Template No: QPT6.10.

3
Your Logo Supplier Quality & Food Safety Audit Rev./Date: New /7-7-11
Approved By:
Page 1 of 6

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 (ie. ISO, AIB, NFS, SQF).

Primary products produce at location:

Primary products produce for SOLUT!:

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 and is there a `
plan in place to keep this awareness relevant and effective?    

4. A completed, up to date Quality Manual is available (if on-site audit ask to see it)  
   

C. Adequacy of Product Safety Program (Con’t) YES NO N/A Comments & Notes:
 Template No: QPT6.10.3
Your Logo Supplier Quality & Food Safety Audit Rev./Date: New /7-7-11
Approved By:
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5. Facility has up-to-date 3rd party audit.(ie. AIB, SQF, GMP) If Yes, Provide latest  
copy of Audit and Certificate    

6. Facility has a formal product 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.

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

 Template No: QPT6.10.3
Your Logo Supplier Quality & Food Safety Audit Rev./Date: New /7-7-11
Approved By:
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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    

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    
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Your Logo Supplier Quality & Food Safety Audit Rev./Date: New /7-7-11
Approved By:
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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)    

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  
   
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Your Logo Supplier Quality & Food Safety Audit Rev./Date: New /7-7-11
Approved By:
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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    

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
 Template No: QPT6.10.3
Your Logo Supplier Quality & Food Safety Audit Rev./Date: New /7-7-11
Approved By:
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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: