This document has been superceded by a more recent version. Below is an earlier version.
|
Criteria |
YES |
NO |
|---|---|---|
|
1. The inspection form in use is designed to: a. identify risk factors and interventions b. document in, out, not observed, and not applicable status c. document compliance and enforcement activities |
||
|
1a. |
||
|
1b. |
||
|
1c. |
||
|
2. Your jurisdiction uses a written process that groups food establishments into at least three categories based on potential and inherent food safety risks. |
2. |
|
|
3. Your jurisdiction assigns an annual inspection frequency to each food establishment based on its assigned food safety risk category. |
3. |
|
|
4. Your jurisdiction has an implemented policy that requires: a. On-site corrective actions b. Discussion of long-term control options c. Follow-up activities |
||
|
4a. |
||
|
4b. |
||
|
4c. |
||
|
5. Your jurisdiction has an implemented written policy that addresses code variance requests related to risk factors and interventions. |
5. |
|
|
6. Your jurisdiction has an implemented written policy for the verification and validation of HACCP plans when a plan is required by the code. |
6. |
A "yes" affirmation to each statement is required to meet Standard No. 3. The source documents specified as quality records in Standard No. 3 must be maintained in good order by the regulatory authority to support this summary record and must be made available for purposes of a verification audit.
I affirm that the information represented on this record is true and correct. This jurisdiction meets all the requirements for Standard No. 3, _______YES _______NO
| _________________________________________________ | _______________ |
| Printed Name and Signature of Self-Assessor | Date |
Last updated by dav/ear/cjm 2006-NOV-14