HACCP Inspection Form
Please fill out the following form to conduct a HACCP inspection.
Inspector Name
First Name
Last Name
Date of Inspection
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Location of Inspection
What type of facility are you inspecting?
Restaurant
Catering Service
Food Processing Plant
Retail Food Store
Other
HACCP Plan Availability
Yes
No
Other
HACCP Plan
Are all employees trained on HACCP principles?
Yes
No
Other
Critical Control Points (CCPs) Identified
Receiving
Storage
Preparation
Cooking
Cooling
Reheating
Serving
Other
Monitoring Procedures in Place
Temperature Control
Time Control
Visual Inspection
Other
Corrective Actions Established
Yes
No
Other
Corrective Actions
Verification Procedures in Place
Yes
No
Other
Record Keeping Procedures Established
Yes
No
Other
Additional Comments or Observations
Submit
Should be Empty: