FDA Procedures for Standardization and Certification
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Cover Memo
Contents
Expanded Contents
Risk Control Plan |
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| Establishment Name: | Type of Facility: | |||||||
| Physical Address: | Person in Charge: | |||||||
| City: | State: | Zip: | County: | |||||
| Inspection Time In: | Inspection Time Out: | Date: | Candidate's Name: | |||||
| Agency: | Standard's Name: | Indicate Person Filling Out Form: (circle one) Candidate's Form / Standard's Form |
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Cold Holding Requirement For Jurisdiction: [5° C (41° F)_____] or [7° C (45° F)_____ ] or [5° C (41° F) and 7° C (45° F) combination:______] |
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Based on this day's inspection the following uncontrolled hazards known to contribute to foodborne illness were identified: (Uncontrolled hazards include the occurrence of any risk factor or lack of public health interventions as described in the Food Code).
| Chart 1: Risk Factors Identified/ Corrective Action Required | ||||
|---|---|---|---|---|
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RISK FACTORS IDENTIFIED / CORRECTIVE ACTION REQUIRED |
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| OBSERVATION |
UNCONTROLLED PROCESS STEP OR CCP |
HAZARD (most common) |
CRITICAL LIMITS |
CORRECTIVE ACTION WHEN LIMITS ARE NOT MET |
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II. The following risk control plan is recommended to establish active managerial control of the identified uncontrolled hazards. (For unmet critical limits, the plan delineates what needs to be controlled and how it will be controlled, along with necessary records and responsible personnel. It will also indicate what training is necessary.)
As the person in charge of the ___________________ located at _________________________, I have reviewed, and understand the provisions of this voluntary Risk Control Plan.
| _____________________________ | ________________________ |
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| (Establishment manager) |
(Date) |
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| _____________________________ | ________________________ |
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| (Regulatory offical) |
(Date) |
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Retail Food Inspections Table of Contents