Supplier Audit-Self Questionnaire checklist

A. Supplier & Audit Information

Supplier
Your Company On Site Audit Supplier Internal Audit
Name:
Address: Date: Date:

Phone: By: By:

Fax:

Website:

B. Primary Contacts and Manufacturing Information

Name Mobile Email

Operations
Manager:
QA Manager:
Customer
Service:
Other:
Industry standard certifications (HACCP, ISO, FSSC, BRC, etc..).

Primary products produce at location:

Primary products produce for mwarrid:

C. Adequacy of Product Safety Program YES NO N/A Comments & Notes:

1. Responsibility and authority over facility's compliance with regulatory laws is
assigned to a competent supervisory-level person or persons - Who?
2. Is there an organization chart that clearly defines the quality function and
responsibility? – Please provide a copy if available.
3. Are all employees aware of their responsibilities regarding quality& food safety `
and is there a plan in place to keep this awareness relevant and effective?
4. A completed, up to date Quality & Food Safety Manual is available (if on-site audit
ask to see it)

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Supplier Audit-Self Questionnaire checklist

C. Adequacy of Product Safety Program (Con’t) YES NO N/A Comments & Notes:
5. Facility has up-to-date 3rd party audit.(HACCP, ISO, FSSC, PRC, etc..) If Yes,
Provide latest copy of Audit and Certificate
6. Facility has a formal quality & food safety committee and inspections are done
monthly (If Yes, please provide copy of last inspection report)
8. Specifications and certificates of analysis are on file for raw materials (If Yes,
Please provide at least one example)
9. Incoming raw materials are inspected according to written procedures for damage,
cleanliness and pest activity.
10. Facility has a formal HACCP program established or has conducted a risk
assessment of the process and products produced based on the 7 principles of
HACCP. (If yes, please provide a copy of all current plans)

11. A GMP training program exists and records are maintained. (Must provide Copy
of Program) REQUIRED FOR SUPPLIER APPROVAL
12. Facility has a procedure in place to control and segregate non-conforming
products
13. A written policy on glass not being used in the facility is in place. In the policy is
a procedure for handling broken glass. A list of essential glass materials is in place
14. Specifications are on file for finished products and these include critical test
criteria.
15. A formal process is used to approve raw material suppliers

D. Pest Control YES NO N/A Comments & Notes:

1. A formal preventative pest control program exists

2. Pest control services are provided by a certified operator (in-house or contracted

outside)
3. MSDS sheets and sample labels are on file and maintained for pesticides used on
the premises
4. If Outside bait stations are used are they: tamper resistant, locked, properly labeled,
and properly located around the exterior perimeter at 50 - 100 foot intervals. The
stations are serviced at least once per month

5. Inside facility, mechanical traps are used along the external walls and beside both
sides of overhead doors and pedestrian doors to the outside. Devices are cleaned and
inspected weekly.

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Supplier Audit-Self Questionnaire checklist

D. Pest Control (Con’t) YES NO N/A Comments & Notes:

6. There are no pesticides or pesticide application equipment stored onsite or they are
stored in a locked enclosure outside production areas
7. There are no conditions outside the facility which will attract rodent activity. There
are no noticeable openings in exterior which would allow rodent entrance into facility.
8. Electronic flying insect monitors (ILTs) are used in the facility to monitor insect
activity. The traps are more than 10 feet from exposed product.

E. Operational Methods and Personnel Practices YES NO N/A Comments & Notes:

1. Raw Materials (Except Roll Stock of paper or plastic) in warehouse are stored off
the floor (pallets, slip-sheet's, or stands) and at least 18 inches from walls and ceilings.
2. Roll stock of paper or plastic are covered. Roll ends are kept off the floor or ends
are trimmed or turns discarded before use
3. Supplier rotates raw material and packaging stock using FIFO methods, and stock
area is well organized
4. Pallets are clean and in good repair.

5. Resins, regrind, trim, etc intended for use are stored in covered, clean and properly
identified containers
6. Regrinding of plastics or shredding of paper is conducted in rooms separate from
the fabricating room
7. Material handling equipment (hand jacks, forklifts, etc) are properly maintained (no
excessive grease or oil leaks)
8. Trash and rubbish are stored in properly identified and covered containers and are
emptied daily
9. There is sufficient access and space for cleaning production equipment

10. Food and packaging materials that are being manufactured by facility are not used
for storing miscellaneous items or chemicals
11. All containers used for storage of materials are clearly labeled as to contents

12. Waxes, adhesives, sealants and inks are stored in covered, properly identified
containers in a clean, adequately ventilated area
13. Food containers are not fabricated using equipment used to fabricate nonfood
grade materials unless equipment is purged and cleaned

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Supplier Audit-Self Questionnaire checklist

E. Operational Methods and Personnel Practices (Con’t) YES NO N/A Comments & Notes:

14. Finished products have permanently legible code marks that are readily seen by
consumers
15. Metal detection equipment is used on the production lines and the metal detectors
are tested at least once per shift and documented
16. Shipping vehicles (Internal or external) are inspected and documented prior to
loading for cleanliness and structural defects (door seals are intact, no holes in floors
or walls, watertight roof, interior bulbs shatter protected)

17. Hand washing facilities are convenient to production areas and they have hot and
cold water, soap with antimicrobial properties, and hand dryers or sanitary towels.
"Wash Hands" signs are posted.

18. Toilet rooms do not open directly into production, packing or storage areas

19. There is no evidence of food, beverages, gum chewing or use of tobacco products
outside designated areas. Water is ok in a covered, non-breakable container
20. Employee lunches and/or personal items are not stored in production area or raw
material storage areas (sweaters, jackets, newspapers, etc)
21. Employees in finishing or packaging operations are wearing EFFECTIVE hair
restraints and beard nets.
22. Parts are periodically sampled during production run

23. Inspection sheets are used and contain characteristic to be inspected, frequency of
inspection and tools to be used for inspection, if any
24. Measuring devices are properly calibrated

25. Rejected and discrepant parts are tagged and segregated pending disposition

26. Traceability is possible for all products and all finished boxes are properly labeled

27. Finished product pallets are stretch wrapped

28. There is evidence of proper housekeeping in maintenance shop and tool area (no
metal shavings)

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Supplier Audit-Self Questionnaire checklist

F. Maintenance for Product Safety YES NO N/A Comments & Notes:

1. There is no evidence of chipping, flaking or peeling paint in any of the structural

beams, and other structural systems
2. If cavities or cracks exist in surface of walls and floors, they are filled or sealed

3. Floors are in good condition and can withstand the cleaning materials and methods
used
4. Roofing is adequate, and there is no evidence of roof leaks

5. Adequate lighting is provided in all areas. Light bulbs, fixtures, windows or other
glass suspended over product zones, raw materials and packaging supplies are
protected to prevent breakage. This includes forklifts

6. Where windows or doors must be kept open for ventilation, they are screened

7. All dock doors and man doors used for ventilation have tight fitting doors and
screen doors with no voids
8. There is no evidence of temporary materials (tape, plastic, string) being used for
repairs. If they must be used for emergency, they should be dated and replaced with
permanent solutions

9. Are any unused holes in tubular frames properly sealed to prevent dust, rubbish or
pest harborage
10. There is no evidence of excessive lubrication or leakage in production zones.
Catch pans are used where bearings or gearboxes are located directly above product
zones on the fabrication line.

11. There is evidence that only food grade lubricants are used on product contact
surfaces.
12. Conveyors for upright, open and formed containers shall be protected from
contamination by use of overhead shields
13. There is no evidence of flaking paint or excessive rust on production equipment

14. There is no evidence of litter and waste, weeds or tall grass within the immediate
vicinity of the building
15. There is adequate maintenance of roads, yards and parking areas to keep them free
of dust, standing water or other potential contaminants
16. Outside waste collection containers and compactors are closed and/or covered, are
installed in a manner that allows easy removal and cleaning

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Supplier Audit-Self Questionnaire checklist

F. Maintenance for Product Safety (Con’t) YES NO N/A Comments & Notes:

17. Storage of equipment, drums or other items outdoors is minimal, and where
required the items are stored away from walls and off the ground to prevent harborage
and allow inspection
18. There are measures in place to maintain site security

G. Cleaning Practices YES NO N/A Comments & Notes:

1. A Sanitation Standard Operating Procedure (SSOP) exists that outlines all aspects
of cleaning, sanitizing and monitoring the cleanliness of the facility and equipment
maintained. (Please Provide Copy of Procedure)
REQUIRED FOR SUPPLIER APPROVAL
1. Updated Master Cleaning Schedule exists which specifies responsibility and
frequency for all areas of facility
2. Cleaning procedures for equipment and facility are available and indicate chemicals
and tools to use
3. There is no evidence of dust buildup on anything passing over production lines

4. Cleaning equipment and tools are available and stored away from production areas

5. Is all Equipment clean and free from excessive buildups

4. Cleaning compounds, lubricants, and sanitizers are properly labeled and stored in
locked compartment away from production and product storage areas
Additional Comments: