Food Safety Plan

(Template)

Auburn Hospital
 Table of Contents

1 INTRODUCTION

2 HACCP PLAN

2.1 HACCP Team

2.2 Scope
2.3 Product Description and Intended Use
2.4 Process Flow Chart
2.5 Hazard Analysis
2.6 Hazard Audit Table
2.6.1 Justification Table
2.6.2 Verification Table

3 SUPPORT PROGRAMS
3.1 Maintenance Program
3.2 Approved Supplier Program
3.3 Good Food Handling Practices
3.4 Cleaning and Sanitation Program
3.5 Pest Control Program
3.6 Personal Hygiene Program
3.7 Product Recall Program
3.8 Staff Training Program
3.9 Calibration Program
3.10 Internal Audit
3.11 Document and Data Control Program

4 APPENDICES
Form 1 Monthly Maintenance Checklist
Form 2 Temperature Monitoring Sheet
Form 3a Supplier Approval Letter
Form 3b Supplier Approval Application
Form 4 Approved Supplier List
Form 5 Product Receival Sheet
Form 6 Product Monitoring Sheet
Form 7 Product Despatch
Form 8 Pre-operational Checklist
Form 9 Staff Training Matrix
Form 10 Internal Audit Checklist
Form 11 Product testing Schedule

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Food Safety Plan
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The Use of NSW Food Authority Assistance Materials

The NSW Food Authority “General Guidelines for the Development and Implementation of a Food Safety Program”,
“Food Safety Program Template” and “Industry Specific Guides” are guidance documents only. NSW Food
Authority disclaims any liability for any loss or injury directly or indirectly sustained by any person as a result of
reliance upon these documents. Businesses must not assume that these guidance documents cover all food
safety hazards within their business. If using these documents to develop your Food Safety Program then
you must adapt these to fit your business, products, and market requirements, and to ensure that all
potential food safety hazards are identified and controlled. You are advised to seek independent legal advice
in relation to any query you may have regarding the legal obligations imposed under the relevant Food Safety
Scheme Regulation.

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1. Introduction

In this Section you should give a general introduction to your

organisation and outline the principle of management’s
commitment to the development and implementation of a Food
Safety Program. This could include:
 Nature of business
 Scope of products
 Major customers
 Commitment to quality statement
 Organisational chart showing positions within the
organisation responsible for food safety
Refer to:
 the General Guidelines for the Development and
Implementation of a Food Safety Program.

 Nature of business- Hospital(Auburn Hospital)

 Scope of products- For example, the food safety program covers food prepared and/or served by
the hospital food service department. It does not cover events where food is prepared by others for supply to
patients or the general public, for example, the annual fete, women’s auxiliary cake stall, relatives bringing food
in for clients etc. The health care sector is one of the world’s biggest and fastest-developing sectors,
consuming more than 12 % of GDP of most developed countries. Most of the private sector jobs over the past
10 years came from healthcare sector and the sector continues to develop faster than most other industry
segments.
 Major customers- Patients
 Commitment to quality statement- Additionally hospitals and healthcare providers deliver opportunities for
those who desire to do well by doing good.

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2. HACCP-based Food Safety Plans
2.1 HACCP Team

In this section record the team that is responsible for

developing and maintaining this food safety plan, updating the
HACCP manual, analysing and improving procedures and
implementing effective controls to manage food safety risks.
Refer to:
 the General Guidelines for the Development and
Implementation of a Food Safety Program.

The HACCP team includes:

NAME POSITION IN COMPANY

TEAM LEADER John engineering

TEAM MEMBER Rita production

TEAM MEMBER Rommy sanitation

TEAM MEMBER Sandip quality assurance

TEAM MEMBER Rupa Food microbiology.

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2.2 Scope and Purpose

In this section document the scope and purpose of the food

safety plan.
Refer to:
 the General Guidelines for the Development and
Implementation of a Food Safety Program.
 your Industry Guide.


A Food Safety Plan (FSP) consists of the primary documents in a preventive

controls food safety system that provides a systematic approach to the
identification of food safety hazards that must be controlled to prevent or
minimize the likelihood of foodborne illness or injury. Food safety problems are
a leading cause of more than 200 preventable diseases worldwide. Each year,
one in ten people will suffer from foodborne illness or injury. An estimated
420,000 people die every year as a result of eating contaminated food and
more than a quarter of these victims are small children.

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2.3 Product Description and Intended Use

In this section complete details for each product you produce

(the example layout below can be used as a guide).
Refer to:
 the General Guidelines for the Development and
Implementation of a Food Safety Program.
 your Industry Guide.


Product Name Vegetable soup

tablespoons olive oil

2 cups chopped onion (1 medium)

1 ½ cups chopped carrot (3 to 4 carrots)

Ingredients used/composition
1 ½ cups chopped celery (2 to 3 stalks)

2 tablespoons tomato paste

4 teaspoons minced garlic

Form

Packaging Not pack

Shelf Life 4 hour

Storage and Transport Store in fridge

Intended Use yes

Consumer patient

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2.4 Process Flow Chart

In this section construct a flow chart for each product or like-

products by providing a simple, clear description of the steps
involved in your process.
Refer to:
 the General Guidelines for the Development and
Implementation of a Food Safety Program.
 your Industry Guide.
 your Industry Guide.

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2.5 Hazard Analysis

In this section carry out a Hazard Analysis for each product or like products in your process.
Refer to:
 the General Guidelines for the Development and Implementation of a Food Safety Program,
 your Industry Guide, and the CCP Decision Tree (located in general guide).
Note:
CCP’s should be decided using the CCP decision tree and should assume that the control measures are followed.
Copy more pages of the table as needed.

CCP= Critical Control Point SP= Support Program

PROCESS STEP HAZARD CONTROL MEASURE Q1 Q2 Q3 Q4 Q5 CCP

sensory checking all foods
received
Expiry of product, temperature issue,
Receiving  checking the temperature of
contamination
a sample of potentially
Hazardous foods received.
storing all food in clean,
pest free areas
 storing potentially
hazardous food under
temperature control
Storing Temperature issue, contamination  minimising the time food is
in storage (stock rotation)
 limiting the time that
Listeria risk foods,
processed on-site, are
stored to 24 hours.
Biological hazards include bacteria, parasites, Ensure food does not become
fungi and viruses. ... unsafe during preparation by:
preperation Chemical hazards are harmful substances  adhering to time and
such as pesticides or machine oils. ... temperature control of
Physical hazards are objects which potentially hazardous foods

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 PROCESS STEP HAZARD CONTROL MEASURE Q1 Q2 Q3 Q4 Q5 CCP
 adhering to food handler
health and hygiene
 maintaining good food
handling practices.
contaminate your foods such as pieces of  washing fruit and
glass or metal, toothpicks, jewelry or hair vegetables that will be
eaten raw
 slicing ready to eat meats
and using within 24 hours
or freezing.

Eliminate pathogens by
adequately cooking and
Cooking and reheating food poisoning, food burn
reheating potentially hazardous
food.

Cool potentially hazardous

Improperly cooled, it provides an ideal
cooling
environment for bacteria to multiply.
Transport (offsite) Temperature issue, packaging contamination
food (for use later) so that it
does not become unsafe by
cooling rapidly from:
 60C to 21C within 2
hours, and
 within a further 4 hours
from 21C to 5C
Food is transported so that it
does not become unsafe by:
 protecting all food from
contamination by
packaging or covering
adequately
 transporting potentially
hazardous food so that it is
5C or below or 60C or
above.

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 PROCESS STEP HAZARD CONTROL MEASURE Q1 Q2 Q3 Q4 Q5 CCP
Ensure food does not become
unsafe during service and
delivery by adhering to food
handling fundamentals for:
 time and temperature
Service and delivery
Quality, temperature, hygiene, contamination control of potentially
(onsite)
hazardous foods
 food handler health and
hygiene
 good food handling
practices

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2.6 Hazard Audit Table

In this section set up the Hazard Audit table for each product or like products in your process.
Refer to:
 the General Guidelines for the Development and Implementation of a Food Safety Program
 your Industry Guide.
Copy more pages of the table as needed.

Step Hazard Control Measure Monitoring Procedures Critical Limits Corrective Action Records
Receiving Contamination, Assess food What: Monitor food deliveries to reject and return Direct record
expiry product, received to ensure ensure: foods to the Record 2: Food
temperature only safe and  packaging is undamaged and supplier that: receipt or similar
issue suitable food is there’s no signs of contamination - are in damaged (for
accepted (within  foods are within use-by dates packaging and likely example, on
the hospital’s  frozen food is received hard to be contaminated, purchase
control) by: frozen or orders, receipts,
 sensory checking  the temperature of a sample of - have expired use- invoices or other
all foods deliveries of potentially hazardous by dates, or internal system)
received foods are at or below 5°C. - are potentially
 checking the When: Depending on the business, hazardous and are
temperature of but often enough to have above 5°C, unless
a sample of confidence that food received is the supplier can
potentially safe and suitable. Suggest: demonstrate that
hazardous foods each day that potentially hazardous food safety has not
received. foods are delivered. been adversely
Who: Manager or delegate. affected.
How: By:  contact the
 assessing all food deliveries as supplier to advise
they are unpacked and recording that
on Record 2 potentially hazardous
 measuring the temperature of a foods must
sample of potentially hazardous be delivered at 5°C
food and recording on Record 2. or below

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 Step Hazard Control Measure Monitoring Procedures Critical Limits Corrective Action Records
 change suppliers if
potentially
hazardous foods are
consistently
delivered above 5°C
Storage storing all food in What: Monitor If fridge temperature Direct records
clean,  the temperature of refrigerator is above 5oC: Record 3: Storage
pest free areas units to ensure that food is stored  Check the obvious: temperatures
 storing potentially at or below 5°C plugged in and Record 12: Internal
hazardous food  freezers to ensure that frozen turned on, thermostat assessment
under food is stored hard frozen gauge is set Associated records
temperature control  food storage areas to ensue they appropriately, door Record 5: Cleaning
 minimising the are clean and free of pests, and has been closed. and sanitising
time food is food stocks are rotated Check again in 30 schedule
in storage (stock  the time fresh Listeria risk foods minutes. If not Record 8: Pest
rotation) are stored getting colder advise control
 limiting the time When: Depending on the business manager or
that but often enough to have delegate or organise
Listeria risk foods, confidence that food is stored the fridge
processed on-site, safely. Suggest: maintenance person
are  refrigerator units: daily or often to repair.
stored to 24 hours.  storage areas and stock rotation:  Assess the
monthly or similar temperature of some
Who: Manager or delegate potentially hazardous
How: By: food using a
 manually or electronically temperature
checking and recording the measuring device. If
temperature of fridges and food is above 5oC
recording on Record 3 assess its safety. If
 conducting internal assessment in doubt, throw it out!
of food storage areas and If ok move to
recording on Record 12 another fridge or use.
If storage areas are
not clean or there is
pest activity discuss
with food handlers
and if necessary
adjust cleaning
schedule.
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 Step Hazard Control Measure Monitoring Procedures Critical Limits Corrective Action Records
If food exceeds used
by date.

Step Hazard Control Measure Monitoring Procedures Critical Limits Corrective Action Records
What: Monitor adherence with the Discard any
controls for: potentially hazardous
 adhering to time
Biological  the time/temperature of food
and
hazards include potentially hazardous foods that has been
temperature control
bacteria, (fundamental between 5°C and
of
parasites, fungi 6.1) 60C for
potentially
and viruses. ...  the health and hygiene policy > 4 hours and any
hazardous foods
Chemical (fundamental 6.2) food suspected of
 adhering to food
hazards are  good food handling practices being unsafe.
handler health and
harmful (fundamental 6.3) Discard food that Direct record
hygiene
substances such  washing of fruit and vegetables may have been Record 6 Adequate
 maintaining good
as pesticides or control exposed to Cooking
food
Prepration machine oils. ...  sliced ready to eat meats control contamination Associated records
handling practices.
When: Depending on the business through Record 5: Cleaning
 washing fruit and
but often enough to have failure to follow and sanitising
vegetables that will
Physical hazards confidence that food is prepared preparation controls. schedule
be
are objects which safely. Suggest: Weekly. Provide additional
eaten raw
contaminate your Who: Manager or delegate. skills and knowledge
 slicing ready to
foods such as How Recording times or the use of for food handlers
eat meats
pieces of glass or a standard process that has been who are unclear
and using within 24
metal, toothpicks, validated on Record 6. about
hours
jewelry or hair the food handling
or freezing.
fundamentals and
additional Listeria
controls.
Cooking and food poisoning, Eliminate What: Monitor: If the temperature is Direct records
reheating food burn pathogens by  the temperature to ensure it not reached or the Standard recipes/
adequately cooking reaches 75C or above, or centre food is not cooked procedure for
and physical appearance (no pink) of thoroughly then cooking potentially
reheating potentially hazardous cooked continue until hazardous foods (if
potentially foods that do not undergo sustained thoroughly cooked being used as a

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 boiling, simmering or
steaming
 the temperature of reheated
potentially hazardous food that will
be held hot (60C or above)
 the use of and adherence to
recipes and
When: Depending on the business the safety of the food
record).
but often enough to have is assured.
Record 6: Adequate
confidence that: Discard product if it
cooking
 potentially hazardous foods are is not reheated to
or
fully cooked 60C or above in 2
Temperatures may
 reheated potentially hazardous hours and review
be recorded on the
food to be held hot, are reheated reheating
recipe or menu,
to 60C or above. Suggest: daily procedures/equipme
hazardous data logged,
when potentially hazardous nt.
food. entered
foods are cooked or re-heated If a standard recipe
into PDA or other
 recipes during internal fails to deliver
method as long as it
assessment adequately cooked
can be filed for an
Who: Food handlers for food check that
auditor to review if
temperature and visual checks. equipment is
required.
Manager or delegate for recipes. operating correctly
Record 12: Internal
How: By: and/or
assessment
 using a temperature measuring review and re-test
device or cutting open 2 or 3 units the recipe.
of a cooked food and recording on
Record 6
 asking cooks if the recipe was
followed and is accurate during
internal assessment and recording
on Record 12
cooling Improperly Cool potentially Discard potentially Direct records
cooled, it hazardous What: Monitor the temperature hazardous food that Record 6: Adequate
provides an ideal food (for use later) relative to time of potentially is not cooled within cooking
environment for so that it hazardous cooked foods being the cooling or
bacteria to does not become cooled for later use. requirements. Temperatures may
multiply. unsafe by When: Depending on the business If food isn’t cooling be recorded on the
cooling rapidly but often enough to have quickly enough, for recipe or menu,
from: confidence that potentially future batches: data logged,
 60C to 21C hazardous food that is cooled for  divide food into entered

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 use later does not become unsafe.
Suggest: daily when
potentially hazardous foods are
cooled.
Who: Manager or delegate.
small portions: 2 or
How: By using a temperature
within 2 3 containers into PDA or other
measuring device or data logger to
hours, and  stir occasionally to method as long as it
assess the temperature after
 within a further 4 assist heat to can be filed for an
cooking. When the food is 60C
hours dissipate, for auditor to review if
note the time on Record 6 and
from 21C to 5C example, after 1 hour required.
return after 2 hours, record the
of cooling
temperature, and return again after
a further 4 hours and
record the temperature.
Note: once food reaches 60C it
should be refrigerated
Transport Temperature protecting all food What: Monitor: Refrigerate or Direct records
(offsite) issue, packaging from  the temperature of potentially consume potentially Record 9: Transport
contamination contamination by hazardous food or the time hazardous foods that temperatures
packaging or potentially hazardous food is not are between 5C or
covering under temperature control and 60C for less Temperatures may
adequately during transport than 2 hours. be
 transporting  food handlers adherence with the Consume potentially recorded by data
potentially food handling fundamentals hazardous foods logger, or PDA or
hazardous food so  that food is protected from that are between other method as
that it is contamination 5C and 60C for long
5C or below or When: Depending on the business greater as it can be filed for
60C or but often enough to have than 2 hours but less an auditor to review
above. confidence that food that is than 4 hours. if required.
transported does not become Discard potentially Record 12: Internal
unsafe. Suggest: Daily when hazardous foods that assessment
potentially hazardous food is are between 5C
transported off site. and 60C for > 4
Who: Manager or delegate. hours.
How: By: Review the relevant
 using a temperature measuring transport procedure.
device or data logger to assess the
temperature at dispatch and arrival
and recording on Record 9
 using a standard process that

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 has been validated
 recording the time of dispatch
and arrival on Record 9
 assessing food handlers and the
protection of food during
transport during internal
assessment and recording on
Record 12

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2.6.1 Justification Table

Hazard/Control Measure Critical Limit Reference/Justification

2.6.2 Verification Table

CCP or Support Verification Activity Frequency Person Responsible Records Corrective

Program Action/Comments

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3. SUPPORT PROGRAMS

In the following sections document information on policies and

procedures for each of the Support Programs established in
your organisation.
Refer to:
 the General Guidelines for the development and
implementation of a food safety program
 your Industry Guide.

3.1 MAINTENANCE PROGRAM

In this section, document information on policies and

procedures for the Maintenance Program established in your
organisation.
Ensure that you include the relevant aspects of the premises,
equipment and food transport vehicles as part of the program.
An example of a Monthly Maintenance Checklist can be found
in the Appendix (Form 1) and Pre-Operational Checklist (Form
8) of this document.
Refer to:
 the General Guidelines for the Development and
Implementation of a Food Safety Program.

Form 1: Monthly Maintenance Checklist

Completed at the end of each month.

Satisfactory (S) Unsatisfactory (U) and complete corrective action/comments column

Completed by:_____________________________ Date:____________________

Item S/U Corrective action/Comment
Processing Area
Ceiling, walls and floors free from S
cracks and other signs of damage
Food processing benches free from S
rust, damage and deterioration
All equipment free from rust, damage S
and deterioration – no exposed wood
present
Lights above processing area covered S

All sinks (including hand washing) S

accessible and in working order
Other fitting and fixtures in good S
condition and in working order

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 Coolrooms/Freezers/Ice Room
Walls, floors and ceiling clean and in S
good condition
Shelving free from rust and kept S
cleaned
Lights covered S

Seals clean and in good condition S

Cooling units free from rust and S

corrosion
Storage Areas
Chemicals stored separately to food S
and packaging material
All food and packaging material stored U Need to put the stored material according to shelves
in a manner to prevent contamination
Staff Amenities (eg. toilets, staff rooms)
Staff amenities kept clean and tidy S

Hand washing facilities accessible and S

in good order
Pest Control
No sign of pest within processing area, S
storage area or staff amenities
Rodent and insect bait stations S
maintained and correctly situated

Comments/Further Action:

Thermometer/Temperature gauge calibration

Date Thermometer number/Gauge Temperature reading Difference Signed
position
25-06-2022 1  above 140 °F. 00
26-06-2022 1  above 140 °F. 00
27-06-2022 1  above 140 °F. 00
28-06-2022 1  above 140 °F. 00

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 Form 8: Pre-Operational Checklist
Complete at the commencement of each shift/day
Satisfactory (S) Unsatisfactory (U) and complete corrective action/comments column

Completed by:_____________________________

Date-20-06-2022 20 21 22 23 24 25 26 Corrective Action

S S S S S S S
Premises clean and tidy

Processing areas clean S S S S S S S

and tidy
S S S S S S S
No evidence of pests

Hand washing facilities S S S S S S S

clean and accessible with
soap and paper towels
available
Food contact surfaces U S S S S S S Need to clean
clean
S S S S S S S
All equipment clean

All packaging material S S S S S S S

stored correctly
Coolrooms/Freezers and/or S S S S S S S
Ice Rooms clean and tidy
Food transport vehicles S S S S S S S
clean and tidy

3.2 APPROVED SUPPLIER PROGRAM

In this section document your Approved Supplier Program.

An example guide of an Approved Supplier Program and
documents required is as follows:
 All goods and services are to be sourced from an approved
supplier.
 Suppliers are required to complete the Supplier Approval
Application (Form 3b) which is sent to each supplier along
with the Supplier Approval Letter (Form 3a).
 It is your responsibility to determine criteria for approving
and maintaining suppliers (eg HACCP program required for
high risk ingredients).
 All suppliers approved are listed on the Approved Supplier
List (Form 4) along with the products they supply.
 Documents provided by the supplier and the completed
Supplier Approval Application Form need to be kept.
Refer to:
Food Safety Program
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Implementation of a Food Safety Program Page 21 of 36
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 Form 3a: Supplier Approval Letter

Application to supply goods

Dear supplier,

Our business is committed to providing our customers with product that is of the highest quality and which
complies with the requirements of the Food Production Food Act 2003 and the Food Regulation 2004.

To facilitate this commitment we have implemented a food safety program that complies with these requirements.
This program identifies the potential food safety hazards and, where necessary, introduces measures to control
and correct them.

A critical component of this food safety program requires all suppliers of product to demonstrate that their goods
are produced with due care. We therefore ask that you complete the attached application to join our Approved
Suppliers List. Once completed the form should be returned to us at the address below.

This business values your past custom and upon receiving details of your commitment to a food safety program,
we look forward to continuing our business relationship and your assistance in offering our customers the highest
possible level of food safety.

Yours sincerely

Name of business- Hospital

Postal address of business:
Contact name: Australia
Contact details:

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 Form 3b: Supplier Approval Application

Supplier Details

Registered Name: Rajan green leaf

Trading As:
Address: Australia

Contact: Phone: 1234567890

Mobile:
Fax:
Details of product that you will supply

Raw foods

Details of current food safety or quality assurance programs (which may include: HACCP accreditation or
testing program eg. NSW Food Authority licence)

HARPS

Please complete the above details and return as soon as possible

Note: All details provided to us will be treated as confidential and only used to support the accredited supplier
requirements of our food safety program

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 Form 4: Approved Suppliers List
List of suppliers to our business (including suppliers of product, packaging and ingredients)

Supplier Contact details Goods Supplied Special Instructions

Rajan green leaf Australia Raw vegetables Nil

Melbourne spices Australia spices Nil

Shayam dry fruits Australia Almonds, nuts Nil

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 3.3 GOOD FOOD HANDLING
PRACTICES

In this section document information on policies and procedures

for Good Handling Practices established in your organisation.
Refer to:
 the General Guidelines for the Development and
Implementation of a Food Safety Program.
 Appendix 5 of this document for an example of good food
handling policy.
Ensure that you incorporate all areas relevant to your business.

Form 5: Product Receivable Sheet

Product
Products Visual Corrective
Date Supplier name Temperatur Signature
Supplied Inspection Action
e
25-06- Rajan green leaf Carrots, onion 20 degrees F yes Nill
2022

25-06- Rajan green leaf Green chili, onion, 19 degrees F yes Nill
2022 carrot

25-06- Shayam dry fruits Almonds, nuts less than 45 Yes Nil
2022 °F

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 3.4 CLEANING AND SANITATION PROGRAM

In this section, document information on policies and

procedures for the Cleaning and Sanitation Program
established in your organisation.
Ensure that you incorporate the relevant aspects of the
premises, equipment and food transport vehicles as part of the
program.
A Pre-Operational Checklist is a useful tool. This type of check
can be used at the commencement of each shift/day to ensure
the premises and equipment are satisfactory for use. Ths can
be carried out daily before processing to ensure that all
surfaces are clean prior to use. An example is found in Form 8
of the Appendix.
Refer to:
 the General Guidelines for the Development and
Implementation of a Food Safety Program.

Form 8: Pre-Operational Checklist

Complete at the commencement of each shift/day
Satisfactory (S) Unsatisfactory (U) and complete corrective action/comments column

Completed by:_____________________________

Date-20-06-2022 20 21 22 23 24 25 27 Corrective Action

S S S S S S S
Premises clean and tidy

Processing areas clean S S S S S S S

and tidy
S S S S S S S
No evidence of pests

Hand washing facilities S S S S S S S

clean and accessible with
soap and paper towels
available
Food contact surfaces S S S S S S S
clean
S S S S S S S
All equipment clean

All packaging material S S S S S S S

stored correctly
Coolrooms/Freezers and/or S S S S S S S
Ice Rooms clean and tidy

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 Food transport vehicles S S S S S S S
clean and tidy

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 3.5 PEST CONTROL PROGRAM

In this section document information on policies and procedures

for the Pest Control Program established in your organisation.
Animals and pests including insects and rodents must be
excluded from the premises. As an example, any evidence of
pests can be recorded on the Pre-Operational Checklist (Form
8).
Refer to:
 the General Guidelines for the Development and
Implementation of a Food Safety Program.

Form 8: Pre-Operational Checklist

Complete at the commencement of each shift/day
Satisfactory (S) Unsatisfactory (U) and complete corrective action/comments column

Completed by:_____________________________

Date-20-06-2022 20 21 22 23 24 25 26 Corrective Action

S S S S S S S
Premises clean and tidy

Processing areas clean and S S S S S S S

tidy
S S S S S S U Place cockroach baits
No evidence of pests

Hand washing facilities S S S S S S S

clean and accessible with
soap and paper towels
available
Food contact surfaces S S S S S S S
clean
S S S S S S S
All equipment clean

All packaging material S S S S S S S

stored correctly
Coolrooms/Freezers and/or S S S S S S S
Ice Rooms clean and tidy
Food transport vehicles
clean and tidy

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 3.6 PERSONAL HYGIENE PROGRAM

In this section document information on policies and procedures

for the Personal Hygiene Program established in your
organisation.
Personal hygiene is a vital part of minimising the risk of food
poisoning or a contamination incident affecting the business.
Refer to:
 the General Guidelines for the Development and
Implementation of a Food Safety Program.

Personal hygiene (example policy)

Food handlers must abide by the following requirements:
Fingernails, jewellery and hair
 Keep fingernails short and clean; do not wear nail polish or nail decorations or artificial fingernails;
 Wear minimal jewellery (for example, plain wedding rings, sleepers) especially on hands and wrists.
Do not wear loose jewellery, especially earrings;
 Wear gloves over jewellery on hands, if they are in direct contact with food; and
 Tie back or cover long hair.
Clothes
 Wear outer clothing that will not contaminate food or food contact surfaces and has a level of
cleanliness appropriate for the handling of food that is undertaken; and
 Wear a clean apron or similar and remove when going to the toilet, on a break or away from food
handling duties.
Exposed cuts or sores
 Cover cuts or sores with a bandage (for example, bandaid). If exposed (for example, on hands) cover
with gloves or other waterproof covering to prevent seepage.
Eating
 Do not eat over unprotected food (that will be served to others) or food contact surfaces.
Personal belongings
 Personal belongings not required for food handling must be stored in allocated staff areas.

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 3.7 PRODUCT RECALL PROGRAM

In this section document information on policies and procedures

for the Product Recall Program established in your
organisation.
Refer to:
 the General Guidelines for the Development and
Implementation of a Food Safety Program
 your Industry Guide.

A product recall is defined as a request to return, exchange, or replace a product after a manufacturer or
consumer watch group discovers defects that could hinder performance, harm consumers, or produce
legal issues for the producers.
1. Compile a list of all the distribution outlets of the product under recall.
2. Notify everyone along the distribution chain through the decided communication forms.
3. Send out a press release if management deems it necessary.
4. Gain control of all of the recalled products.
5. Verify the recall effectiveness.
6. Take the appropriate corrective action (by disposal or fixing the problem).
7. Terminate the recall.
8. Determine the problem that necessitates a recall.
9. Assemble the recall team to being working.
10. Determine risk classification of the product under recall.
11. Send notification of the problem to your FDA district recall coordinator.
12. Identify and locate all products subject to recall according to their tracking information.
13. Quarantine any affected products that are still under the company's control

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 3.8 STAFF TRAINING PROGRAM

In this section document information on policies and procedures

for the Staff Training Program established in your organisation.
Refer to:
 the General Guidelines for the Development and
Implementation of a Food Safety Program and
 your Industry Guide.
All staff must be trained to enable them to perform their job
safely and competently. All staff are trained for their appropriate
work activity, which may include at least:
 Good personal hygiene;
 Food handling procedures; and
 Cleaning and sanitation.
Records of staff training should be kept. An example of a Staff
Training Matrix, where staff training can be recorded, is shown
in Form 9 of the Appendix.

Form 9: Staff Training Matrix

Record all food safety training conducted by staff involved in the business

Date Staff member Type of training Trained by Staff signature

20-06- Good personal hygiene AS BS
2022 John
21-06- Good personal hygiene AS BS
2022 Rita
22-06- Cleaning and sanitation AS BS
2022 Rommy
23-06- Cleaning and sanitation AS BS
2022 Sandip
24-06- Food handling AS BS
2022 Rupa procedures

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 3.9 CALIBRATION PROGRAM

In this section document information on policies and procedures

for the Calibration Program established in your organisation.
Refer to:
 the General Guidelines for the Development and
Implementation of a Food Safety Program and
 your Industry Guide.
All equipment used at the premises must be calibrated and
maintained in working order.
Records must be kept and an example of hand-held
thermometers calibrated monthly on a Monthly Maintenance
Checklist is shown in Form 1 of the Appendix. If in-house
calibration of the temperature gauges on coolrooms/freezers
occurs then this is also recorded on the same checklist.
Thermometer gauges on coolrooms, freezers and ice rooms
should be calibrated regularly, for example every 6 months and
the calibration result recorded.
 An example of calibration intervals and methods in shown in
Appendix 3 of the General Guidelines for the Development
and Implementation of a Food Safety Program.

Date Thermometer number/Gauge Temperature reading Difference Signed

position
20-06-2022 1 160°F Nil AB
20-06-2022 1 160°F Nil AB
20-06-2022 1 160°F Nil AB
20-06-2022 1 160°F Nil AB

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 3.10 INTERNAL AUDIT PROGRAM

In this section document information on policies and procedures

for the Internal Audit Program established in your organisation.
Refer to:
 the General Guidelines for the Development and
Implementation of a Food Safety Program.
 your Industry Guide.
Internal audits are conducted to ensure that procedures and
practices used at the business are being controlled adequately
according to what is documented in this manual and in the
records associated with this manual.
An example of an Internal Audit Checklist is shown in Form 10
of the Appendix. Where non-conformities are found, corrective
actions are taken and recorded.

Form 10: Internal Audit Checklist

Complete every 6 months
Satisfactory (S) Unsatisfactory (U) and complete corrective action/comments column

Completed by:______HS_______________________ Date:____28-06-2022________________

Section S/U Corrective Action

1. Management responsibility S
Is the food safety statement still current?
Is the scope and purpose still current?
Are the members of the HACCP team still current?
2. HACCP Plan S
Are the product specifications still valid?
Is the flow chart still correct?
Is the Risk Analysis still valid?
3. Premises and Equipment S
Has the Monthly Maintenance Checklist been
completed?
Have the Temperature Monitoring Sheets been
completed?
4. Supplier Approval Program S
Is the Supplier Approval List up to date?

5. Food Handling Procedures S

Is the Treatment Register Sheet up to date?
Has the Fish Treatment Diary been completed?
Have the Product Dispatch Monitoring Sheets been
completed?
6. Testing and Calibration S
Have water and ice tests been completed?
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 Are all results within the Standards specified?
Have any results which exceed the Standards been
reported to the NSW Food Authority
Have all thermometers and temperature gauges
been calibrated every six months?
7. Cleaning and Sanitation S
Has the Pre-Operational Checklist been completed?
Are the chemicals listed still used?
8. Pest Control S
Are procedures still correct?
Are pest company records available?
9. Personal Hygiene S
Have all staff been briefed on personal hygiene?
10. Product Identification and Traceability S
Is the list of customers up to date?
Are invoices for each sale available?
11. Food Recall S
Is there a copy of the FSANZ Food Recall Protocol
available?
Are the contact numbers up to date?
12. Staff Training S
Is the Staff Training Matrix up to date?
Comments/Further Action:

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Food Safety Program
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 3.11 DOCUMENT AND DATA CONTROL
PROGRAM

In this section, document information on policies and

procedures for the Data and Document Control Program
established in your organisation.
Refer to:
 the General Guidelines for the Development and
Implementation of a Food Safety Program.
 your Industry Guide.

The hospital must identify and document controls, monitoring, corrective action and records. The template
offers a format (control tables) and provides generic examples. The hospital must assess these examples and
amend if they are not appropriate or additional information is required. Information needs to be inserted in
the monitoring part of the control tables. If amending the food safety program electronically then type this
information in to the control tables. If writing the information into the food safety program use the area
provided below each control.
Controls: The controls for each key activity describe the action taken to control food safety hazards. The
business must assess each of the generic controls in this template to determine if it is appropriate and make
amendments or additions if required.
Monitoring of controls: Monitoring of controls is the regular checking that the control measure is effective.
The hospital is seeking evidence that the control is effectively preventing, eliminating or reducing a food
safety hazard to an acceptable level Monitoring has four components: what, when, who and how.
Corrective action: If monitoring of a control identifies that a hazard is not under control then the hospital
must take action to ensure the situation is corrected. The template provides examples of corrective action.
The hospital needs to assess the examples to determine if they are appropriate. If amendments or additions
are required enter this information into the appropriate control.
Records: The hospital must keep evidence of the monitoring of control and corrective actions for auditing.
It is valuable to link each control with relevant records keeping.

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Appendices

Table of Contents

Form 1 Monthly Maintenance Checklist

Form 2 Temperature Monitoring Sheet
Form 3a Supplier Approval Letter
Form 3b Supplier Approval Application
Form 4 Approved Suppliers List
Form 5 Product Receival Sheet
Form 6 Product Monitoring Sheet
Form 7 Product Despatch
Form 8 Pre-operational Checklist
Form 9 Staff Training Matrix
Form 10 Internal Audit Checklist
Form 11 Product Testing Schedule

Figure 1 CCP Decision Tree

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 Form 1: Monthly Maintenance Checklist

Completed at the end of each month.

Satisfactory (S) Unsatisfactory (U) and complete corrective action/comments column

Completed by:_____________________________ Date:____________________

Item S/U Corrective action/Comment
Processing Area
Ceiling, walls and floors free from
cracks and other signs of damage
Food processing benches free from
rust, damage and deterioration
All equipment free from rust, damage
and deterioration – no exposed wood
present
Lights above processing area covered

All sinks (including hand washing)

accessible and in working order
Other fitting and fixtures in good
condition and in working order
Coolrooms/Freezers/Ice Room
Walls, floors and ceiling clean and in
good condition
Shelving free from rust and kept
cleaned
Lights covered

Seals clean and in good condition

Cooling units free from rust and

corrosion
Storage Areas
Chemicals stored separately to food
and packaging material
All food and packaging material stored
in a manner to prevent contamination
Staff Amenities (eg. toilets, staff rooms)
Staff amenities kept clean and tidy

Hand washing facilities accessible and

in good order
Pest Control
No sign of pest within processing area,
storage area or staff amenities
Rodent and insect bait stations
maintained and correctly situated

Comments/Further Action:

Thermometer/Temperature gauge calibration

Date Thermometer number/Gauge Temperature reading Difference Signed
position

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 Form 2: Temperature Monitoring Sheet
Temperature for each area is recorded twice daily when being used
Week commencing:_________________________
Temperature (°C)
Area Corrective action Initials
M T W T F S S
AM
Coolroom
PM

AM
Freezer
PM

AM

PM

AM

PM

Week commencing:_________________________
Temperature (°C)
Area Corrective action Initials
M T W T F S S
AM
Coolroom
PM

AM
Freezer
PM

AM

PM

AM

PM

Week commencing:_________________________
Temperature (°C)
Area Corrective action Initials
M T W T F S S
AM
Coolroom
PM

AM
Freezer
PM

AM
PM
AM

PM

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 Form 3a: Supplier Approval Letter

Application to supply goods

Dear supplier,

Our business is committed to providing our customers with product that is of the highest quality and which
complies with the requirements of the Food Production Food Act 2003 and the Food Regulation 2004.

To facilitate this commitment we have implemented a food safety program that complies with these requirements.
This program identifies the potential food safety hazards and, where necessary, introduces measures to control
and correct them.

A critical component of this food safety program requires all suppliers of product to demonstrate that their goods
are produced with due care. We therefore ask that you complete the attached application to join our Approved
Suppliers List. Once completed the form should be returned to us at the address below.

This business values your past custom and upon receiving details of your commitment to a food safety program,
we look forward to continuing our business relationship and your assistance in offering our customers the highest
possible level of food safety.

Yours sincerely

Name of business
Postal address of business:
Contact name:
Contact details:

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 Form 3b: Supplier Approval Application

Supplier Details

Registered Name:
Trading As:
Address:

Contact: Phone:
Mobile:
Fax:
Details of product that you will supply

Details of current food safety or quality assurance programs (which may include: HACCP accreditation or
testing program eg. NSW Food Authority licence)

Please complete the above details and return as soon as possible

Note: All details provided to us will be treated as confidential and only used to support the accredited supplier
requirements of our food safety program

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 Form 4: Approved Suppliers List
List of suppliers to our business (including suppliers of product, packaging and ingredients)

Supplier Contact details Goods Supplied Special Instructions

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 Form 5: Product Receival Sheet
Product
Products Visual Corrective
Date Supplier name Temperatur Signature
Supplied Inspection Action
e

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 Form 6: Product Monitoring Sheet

Date Product type Temperature of product Chemicals used Other comments Signed

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 Form 7: Product Despatch Sheet
Batch Company Numbers Supplied to
Date Temperature
Number Supplied to

Date Batch Temperature Company

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 Form 8: Pre-Operational Checklist
Complete at the commencement of each shift/day
Satisfactory (S) Unsatisfactory (U) and complete corrective action/comments column

Completed by:_____________________________

Date Corrective Action

Premises clean and tidy

Processing areas clean and

tidy

No evidence of pests

Hand washing facilities

clean and accessible with
soap and paper towels
available
Food contact surfaces
clean

All equipment clean

All packaging material

stored correctly
Coolrooms/Freezers and/or
Ice Rooms clean and tidy
Food transport vehicles
clean and tidy

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 Form 9: Staff Training Matrix
Record all food safety training conducted by staff involved in the business

Date Staff member Type of training Trained by Staff signature

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 Form 10: Internal Audit Checklist
Complete every 6 months
Satisfactory (S) Unsatisfactory (U) and complete corrective action/comments column

Completed by:_____________________________ Date:____________________

Section S/U Corrective Action

1. Management responsibility
Is the food safety statement still current?
Is the scope and purpose still current?
Are the members of the HACCP team still current?
2. HACCP Plan
Are the product specifications still valid?
Is the flow chart still correct?
Is the Risk Analysis still valid?
3. Premises and Equipment
Has the Monthly Maintenance Checklist been
completed?
Have the Temperature Monitoring Sheets been
completed?
4. Supplier Approval Program
Is the Supplier Approval List up to date?

5. Food Handling Procedures

Is the Treatment Register Sheet up to date?
Has the Fish Treatment Diary been completed?
Have the Product Dispatch Monitoring Sheets been
completed?
6. Testing and Calibration
Have water and ice tests been completed?
Are all results within the Standards specified?
Have any results which exceed the Standards been
reported to the NSW Food Authority
Have all thermometers and temperature gauges
been calibrated every six months?
7. Cleaning and Sanitation
Has the Pre-Operational Checklist been completed?
Are the chemicals listed still used?
8. Pest Control
Are procedures still correct?
Are pest company records available?
9. Personal Hygiene
Have all staff been briefed on personal hygiene?
10. Product Identification and Traceability
Is the list of customers up to date?
Are invoices for each sale available?
11. Food Recall
Is there a copy of the FSANZ Food Recall Protocol
available?
Are the contact numbers up to date?
12. Staff Training
Is the Staff Training Matrix up to date?
Comments/Further Action:
 Form 11: Product Testing Schedule
As an example of a verification activity, finished product testing can be undertaken to verify that the practices and
procedures in place at this business are achieving safe food. Five samples of the same product can be sampled
(can be pooled) and provided to the laboratory. An example of schedule of tests follows.

Product Testing frequency Tests Standard

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