. |
RAW MATERIALS |
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A. |
Toilet facilities not provided for each sex. |
3 |
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A. |
Raw materials used in the product not handled in a |
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sanitary manner that would prevent adulteration of finished |
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B. |
Toilets and urinals not water-flushed. |
3 |
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product. |
Critical |
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C. |
Toilet room(s) not equipped with self-closing |
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doors. |
3 |
3 |
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III. |
CONSTRUCTION OF BUILDING |
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D. |
Toilet room(s) open directly into a processing |
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A. |
Plant construction does not exclude probable |
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or food storage room where food is exposed. |
Critical |
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entrance of insects, rodents, birds or other animals. |
5 |
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E. |
Cold and hot, water or tapped water not |
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B. |
Walls, partitions, ceilings, and exposed structural |
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provided at wash basins. |
3 |
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supports in poor repair. |
3 |
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F. |
Hand cleaner and towels not provided at or |
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C. |
Floors not smooth and readily cleanable. |
3 |
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near each basin. |
3 |
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D. |
Floors that frequently get wet not constructed to |
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prevent pooling or are not kept dry. |
3 |
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G. |
Adequate hand-washing signs not posted. |
3 |
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E. |
Exposed, unprotected overhead sewer lines present |
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in product lines. |
Critical |
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H. |
Adequate dry waste receptacles not provided. |
5 |
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F. |
Wooden floors, where present, not coated with a suitable |
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floor seal that effectively minimizes cracks and crevices. |
5 |
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I. |
Toilet facilities not working. |
4 |
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G. |
Walls not sealed at juncture with floor. |
3 |
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J. |
Toilet and locker room not satisfactorily |
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H. |
Walls and ceilings not free of flaked paint, nor in good |
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ventilated. |
5 |
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repair. |
3 |
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K. |
Toilet and dressing rooms not kept in a clean |
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orderly condition. |
5 |
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I. |
Windows not intact. |
3 |
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J. |
Entrances to production rooms not equipped with |
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self-closing doors nor provided with other effective means |
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IX. |
CONSTRUCTION AND REPAIR OF EQUIPMENT |
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to prevent entrance of vermin. |
3 |
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A. |
Equipment product contact surfaces not |
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constructed of smooth, nontoxic, corrosion- |
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K. |
Screen doors, where present, not self closing. |
3 |
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resistant, odorless, materials; wood, where used, |
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4 |
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L. |
Utility rooms or areas, including boiler rooms and |
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not fine, close grained, high-density type. |
5 |
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maintenance shop, not isolated enough or separated from |
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B. |
Equipment product zone surfaces not free of |
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production rooms. |
4 |
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cracks, crevices, pits, or other imperfections |
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(such as knots in wood). |
5 |
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IV. |
LIGHTING |
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C. |
Adequate space not allowed around equipment |
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A. |
Production rooms not adequately lighted (20-foot candles). |
3 |
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for cleaning and inspection purposes. |
4 |
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B. |
Places where detailed inspection of the product |
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D. |
Equipment not designed to protect the product |
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or ingredients is required not adequately lighted |
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zone against contamination or extraneous |
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(50-foot candles). |
4 |
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material. |
5 |
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C. |
Places where detailed inspection of the processes or |
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E. |
Equipment not free of parts or areas inaccessible |
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operations is required not adequately lighted |
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for cleaning and inspection purposes. |
4 |
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(50-foot candles). |
3 |
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F. |
Electrical system not constructed or positioned |
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to prevent insect harborage. |
3 |
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D. |
Storage areas not adequately lighted (20-foot candles) |
3 |
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G. |
Equipment not kept in good repair. |
2 for each item not in good repair |
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E. |
Toilets and dressing rooms not adequately lighted |
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(20-foot candles). |
3 |
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F. |
Light bulbs, fixtures, skylights, or other glass suspended |
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X. |
CLEANING |
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over food in any stage of preparation not of a safety type |
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A. |
Equipment not cleaned at frequencies necessary |
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or otherwise protected where essential to prevent |
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to prevent contamination of the product. |
Critical |
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contamination of the product during production. |
5 |
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B. |
A dust-free method of cleaning not used |
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whenever possible. |
3 |
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V. |
VENTILATION |
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A. |
Plant not reasonably free of undesirable odors, hot air |
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XI. |
CONTROL OF INSECTS AND ANIMALS |
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vapors, or dust. |
3 |
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A. |
Presence of evidence of any rodents in plant. |
5 |
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B. |
Evidence or presence of excessive condensate on walls, |
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B. |
Presence of any birds or any other animals |
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ceilings, equipment, or pipelines. |
4 |
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including domestic types in the plant. |
5 |
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C. |
Areas where steam or hot air vapors are predominant not |
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C. |
Presence of live insects in processing or product |
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effectively exhaust-ventilated. |
3 |
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storage areas(two or more). |
Critical |
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D. |
Cooling and air-conditioning units not equipped with |
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D. |
Presence of dead insects in processing equipment |
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filtering devices; filters not changed or cleaned when |
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(two or more). |
Critical |
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necessary. |
3 |
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E. |
Presence of live or dead insects in other plant areas |
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E. |
Window openings to the outside not screened with 14-mesh |
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(three or more). |
5 |
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or finer window screen (during presence of flies or other |
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F. |
Rodenticides, insecticides, and other control |
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flying insects. |
3 |
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or eradication material including applicatory |
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F. |
Exhaust fans not screened or equipped with self-closing |
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equipment not used in a safe acceptable manner. |
Critical |
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louvers. |
3 |
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G. |
Evidence that effective pest control not exercised |
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where needed. |
3 |
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VI. |
WATER SUPPLY |
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H. |
Type of insecticides and rodenticides not in |
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A. |
Lack of satisfactory evidence that the water supply is potable. |
Critical |
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compliance with Federal Food and Drug |
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B. |
Presence of a cross-connection between water lines and |
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Administration regulations. |
4 |
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sewage system (not allowed). |
Critical |
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I. |
Poisoned baits, if used, not adequately secured. |
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5 |
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FORM FGIS 952 (7-02) (Replaces Form FGIS-952 (1-84). Expires January 2015 |
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PAGE 2 OF 2 |
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Assigned |
Inspr's |
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Assigned |
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Inspr's |
SANITARY DEFECTS |
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Defect |
Defect |
SANITARY DEFECTS |
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Defect |
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Defect |
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Points |
Points |
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Points |
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Points |
XII. |
COOLING AND REFRIGERATION FACILITIES |
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XIV. |
PERSONNEL |
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A. |
Perishable supplies and products not adequately |
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A. |
Employees not wearing garments suitable for |
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protected from contamination or from |
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work being performed. |
4 |
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becoming spoiled. |
5 |
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B. |
Personnel in contact with unwrapped product or |
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B. |
Storage areas not free of visible mold and |
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ingredients not using proper headwear |
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objectionable odors. |
3 |
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including protection from facial hair. |
4 |
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C. |
Storage area not reasonably clean. |
3 |
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C. |
Fingernail polish, costume jewelry, and |
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D. |
Where required refrigeration facilities not |
3 |
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wrist watches worn by plant personnel |
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properly cooling and keeping perishable |
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working on the processing line. |
3 |
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supplies and products at temperatures |
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D. |
Gloves, if worn, not kept in a sanitary condition. |
3 |
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not exceeding 45 degrees F. |
5 |
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E. |
Storage of employees personal effects in |
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E. |
Adequate skids or pallets not used when |
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production rooms. |
3 |
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needed. |
3 |
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F. |
Employees not washing hands after |
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F. |
Items not stored in an orderly, easily |
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contamination. |
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Critical |
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accessible manner in suitable, covered, or |
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G. |
Failure of employees to be hygienically |
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3 |
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closed containers. |
3 |
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clean: fingernails not kept clean and |
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trimmed. |
4 |
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XIII. |
STORING AND STORAGE FACILITIES |
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H. |
Employees affected with or a carrier |
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A. |
Supplies and products not adequately |
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of a communicable or infectious disease |
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protected from contamination nor |
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not excluded from product area. |
Critical |
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from becoming spoiled. |
5 |
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I. |
Plant employees having an infectious wound, sore, |
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B. |
Storage areas not well ventilated and |
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or lesion on hands, arms, or other exposed parts of |
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free from objectionable odors. |
3 |
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the body not excluded from contacting |
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ingredients, products, or product zone. |
5 |
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C. |
Storage areas not clean and dry. |
3 |
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J. |
Plant personnel not instructed in |
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D. |
Materials not stored in an orderly manner |
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acceptable hygienic practices and proper |
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in suitable, covered, or closed containers. |
3 |
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sanitary rules of food handling. |
5 |
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E. |
Supplies and product not protected |
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K. |
Personnel not prohibited from |
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against unfavorable temperatures and |
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expectorating, eating, or smoking |
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humidity. |
3 |
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in product areas. |
5 |
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F. |
Adequate skids or pallets not used where |
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needed. |
3 |
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TOTAL…………………………………………………………………… |
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Plant operations are considered to be insanitary if one or more critical defects are found or if the plant receives a score of 76 or higher. |
When Section XII, "Cooling and Refrigeration Facilities" is not applicable, the plant must have a score of 54 or higher. |
REMARKS |
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FORM FGIS 952 (7-02) Reverse |
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PAGE 1 OF 2 |
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FORM APPROVED OMB NO. 0580-0013: According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 00580-0013. The time required is estimated to average 1.5 hours per response and 1 minute of recordkeeping, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. |
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SANITATION INSPECTION REPORT |
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(PROCESSED PRODUCTS) |
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SANITATION INSPECTION OF (Name and Address of Plant) |
INSPECTOR |
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DATE INSPECTED |
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PLANT OWNED BY (Company or Individual) |
INSPECTOR ACCOMPANIED BY (Name and Title) |
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Assigned |
Inspr's |
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Assigned |
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Inspr's |
SANITARY DEFECTS |
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Defect |
Defect |
SANITARY DEFECTS |
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Defect |
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Defect |
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Points |
Points |
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Points |
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Points |
I. |
PREMISES |
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A. |
Outside premises not well drained. |
3 |
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B. |
Outside premises not free of weeds, clutter, |
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VII. |
DISPOSAL OF WASTES |
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unused equipment or other materials. |
3 |
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A. |
Garbage, trash, and dry waste materials, inside or |
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C. |
Waste not properly stored or contained. |
3 |
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outside the building, not satisfactorily contained. |
4 |
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D. |
Outside premises not free of harborage or breeding |
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B. |
Waste is not disposed of frequently enough |
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places for insects, rodents, birds, or other animals. |
4 |
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to prevent unsightliness or undesirable odors. |
4 |
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E. |
Approaches to docks not clean or treated to minimize |
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dust. |
3 |
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VIII. |
TOILET, HAND-WASHING, AND DRESSING ROOM |
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FACILITIES |
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II. |
RAW MATERIALS |
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A. |
Toilet facilities not provided for each sex. |
3 |
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A. |
Raw materials used in the product not handled in a |
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sanitary manner that would prevent adulteration of finished |
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B. |
Toilets and urinals not water-flushed. |
3 |
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product. |
Critical |
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C. |
Toilet room(s) not equipped with self-closing |
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doors. |
3 |
3 |
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III. |
CONSTRUCTION OF BUILDING |
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D. |
Toilet room(s) open directly into a processing |
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A. |
Plant construction does not exclude probable |
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or food storage room where food is exposed. |
Critical |
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entrance of insects, rodents, birds or other animals. |
5 |
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E. |
Cold and hot, water or tapped water not |
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B. |
Walls, partitions, ceilings, and exposed structural |
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provided at wash basins. |
3 |
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supports in poor repair. |
3 |
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F. |
Hand cleaner and towels not provided at or |
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C. |
Floors not smooth and readily cleanable. |
3 |
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near each basin. |
3 |
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D. |
Floors that frequently get wet not constructed to |
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prevent pooling or are not kept dry. |
3 |
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G. |
Adequate hand-washing signs not posted. |
3 |
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E. |
Exposed, unprotected overhead sewer lines present |
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in product lines. |
Critical |
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H. |
Adequate dry waste receptacles not provided. |
5 |
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F. |
Wooden floors, where present, not coated with a suitable |
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floor seal that effectively minimizes cracks and crevices. |
5 |
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I. |
Toilet facilities not working. |
4 |
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G. |
Walls not sealed at juncture with floor. |
3 |
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J. |
Toilet and locker room not satisfactorily |
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H. |
Walls and ceilings not free of flaked paint, nor in good repair. |
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ventilated. |
5 |
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repair. |
3 |
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K. |
Toilet and dressing rooms not kept in a clean |
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orderly condition. |
5 |
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I. |
Windows not intact. |
3 |
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J. |
Entrances to production rooms not equipped with |
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self-closing doors nor provided with other effective means |
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IX. |
CONSTRUCTION AND REPAIR OF EQUIPMENT |
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to prevent entrance of vermin. |
3 |
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A. |
Equipment product contact surfaces not |
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constructed of smooth, nontoxic, corrosion- |
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K. |
Screen doors, where present, not self closing. |
3 |
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resistant, odorless, materials; wood, where used, |
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4 |
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L. |
Utility rooms or areas, including boiler rooms and |
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not fine, close grained, high-density type. |
5 |
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maintenance shop, not isolated enough or separated from |
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B. |
Equipment product zone surfaces not free of |
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production rooms. |
4 |
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cracks, crevices, pits, or other imperfections |
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(such as knots in wood). |
5 |
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IV. |
LIGHTING |
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C. |
Adequate space not allowed around equipment |
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A. |
Production rooms not adequately lighted (20-foot candles). |
3 |
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for cleaning and inspection purposes. |
4 |
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B. |
Places where detailed inspection of the product |
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D. |
Equipment not designed to protect the product |
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or ingredients is required not adequately lighted |
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zone against contamination or extraneous |
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(50-foot candles). |
4 |
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material. |
5 |
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C. |
Places where detailed inspection of the processes or |
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E. |
Equipment not free of parts or areas inaccessible |
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operations is required not adequately lighted |
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for cleaning and inspection purposes. |
4 |
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(50-foot candles). |
3 |
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F. |
Electrical system not constructed or positioned |
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to prevent insect harborage. |
3 |
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D. |
Storage areas not adequately lighted (20-foot candles) |
3 |
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G. |
Equipment not kept in good repair. |
2 for each item not in good repair |
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E. |
Toilets and dressing rooms not adequately lighted |
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(20-foot candles). |
3 |
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F. |
Light bulbs, fixtures, skylights, or other glass suspended |
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X. |
CLEANING |
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over food in any stage of preparation not of a safety type |
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A. |
Equipment not cleaned at frequencies necessary |
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or otherwise protected where essential to prevent |
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to prevent contamination of the product. |
Critical |
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contamination of the product during production. |
5 |
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B. |
A dust-free method of cleaning not used |
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whenever possible. |
3 |
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V. |
VENTILATION |
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A. |
Plant not reasonably free of undesirable odors, hot air |
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XI. |
CONTROL OF INSECTS AND ANIMALS |
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vapors, or dust. |
3 |
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A. |
Presence of evidence of any rodents in plant. |
5 |
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B. |
Evidence or presence of excessive condensate on walls, |
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B. |
Presence of any birds or any other animals |
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ceilings, equipment, or pipelines. |
4 |
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including domestic types in the plant. |
5 |
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C. |
Areas where steam or hot air vapors are predominant not |
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C. |
Presence of live insects in processing or product |
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effectively exhaust-ventilated. |
3 |
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storage areas(two or more). |
Critical |
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D. |
Cooling and air-conditioning units not equipped with |
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D. |
Presence of dead insects in processing equipment |
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filtering devices; filters not changed or cleaned when |
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(two or more). |
Critical |
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necessary. |
3 |
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E. |
Presence of live or dead insects in other plant areas |
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E. |
Window openings to the outside not screened with 14-mesh |
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(three or more). |
5 |
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or finer window screen (during presence of flies or other |
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F. |
Rodenticides, insecticides, and other control |
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flying insects. |
3 |
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or eradication material including applicatory |
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F. |
Exhaust fans not screened or equipped with self-closing |
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equipment not used in a safe acceptable manner. |
Critical |
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louvers. |
3 |
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G. |
Evidence that effective pest control not exercised |
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where needed. |
3 |
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VI. |
WATER SUPPLY |
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H. |
Type of insecticides and rodenticides not in |
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A. |
Lack of satisfactory evidence that the water supply is potable. |
Critical |
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compliance with Federal Food and Drug |
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B. |
Presence of a cross-connection between water lines and |
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Administration regulations. |
4 |
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sewage system (not allowed). |
Critical |
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I. |
Poisoned baits, if used, not adequately secured. |
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5 |
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FORM FGIS 952 (7-02) (Replaces Form FGIS-952 (1-84) |
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PAGE 2 OF 2 |
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Assigned |
Inspr's |
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Assigned |
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Inspr's |
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SANITARY DEFECTS |
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Defect |
Defect |
SANITARY DEFECTS |
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Defect |
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Defect |
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Points |
Points |
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Points |
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Points |
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XII. |
COOLING AND REFRIGERATION FACILITIES |
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XIV. |
PERSONNEL |
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A. |
Perishable supplies and products not adequately |
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A. |
Employees not wearing garments suitable for |
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protected from contamination or from |
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work being performed. |
4 |
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becoming spoiled. |
5 |
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B. |
Personnel in contact with unwrapped product or |
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B. |
Storage areas not free of visible mold and |
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ingredients not using proper headwear |
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objectionable odors. |
3 |
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including protection from facial hair. |
4 |
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C. |
Storage area not reasonably clean. |
3 |
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C. |
Fingernail polish, costume jewelry, and |
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D. |
Where required refrigeration facilities not |
3 |
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wrist watches worn by plant personnel |
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properly cooling and keeping perishable |
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working on the processing line. |
3 |
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supplies and products at temperatures |
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D. |
Gloves, if worn, not kept in a sanitary condition. |
3 |
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not exceeding 45 degrees F. |
5 |
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E. |
Storage of employees personal effects in |
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E. |
Adequate skids or pallets not used when |
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production rooms. |
3 |
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needed. |
3 |
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F. |
Employees not washing hands after |
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F. |
Items not stored in an orderly, easily |
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contamination. |
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Critical |
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accessible manner in suitable, covered, or |
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G. |
Failure of employees to be hygienically |
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3 |
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closed containers. |
3 |
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clean: fingernails not kept clean and |
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trimmed. |
4 |
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XIII. |
STORING AND STORAGE FACILITIES |
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H. |
Employees affected with or a carrier |
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A. |
Supplies and products not adequately |
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of a communicable or infectious disease |
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protected from contamination nor |
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not excluded from product area. |
Critical |
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from becoming spoiled. |
5 |
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I. |
Plant employees having an infectious wound, sore, |
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B. |
Storage areas not well ventilated and |
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or lesion on hands, arms, or other exposed parts of |
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free from objectionable odors. |
3 |
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the body not excluded from contacting |
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ingredients, products, or product zone. |
5 |
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C. |
Storage areas not clean and dry. |
3 |
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J. |
Plant personnel not instructed in |
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D. |
Materials not stored in an orderly manner |
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acceptable hygienic practices and proper |
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in suitable, covered, or closed containers. |
3 |
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sanitary rules of food handling. |
5 |
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E. |
Supplies and product not protected |
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K. |
Personnel not prohibited from |
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against unfavorable temperatures and |
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expectorating, eating, or smoking |
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humidity. |
3 |
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in product areas. |
5 |
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F. |
Adequate skids or pallets not used where |
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needed. |
3 |
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TOTAL…………………………………………………………………… |
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Plant operations are considered to be unsanitary if one or more critical defects are found or if the plant receives a score of 76 or higher. |
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When Section XII, "Cooling and Refrigeration Facilities" is not applicable, the plant must have a score of 54 or higher. |
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REMARKS |
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FORM FGIS 952 (7-02) Reverse |
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