A.  Operation description
B.  Types of foodservice / distribution
C.  Facility plan
D.  Facility food flows
E.  Facility pest control
F.  Menu items grouped by HACCP categories
G.  Recipe HACCP - Receiving, storage, and ingredient pre-preparation and menu item production flow

The purpose of this section is to enable the owner to define the performance capabilities of the unit to himself/herself and to regulatory officials.  Many foodborne illness outbreaks occur because a production facility is preparing more food than it was designed to produce.  The forms in this section can be used to warn management about the upper capability limits of the food production facility.  They can also be used as the basis for developing a food operation plan or for renovation of the facility.  One of the required capabilities of the PIC is to be able to describe the capability of the equipment in the kitchen to produce food.

A.  The Operation Description (Section III, encl. 1) should include:
        1.  Name and address of the operation
        2.  Hours of operation
        3.  Establishment number / license number, names of regulatory agency(s) having jurisdiction
        4.  Photographs (if appropriate) of the outside and inside of the facility to show the degree of maintenance of the building.
        5.  Description of environment surrounding the facility. There are potential hazards in the environment.  The first is water that may be contaminated by sewage.  Waste must be controlled.  Air can also contain bacteria from birds nesting in trees, dust from an animal pasture, and dust from a farmer plowing ground.  Mist (fine droplets of water) from a cooling tower may be a source of pathogenic bacteria.  Describe the hazards and controls in the environment around the facility.
        6.  Description of clientele to be served.  Identify the immune level of the clientele. If the food being produced is for immune-compromised people (e.g., hospital patients, rest home residents), food must be prepared and processed to provide a 10,000,000:1 (7D) pathogen reduction [for example, heating a ground meat patty to 150°F for 1.2 minutes (72 seconds)]

B.  Types of Foodservice / Distribution (Section III, encl. 2).  In order to do a HACCP plan, it is necessary to list all types of food production in the facility, the amount of food produced, and how the food is handled until it is consumed.  This descriptive form contains this information.

C.  Facility Plan (Section III, encl. 3).  The facility plan is especially useful for assuring that all areas are properly cleaned; there is a minimum of cross-traffic from high-pathogen areas to low-pathogen areas; all equipment is maintained; and pest infestation is controlled and checked.  It is a good control step to put a laminated plan on the kitchen wall or other designated display area, so that employees know and understand the various areas in the facility in order to clean, maintain equipment, and prevent and control pest infestation.
        Label / number each major item of equipment and list the items (e.g., fryers, ovens, broilers, grills, dishwashers, refrigerators, and freezers) on the Major Equipment Items list (Section III, encl. 4).  The purpose of this list is to show the capability of the facility (kitchen) to prepare food.

D.  Facility Food Flows (Section III, encl. 5).  Using a second copy of the floor plan, show the flow of food through the facility.  Show that raw food cannot contaminate cooked, ready-to-eat food.  Use colored markers as follows.  On the facility plan, with a red marker, show the receiving / raw food area; mark a yellow zone where raw food is cooked / washed to make it safe; mark a green zone (shipping) for safe food.

E.  Facility Pest Control (Section III, encl. 6).    Using a third copy of the facility plan, number and show the location of all rodent traps, insect traps, and chemical application points.

F.  Menu Items Grouped by HACCP Categories (Section III, encl. 7).  This form is used to evaluate the menu and group menu items by production method and hazard control for that group.  The methods used to control hazards in food are:
     1.  Supplier food safety control (the supplier makes the food safe.)
     2. Engineering the recipe with acid, water activity, or additive control.
     3. Washing fresh produce.
     4. Pasteurization of food items by the cook.
     5. Control of pathogenic bacteria growth with acid.
     6. Control of cross contamination

G.  Recipe HACCP - Receiving, Storage, and Ingredient Pre-preparation (Section III, encl. 8) and Menu Item Production Flow (Section III, encl. 9). These examples of the major food HACCP flow diagrams showing storage and preparation times and temperatures will be used as guide to write HACCP flow diagrams for the major menu food groups.

Encl. 1

1.  Name:  _________________________________


2.  Hours of operation:  Facility is open _______ hours a day, _______ days a week.

3.  Establishment number  _____________        License number____________________________
    Regulatory agencies having jurisdiction_____________________________________________

4.  Photograph(s) that depict the outside and inside of the facility.

5.  Environment surrounding the facility.

      -  Water source description  __________________________________________________________________________
      -  Waste disposal
            Garbage  ______________________________________________________________________________________
            Trash  ________________________________________________________________________________________
            Recycled material  ______________________________________________________________________________
      -  Sewage disposal  _________________________________________________________________________________
      -  Other  _________________________________________________________________________________________

6.  Description of clientele to be served (in terms of immune competent / compromised).

    -  Describe any food given to charitable organizations and how it is handled.

    -  Other information.

Encl. 2

1.  List under style of service / service area, which styles are used.  Examples include:  cafeteria, fast food, buffet, deli, table service (American, English, French, Russian), bulk food sales, distributed food service (banquet, room, home, other buildings/wards), off-site (catering, temporary, mobile [cars, trucks, carts], vending and others).  Fill in the columns appropriately.

Style of service / service 
 Meal time service period
 Max. # of people served
Do they have their own kitchen or service pantry area?
  How are soiled dishes handled?











2.  What is done with leftover food?  (For example, is it thrown away, saved and served later, or given to a charitable cause?)

Encl. 3


Encl.  4

The major equipment items and operating temperatures are listed in the following chart.

 Floor Plan No.
Operating Temperature
  Cooking:  Size / Capacity / Horsepower / British thermal unit (Btu)












Encl. 5


Encl. 6


Encl. 7

Thick Food >2"
Thin Food <2"
Sauces, Soups
Fruits & Vegs
Hot Combo
Cold Combo
Breads, Pastries, Desserts
Served hot


Center pasteurize




Washed, not cooked


pH >4.6


pH >4.6


Bread, biscuits, muffins, cake


Cheese, dairy


 Surface pasteurize


Potato soups
Fruits soups
Hazardous beverages


Served cold




pH <4.6


pH <4.6


Fruit pies


Eaten raw


pH <4.6


  Refrigerated pastries, pies


pH <4.6 beverages


To Table of Contents
To Section II
To Section IV