Food Safety Form
A food safety form is an important document which needs to be filled by employees who directly deal with food items by selling them or preparing eatables. Food is the one of the primary sources of spread of infection and diseases if proper hygiene is not maintained and so people working in supermarkets, restaurants, grocery stores and so on must be aware of the various rules and safety precautions they are supposed to follow in order to make sure that the food is fresh, germ and disease-free. By filling this form, one can find out how much a person knows about food safety and accordingly can be made more aware of the rules.
Sample Food Safety Form
New business: Yes No
Please mention type of business (eg restaurant, storehouse, bakery, supermarket etc)
Name of business:
Location:
Phone number:
Name of owner:
Address:
Phone number:
Rate the following points from 1 to 5, 5 being the best.
Food condition and source:
a) All foods are from approved sources and have passed inspection
b) Food received in proper condition and temperature
c) Food properly segregated and packed to prevent contamination
d) Food contact surfaces and equipment are regularly cleaned and sanitized
Date marking and disposal:
Food is correctly date marked
Cooking, holding, cooling temperature control:
Potentially hazardous food cooked to proper temperature
Food reheated properly
Potentially hazardous food kept at proper cooling temperature
Corrective measures required, if any:
Overall impression of the facility:
Evaluation remarks on employee cleanliness and hygiene:
Name and signature of food safety supervisor:
Date:
Additional comments
Category: Medical Forms
