International SOS

Hygiene and Sanitation Checklist for

Remote Sites
Assessment Details

Assessment completed by Surur Rizqi (medic), Yordan B ( Supervisor) Mahmud

Date 2-Apr-21

Site Details

Company requesting assessment

Site name

Site owner PT.NHM

Type of site Exploration

Site Age

Work being carried out at the site: Exploration

Number of employees on site

Maximum number of employees

Employees present during audit 4

© 2014 AEA International Holdings Pte. Ltd.

All rights reserved. Unauthorized copies or distribution prohibited.

This report is prepared solely for the benefit of and use by <Company> and may not be sold, reproduced or in any other way copied or transferred by the
customer to anyone else, whether in whole of in part. Intl.SOS owns and retains all intellectual property rights in this report including, without limiting the
generality of foregoing, all copyrights.
International SOS
Summary
Overall results

In summary, Hygiene and Sanitation level around Muara Tuhup Camp were in good condition. PBU, well known company that
is responsible for maintaining this camp from catering service, camp service and maintaintenace, deliver various services with
apropriate SOP to ensure everything in good condition. However, some minor things might be found during inspection to
potentially cause some unwanted circumstances happened. Some people's habit might also inhibited their achievement.
Therefore, continuous implementation of their SOP should be done together with encouraging people for changing their habit
for better achievement.

Compliance levels

Level From To What it Means

Action must be taken. Corrective actions suggested by Intl.SOS must be implemented to

Low 0% 40%
ensure any non compliant item is addressed and practice is improved.

Action to be considered. Corrective actions suggested by Intl.SOS are recommended to ensure

Medium 41% 70%
any non compliant item is addressed and practice is improved.

Continuous improvement. Compliance is high and does not require corrective actions to be
High 71% 100% implemented. It is recommended that the ongoing effort to improve the current practice is
maintained.

Assessment results

Total Max Compliance

Area Individual Assessment Items %
score score level

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 Continuous
32 36 89
0 0 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 na na na improvement
1. People
36 37 38 39 40 41 42 43

na 1 1 na na na 1 1

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 Continuous
29 30 97
1 1 1 1 1 na na na na na na 1 1 na 1 1 na na 1 1 1 1 1 1 1 1 1 1 1 1 na 1 1 1 1 improvement
2. Plant/Facilities
 2. Plant/Facilities
36 37 38 39 40

0 1 1 1 1

1 2 3 4 5 6 7 8 9 10 11 12 13 14 Continuous
3. Process 11 12 92
na 1 na 1 1 1 1 0 1 1 1 1 1 1 improvement

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 Action must be
5 34 15
4. Living Quarters, 0 0 1 1 1 1 na na na na na 1 na 0 0 0 0 0 0 0 0 0 0 0 na 0 0 0 0 0 0 0 0 0 0 taken
Accommodation,
Laundry, etc. 36 37 38 39 40 41

0 0 0 0 0 0

Action to be
Total 77 112 69
considered

Key recommendations

People should be responsible with their rooms cleanliness, example: smoking, do not
throw rubbish/cigarette butts every where, and do not smoking inside bathroom
1. People

Inspect and clean gutter and water drainage system from any garbage
2. Plant/Facilities

To remind every related employees to work as per SOP, e.c. using approriate SOP,
regular cleaning, quality control for all incoming foods, prevent cross contamination, etc.
3. Process

Regular cleaning, maintain housekeeping

4. Living quarters,
accommodation, laundry, etc.
International SOS
Methodology
Reference Standards
Publicly Available Specification (PAS) 220:2008 – Prerequisite Programs on Food Safety for Food
Manufacturing
ISO/TS 22002-1:2009 – Prerequisite Programs on Food Safety: Food Manufacturing

Assessment

Each assessment item was reviewed and assigned a level of implementation based on the answer to the
assessment question. Each level of implementation has an associated score.

Compliance Score
Yes 1
No 0
N/A -

Total scores were calculated for each section by multiplying the number of occurrences of a compliance
level with its associated score. Items marked Not Applicable (N/A) were excluded from the scoring
calculations.

Terms and Definitions

Document provided by the supplier which indicates the results of

Certificate Of Analysis (COA) specific tests or analyses, including test methodology, performed on a
defined lot of the supplier's product.

Introduction or occurrence of a contaminant in food or food

Contamination
environment.

Any biological or chemical agent, foreign matter or other substances

Contaminant not intentional to food which may compromise food safety or
suitability.

Removal of soil, food residues, dirt, grease or other objectionable

Cleaning
matter.

Cleaning of equipment by impingement or circulation of flowing

chemical solutions, cleaning liquids and water; that rinses into, onto
Cleaning In Place (CIP)
and over surfaces of the equipment or systems, without dismantling,
and designed for the purpose.

System where equipment is disassembled and cleaned in a tank or in

Cleaning Out of Place (COP) an automatic washer by circulating a cleaning solution, and
maintaining a minimum temperature throughout the cleaning cycle.

Reduction, by means of chemical agents and/or physical methods, of

Disinfection the number of microorganisms in the environment, to a level that
does not compromise food safety or suitability.

Any building or area in which food is handled, and the surroundings

Establishment
are under the control of the same management.
 Stock rotation based on the principle of dispatching earliest expiration
First Expired First Out (FEFO)
dates first.

Stock rotation based on the principle of dispatching earliest received

First In First Out (FIFO)
product first.

Lubricants and heat transfer fluids formulated to be suitable for use in

Food Grade food processes where there may be incidental contact between the
lubricant and the food.

Printed matter that is part of the finished product package conveying

Label specific information about the contents of the package, the food
ingredients and any storage and preparation requirements.

General term used to indicate raw materials, packaging, ingredients,

Materials
process aids, cleaning materials and lubricants.

Detailed documented description or enumeration of parameters,

Material Specification including permissible variation and tolerances, which are required to
achieve a defined level of acceptability or quality.

All surfaces that are in contact with the product or the primary
Product Contact
package during normal operation.

Removal of non-conforming product from the market, trade and

Product Recall warehouse, distribution centers and/or customer warehouse because
it does not meet specified standards.

Sanitizing Process of cleaning, followed by disinfection.

All actions dealing with cleaning or maintaining hygienic conditions in

an establishment, ranging from cleaning and/or sanitizing of specific
Sanitation
equipment to periodic cleaning activities throughout the establishment
(including building, structural and ground cleaning activities).

Demarcation of an area within an establishment where specific

operational, hygiene or other practices may be applied to minimize
Zoning the potential for microbiological cross contamination (example
clothing change on entry or exit, positive air pressure, modified traffic
flow patterns, etc.).
International SOS
Hygiene and Sanitation Checklist for Remote Sites

Current
No. Assessment Item Status Comments
(Y, N, na)

1 PEOPLE

Personal Hygiene and Employee Facilities (Kitchen Staff)

Do kitchen staff undergo a pre-employment medical

examination?
1.1 Y
Apakah staf dapur melakukan pre-employment medical check
up?
Are kitchen staff declared fit for the task in 1.1?
1.2 Apakah staf dapur telah dinyatakan fit untuk bekerja menurut Y
hasil pre-employment medical check up?
Do kitchen staff undergo a periodic medical examination?
1.3 Y
Apakah staf dapur melakukan medical check up periodik?
Are kitchen staff declared fit for the task in 1.3?
1.4 Apakah staf dapur telah dinyatakan fit untuk bekerja menurut Y
hasil medical check up periodik?

Awareness, Competence

Are kitchen staff trained for food safety? If yes, provide details in
the Comments section on 1) when the training took place and 2)
ask to view the certificate.
1.5 Y
Apakah staf dapur mendapatkan training food safety? Bila ya, 1)
Kapan training food safety dilaksanakan, 2) Tunjukkan sertifikat
sebagai bukti

Are kitchen staff aware of food safety hazards? Ask 2 or 3

kitchen staff.
1.6 Y staff dapur mampu menjelaskan terkait bahaya keracunan dll
Apakah staf dapur mengerti apa saja risiko/bahaya yang
berhubungan dengan food safety? Tanyakan pada 2 atau 3 staf.

Are kitchen staff aware of how to control food safety hazards?

Ask 2 or 3 kitchen staff.
1.7 Apakah staf dapur mengerti bagaimana mengontrol Y
risiko/bahaya food safety yang ada? Tanyakan pada 2 atau 3
staf.

Personnel Cleanliness

Do kitchen staff wash their hands before handling food

(observe)?
1.8 Y
Apakah staf dapur mencuci tangan sebelum memegang
makanan/bahan makanan? (Observasi)
Do kitchen staff wash their hands after using the toilet
(observe) ?
1.9 Y
Apakah staf dapur mencuci tangan setelah menggunakan toilet?
(Observasi)
Do kitchen staff wash their hands after blowing their nose
(observe)?
1.10 Y
Apakah staf dapur mencuci tangan setelah membuang
ingus/bersin/memegang hidung mereka? (Observasi)
Are kitchen staff aware that spitting is prohibited?
1.11 Y
Apakah staf dapur mengetahui adanya larangan meludah?
Are kitchen staff aware that sneezing/coughing over
material/product are prohibited?
1.12 Y
Apakah staf dapur mengetahui adanya larangan bersin/batuk di
depan makanan/bahan makanan?
Are finger nails of the kitchen staff clean and trimmed? Check 2
or 3 kitchen staff.
1.13 Y
Apakah kuku tangan staf dapur bersih dan rapi? Lakukan
pemeriksaan pada 2 atau 3 orang staf.

Injuries and Illnesses

 Do kitchen staff know that they must report (and do report) to
clinic if they have: jaundice? Ask 2 or 3 kitchen staff.
1.14 Apakah staf dapur mengetahui adanya kewajiban untuk melapor Y
(dan memang melapor) ke klinik bila mereka menderita sakit
kuning? Tanyakan pada 2 atau 3 orang staf.

Do kitchen staff know that they must report (and do report) to

clinic if they have: diarrhea? Ask 2 or 3 kitchen staff.
1.15 Apakah staf dapur mengetahui adanya kewajiban untuk melapor Y
(dan memang melapor) ke klinik bila mereka menderita diare?
Tanyakan pada 2 atau 3 orang staf.
Do kitchen staff know that they must report (and do report) to
clinic if they have: vomiting? Ask 2 or 3 kitchen staff.
1.16 Apakah staf dapur mengetahui adanya kewajiban untuk melapor Y
(dan memang melapor) ke klinik bila mereka muntah? Tanyakan
pada 2 atau 3 orang staf.
Do kitchen staff know that they must report (and do report) to
clinic if they have: fever? Ask 2 or 3 kitchen staff.
1.17 Apakah staf dapur mengetahui adanya kewajiban untuk melapor Y
(dan memang melapor) ke klinik bila mereka mengalami
demam? Tanyakan pada 2 atau 3 orang staf.

Do kitchen staff know that they must report (and do report) to

clinic if they have: sore throat with fever? Ask 2 or 3 kitchen staff.
Apakah staf dapur mengetahui adanya kewajiban untuk melapor
1.18 Y
(dan memang melapor) ke klinik bila mereka mengalami nyeri
tenggorokan disertai demam? Tanyakan pada 2 atau 3 orang
staf.

Do kitchen staff know that they must report (and do report) to

clinic if they have: visible skin infections (boils, cuts, sores)? Ask
2 or 3 kitchen staff.
1.19 Y
Apakah staf dapur mengetahui adanya kewajiban untuk melapor
(dan memang melapor) ke klinik bila mereka mengalami infeksi
kulit (Bisul, luka, koreng)? Tanyakan pada 2 atau 3 orang staf.

Do kitchen staff know that they must report (and do report) to

clinic if they have: discharge from ears, eyes or nose? Ask 2 or 3
kitchen staff.
1.20 Apakah staf dapur mengetahui adanya kewajiban untuk melapor Y
(dan memang melapor) ke klinik bila mereka mengalami
keluarnya cairan dari telinga, mata atau hidung? Tanyakan pada
2 atau 3 orang staf.

Do kitchen staff know that they must report (and do report) to

clinic if they have: wounds? Ask 2 or 3 kitchen staff.
1.21 Apakah staf dapur mengetahui adanya kewajiban untuk melapor Y
(dan memang melapor) ke klinik bila mereka mengalami luka?
Tanyakan pada 2 atau 3 orang staf.
Do kitchen staff know that they must report (and do report) to
clinic if they have: burns? Ask 2 or 3 kitchen staff.
1.22 Apakah staf dapur mengetahui adanya kewajiban untuk melapor Y
(dan memang melapor) ke klinik bila mereka mengalami luka
bakar? Tanyakan pada 2 atau 3 orang staf.
Do kitchen staff receive certificate of fitness to return to work in
the kitchen?
1.23 Y
Apakah staf dapur memiliki sertifikat kelayakan untuk kembali
bekerja di dapur?

Personal Protective Equipment

Do the uniforms look clean?

1.24 Y
Apakah seragam tampak bersih?
Do the uniforms look undamaged?
1.25 Y
Apakah seragam tampak utuh (tidak robek atau rusak)?
Do all kitchen staff wear a hair net or cap (observe)?
1.26 Apakah semua staf dapur memakai hair net atau penutup Y
kepala?
Do all kitchen staff wear appropriate shoes (observe)?
1.27 Apakah semua staf dapur memakai sepatu yang sesuai? Y
(Observasi)
Do kitchen staff wear gloves while they are in contact with food
(observe)?
1.28 Y
Apakah staf dapur memakai sarung tangan saat kontak dengan
makanan? (Observasi)

Hygienic Facilities and Toilets

Are hand washing sinks available in the kitchen?

1.29 Y Tempat cuci tangan jadi satu dengan tempat cuci piring
Apakah terdapat tempat cuci tangan di dapur?
 Is there a sufficient amount of water within the kitchen?
1.30 Y
Apakah jumlah air di dapur mencukupi?
Are the hand washing sinks clean?
1.31 Y
Apakah tempat cuci tangan tampak bersih?
Is there soap available in the hand washing sink?
1.32 Y Tempat cuci tangan ada diluar dapur
Apakah terdapat sabun di tempat cuci tangan?
Are hand drying facilities available? (e.g. hand towel, paper
towel/tissue, hand dryer machine)
1.33 na
Apakah terdapat fasilitas pengering tangan? (Misalnya handuk
tangan, kertas/tisu, mesin pengering)
Are hand washing facilities available in the toilets?
1.34 na
Apakah fasilitas cuci tangan terdapat di toilet?
Is there soap available in the hand washing facilities in the
1.35 toilets? na
Apakah terdapat sabun pada tempat cuci tangan di toilet?
Are there hand drying facilities available in the hand washing
facilities in the toilets?
1.36 na
Apakah terdapat fasilitas pengering tangan pada tempat cuci
tangan di toilet?
Do the toilets look clean?
1.37 Y
Apakah toilet tampak bersih?
Are toilets free of any bad odor?
1.38 Y
Apakah toilet bebas dari bau tidak sedap?

Are changing facilities available for the kitchen staff?

1.39 na Ganti baju dikamar masing masing
Apakah fasilitas untuk ganti baju tersedia untuk staf dapur?

Do the changing facilities look clean?

1.40 na
Apakah fasilitas untuk ganti baju tampak bersih?

Are changing facilities free of any bad odor?

1.41 na
Apakah fasilitas untuk ganti baju bebas dari bau tak sedap?

Do kitchen staff eat in designated area?

1.42 Y
Apakah staf dapur makan di tempat yang telah ditentukan?
During inspection, does all staff follow the rule of not eating in
the kitchen?
1.43 Y
Selama inspeksi, apakah semua staf mengikuti aturan untuk
tidak makan di dapur?

2 PLANT/FACILITIES

Construction, Building, Layout, Workspace

Kitchen Environment

Are controls in place for the access to the kitchen by visitors /

guests or other people who are not kitchen staff?
2.1 Y Terdapat sign larangan masuk kedapur kecuali staff dapur
Apakah dilakukan kontrol terhadap akses masuk ke dapur untuk
pengunjung/tamu/orang lain yang bukan staf?
Is the kitchen clean and in good order?
2.2 Y
Apakah dapur tampak bersih dan rapi?
During inspection, is the kitchen free of any standing water?
2.3 Y
Selama inspeksi, apakah dapur bebas dari genangan air?

Internal Design, Layout, Traffic pattern

Are there adequate workspaces within the kitchen?

2.4 Apakah terdapat ruangan yang cukup untuk bekerja di dalam Y
dapur?
Are there any physical separations (walls, barriers, partitions)
between raw and processed materials?
2.5 Y Hanya dipisahkan dengan sekat dari terpal
Adakah pemisahan secara fisik (dinding, pembatas, sekat)
antara ruangan untuk bahan mentah dan makanan jadi?

Internal Structures and Fittings

Are kitchen walls and floors made from cleanable and washable
material (such as marble, etc)?
2.6 na
Apakah dinding dan lantai dapur terbuat dari bahan yang miudah
dicuci dan dibersihkan? (misalnya marmer, dll)
Are walls cleanable and washable?
2.7 na Dindingberbuat dari kayu dan triplek
Apakah dinding dapur mudah dicuci dan dibersihkan?
Are floors cleanable and washable?
2.8 na
Apakah lantai dapur mudah dicuci dan dibersihkan?
Are junctions cleanable and washable?
2.9 Apakah lekukan/sambungan antara dinding dan lantai di dalam na
dapur mudah dicuci dan dibersihkan?
Are corners cleanable and washable?
2.10 Apakah sudut-sudut di dalam dapur mudah dicuci dan na
dibersihkan?
 Are windows within the kitchen screened?
2.11 na
Apakah jendela dapur ditutup dengan kasa?
Are doors closed when they are not in use?
2.12 Y
Apakah pintu selalu ditutup saat tidak digunakan?

Utilities: Air, Water, Energy

Water Supply

Is there a sufficient amount of water available in the kitchen?

2.13 Y
Apakah jumlah air di dapur mencukupi?

Is the water used for ice potable?

2.14 Apakah air yang digunakan untuk membuat es batu layak na Tidak membuat es batu
minum?
Is the water used to steam potable?
2.15 Y mengunakan air galon
Apakah air yang digunakan untuk mengukus layak minum?
Is the water in contact with food products potable?
2.16 Apakah air yang berkontak dengan produk makanan layak Y
minum?
Are the results of water (microbiological) testing available?
2.17 Apakah terdapat hasil tes laboratorium (mikrobiologi) terhadap na
air yang digunakan?
As per the water testing result, is the residual chlorine (if used) at
an acceptable level?
2.18 Sesuai hasil tes laboratorium terhadap air yang digunakan, na belum dilakukan tes lab
apakah jumlah residu klorin (bila digunakan) masih dalam batas
yang dapat diterima?

Air Quality and Ventilation

Is there adequate ventilation in the kitchen?

2.19 Y
Apakah ventilasi di dalam dapur mencukupi?

Lighting

Is there adequate natural lighting for hygiene operations in the

kitchen?
2.20 Y
Apakah terdapat pencahayaan alami yang memadai untuk
melakukan proses secara higienis?
Is there adequate artificial lighting for hygiene operations in the
kitchen?
2.21 Y
Apakah terdapat pencahayaan artifisial yang memadai untuk
melakukan proses secara higienis?

Equipment, Equipment Cleaning, Maintenance

Equipment Hygienic Design

Do equipments in the kitchen have smooth, cleanable surface?

(e.g. stainless steel or marble)
2.22 Y
Apakah peralatan di dapur memiliki permukaan yang halus dan
mudah dibersihkan? (Misalnya stainless steel atau marmer)

Product Contact Surface

Are equipments' surfaces impermeable?

2.23 Y
Apakah peralatan dapur terbuat dari bahan kedap air?
Are equipments' surfaces rust free?
2.24 Y
Apakah peralatan dapur bebas dari karat?

Cleaning Area, Utensils and Equipment

Can adequate cleaning facilities be found in the kitchen?

2.25 Y
Apakah terdapat fasilitas mencuci yang memadai di dapur?

Can adequate cleaning materials be found in the kitchen?

2.26 Y
Apakah terdapat bahan pembersih yang memadai di dapur?

Preventive and Corrective Maintenance

Are the available maintenance programs in place?

2.27 Apakah terdapat program pemeliharaan (maintenance) untuk Y Setiap habis pakai peraltan dapur langsung di cuci dan dibersihkan kembali
peralatan dapur?

Pest Control

Pest Control Program

 Is the available pest control program able to detect pests within
the kitchen and the galley?
2.28 Y
Apakah program pengendalian hama yang ada mampu
mendeteksi hama yang terdapat di dapur?
Is the available pest control program able to monitor pests within
the kitchen and the galley?
2.29 Y
Apakah program pengendalian hama yang ada mampu
memonitor hama yang terdapat di dapur?
Is the available pest control program able to eradicate pests
within the kitchen and the galley?
2.30 Y
Apakah program pengendalian hama yang ada mampu
membasmi hama yang terdapat di dapur?

Preventing Access

Is any building maintenance in place to seal the holes, drains

and other potential pest access points?
2.31 Apakah terdapat program pemeliharaan untuk menutup lubang, na
saluran air dan tempat-tempat lain yang mungkin menjadi akses
masuknya hama?

Harborage and Infestations

Do storage practices prevent the availability of food and water to

pests?
2.32 Y
Apakah metode penyimpanan yang ada sekarang dapat
mencegah tersedianya makanan dan minuman untuk hama?

Are the potential pest harborages, i.e. burrows, undergrowth and

stores items, removed?
2.33 Y
Apakah tempat persembunyian hama, seperti lubang dan
tumpukan barang-barang telah disingkirkan/dibersihkan?

Warehousing and Food Storage

Food Storage System

Is the storage system of First In First Out rotation in place?

2.34 Apakah penyimpanan barang menggunakan metode First In Y Pertahankan sistem yang sudah berjalan
First Out?
Are the control and monitoring of expired materials in place?
2.35 Apakah dilakukan kontrol dan monitor terhadap barang-barang Y
kadaluarsa?
Is any labeling for materials and products in place?
2.36 Apakah terdapat label untuk produk dan material di tempat N Penyimpanan material perlu dibuatkan label
penyimpanan?

Cold Storage

Is temperature control available and in good function?

2.37 Apakah alat pengontrol suhu tersedia dan berfungsi dengan Y
baik?

Dry Storage

Are chemical materials (cleaning, lubricants, pesticides) stored

separately?
2.38 Y
Apakah bahan-bahan kimia (bahan pencuci, pelumas, pestisida)
disimpan secara terpisah?
Are materials stored on a pallet?
2.39 Y Ada beberapa bahan yang tidak menggunakan palet
Apakah bahan-bahan disimpan di atas palet?
Are materials stacked in such a way that allows the room to be
cleaned?
2.40 Y
Apakah material disusun sedemikian rupa sehingga ruangan
mudah untuk dibersihkan?

3 PROCESS

Management of Purchased Material

Reliable Supplier

Is there any procedure to ensure a reliable supplier?

3.1 Adakah prosedur tertentu untuk memastikan apakah pemasok na
bahan makanan dapat dipercaya?

Incoming Material (Raw/ingredients/packaging)

Are inspections of incoming material (i.e. integrity of seals, free

from infestation) performed?
3.2 Y
Apakah dilakukan inspeksi terhadap barang yang masuk
(misalnya keutuhan segel, hama yang menempel)?
 Prevention of Cross Contamination

Program to Prevent Contamination, Control and Detect Contamination

Is there a program to prevent physical contamination (glass, hard

plastic) of the food materials?
3.3 na
Apakah terdapat program untuk mencegah terjadinya
kontaminasi fisik (kaca, plastik keras) terhadap makanan?
Is there any program to prevent biological contamination
(segregation of raw and process area with walls, barriers, or
partition) of the food materials?
3.4 Apakah terdapat program untuk mencegah terjadinya Y
kontaminasi biologis terhadap makanan (pemisahan area untuk
bahan makanan mentah dan makanan jadi menggunakan
dinding, pembatas atau sekat)?

Cleaning and Maintenance

Cleaning

Are cleaning facilities/areas available?

3.5 Y
Apakah terdapat fasilitas/area pembersihan?
Do the cleaning chemicals contain food grade material?
3.6 Apakah bahan kimia pembersih termasuk dalam kategori food Y
grade?

Are the cleaning tools available and appropriate for cleaning?

3.7 Y
Apakah peralatan kebersihan tersedia dan sesuai?

Waste Disposal

Waste Disposal Program

Are the wastes segregated (e.g. organic/non-organic)?

3.8 Apakah pemisahan sampah dilakukan (Misalnya organik/non- N sampah masih ada yang tercampur antara organic dan an organic
organik)?
Are the wastes removed daily from the kitchen?
3.9 Y
Apakah sampah dari dapur dibuang setiap hari?

Containers

Can the containers for waste be clearly identified?

3.10 Y
Apakah tempat sampah dapat dikenali dengan jelas?
Are the containers located in a designated area?
3.11 Y
Apakah tempat sampah diletakkan di area khusus?

Are the containers for impervious materials cleanable/washable?

3.12 Apakah tempat sampah terbuat dari bahan kedap air dan mudah Y tempat sampah berupa plastic besar dan sekali buang
dibersihkan/dicuci?

Are the containers closed when not in use?

3.13 Y
Apakah tempat sampah ditutup bila tidak digunakan?
Drains and Drainage

Are the drains and drainage maintained and cleaned regularly?

3.14 Apakah saluran air dan drainase dipelihara dan dibersihkan Y
secara rutin?

4 Living Quarters, Accommodation, Laundry, etc.

Living Quarters

Are the sleeping quarters clean?

4.1 Y
Apakah area untuk tidur tampak bersih?

Are the sleeping quarters well lit?

4.2 Y
Apakah area untuk tidur mendapat penerangan yang cukup?

Are the mattresses in good condition?

4.3 Y
Apakah alas tidur/matras dalam kondisi baik?
Are the sheets in good condition?
4.4 Y
Apakah sprei dalam kondisi baik?
Are the blankets in good condition?
4.5 Y
Apakah selimut dalam kondisi baik?
Are the pillows in good condition?
4.6 Y
Apakah bantal dalam kondisi baik?

Does the catering staff change the sheets frequently enough?

4.7 na
Apakah sprei cukup sering diganti?
 Does each man have a personal locker in his room?
4.8 na
Apakah setiap orang memiliki loker sendiri di kamarnya?
Are floors generally in good condition?
4.9 na
Apakah lantai secara umum dalam kondisi baik?
Are walls generally in good condition?
4.10 na
Apakah dinding secara umum dalam kondisi baik?
Are ceiling tiles generally in good condition?
4.11 na
Apakah langit-langit secara umum dalam kondisi baik?
Are the beds in good condition?
4.12 Y
Apakah tempat tidur tampak dalam kondisi baik?
Are the lockers in good condition?
4.13 na
Apakah loker tampak dalam kondisi baik?
Are the desks in good condition?
4.14 Y
Apakah meja tampak dalam kondisi baik?
Are the bed lights in good condition?
4.15 na
Apakah lampu tidur tampak dalam kondisi baik?
Are the chairs in good condition?
4.16 na
Apakah kursi tampak dalam kondisi baik?
Is there a smoke detector in each sleeping space?
4.17 na
Apakah terdapat detektor asap pada setiap ruang tidur?
Is there a trash can in each room?
4.18 Y
Apakah ada tempat sampah di setiap kamar?
Are the living quarters free from insects?
4.19 Y
Apakah area tempat tinggal bebas dari serangga?
Are the living quarters free from vermin?
4.20 Y
Apakah area tempat tinggal bebas dari kutu?
Are the hallways of the living quarters well lighted?
4.21 Apakah lorong-lorong di area tempat tinggal mendapat Y
penerangan yang cukup?

Are the emergency lights in proper working order?

4.22 Y
Apakah lampu-lampu emergency dapat berfungsi dengan baik?

Are the emergency exits properly marked?

4.23 na
Apakah pintu-pintu darurat ditandai dengan jelas?
Are there fluorescence arrows showing the way out of the
quarters in the dark?
4.24 na
Apakah ada tanda yang terbuat dari bahan floresens untuk
menunjukkan pintu keluar disaat gelap?
Can any relevant alarms be clearly heard in the quarter?
4.25 Apakah bunyi alarm dapat terdengar jelas dari dalam area na
tempat tinggal?

Accommodation, Laundry

Are work boots left outside the living quarters?

4.26 N
Apakah sepatu boot kerja diletakkan diluar ruangan?
Are the shower rooms clean and in good condition?
4.27 Y
Apakah kamar mandi bersih dan dalam keadaan baik?
Are the toilet facilities clean and in good condition?
4.28 Y
Apakah toilet bersih dan dalam keadaan baik?
Are the toilet facilities free of any leaking faucets?
4.29 Y
Apakah toilet bebas dari kran yang bocor?
Is the shower equipment functioning properly?
4.30 Y Gayung dan ember
Apakah peralatan untuk mandi berfungsi dengan baik?
Is the toilet equipment functioning properly?
4.31 Y
Apakah peralatan toilet berfungsi dengan baik?
Are the showers facilities clean?
4.32 Y
Apakah fasilitas untuk mandi dalam keadaan bersih?
Are the toilet facilities clean?
4.33 Y
Apakah fasilitas toilet dalam keadaan bersih?
Is the laundry clean and in good condition?
4.34 Apakah tempat untuk mencuci pakaian bersih dan dalam Y
keadaan baik?

Is there adequate hot water for washing clothes?

4.35 na
Apakah tersedia air panas yang cukup untuk mencuci pakaian?

Are the washing machines in proper working order?

4.36 Y
Apakah mesin cuci berfungsi dengan baik?
Are the dryers in proper working order?
4.37 na
Apakah mesin pengering berfungsi dengan baik?
Are the dryer filters cleaned on a daily basis?
4.38 na
Apakah filter mesin pengering dibersihkan setiap hari?
Are dryers free from clothes or equipment stored or stacked on
top of them?
4.39 Y
Apakah bagian atas mesin pengering bebas dari tumpukan alat-
alat/pakaian?
 Is all the plumbing in good condition?
4.40 Apakah pipa saluran air dalam kondisi baik?** Y
(**Pipa saluran tidak bocor/pecah/sambungan terlepas)
Are all electrical fittings and connections in good condition?
4.41 Apakah semua peralatan listrik dan sambungan-sambungannya Y
dalam kondisi baik?
International SOS
ISO/TS 22002-1:2009 & PAS 220
No. Assessment Item
1 Scope
PAS 220: This Publicly Available Specification (PAS) specifies requirements for establishing, implementing
and maintaining prerequisite program (PRP) to assist in controlling food safety hazards.

ISO/TS 22002-1:2009: This technical specification specifies requirements for establishing, implementing and
maintaining prerequisite programmes (PRP) to assist in controlling food safety hazards.

This technical specification is applicable to all organizations, regardless of size or complexity, which are
involved in the manufacturing step of the food chain and wish to implement PRP in such a way as to address
the requirements specified in ISO 22000:2005, Clause 7.

Food manufacturing operations are diverse in nature and not all of the requirements specified in this Technical
Specification apply to an individual establishment or process.

This Technical Specification specifies detailed requirements to be specifically considered in relation to ISO
22000:2005, Clause 7.2.3: a) construction and layout of buildings and associated utilities; b) layout of
premises, including workspace and employee facilities; c) supplies of air, water, energy and other energy; d)
supporting services, including waste and sewage disposal; e) suitability of equipment and its accessibility for
cleaning, maintenance and preventive maintenance; f) management of purchased materials; g) measures for
the prevention of cross-contamination; h) cleaning and sanitizing; i) pest control; j) personal hygiene.

In addition, this Technical Specification adds other aspects which are considered relevant to manufacturing
operations; 1) Rework; 2) Product recall procedures; 3) Warehousing; 4) Product information and consumer
awareness; 5) Food defence, biovigilance and bioterrorism.
2 Normative References
The following referenced documents are indispensable for the application of this document. For dated
references, only the edition cited applies. For undated references, the latest edition of the referenced
document (including any amandement) applies. ISO 22000:2005, Food safety management systems -
Requirements for any organization in the food chain.
3 Terms and Definitions
As described in the methodology.
4 Clause 4 Construction and layout of buildings
4.1 General requirements.
4.2 Environment.
4.3 Locations of establishments.
5 Clause 5 Layout of premises and workspaces
5.1 General requirements.
5.2 Internal design, layout and traffic patterns.
5.3 Internal structure and fittings.
5.4 Location of equipment.
5.5 Laboratory facilities.
5.6 Temporary or mobile premises and vending machines.
5.7 Storage of food, packaging materials, ingredients and non-food chemicals.
6 Clause 6 Utilities - air, water, energy
6.1 General requirements.
6.2 Water supply.
6.3 Boiler chemicals.
6.4 Air quality and ventilation.
6.5 Compressed air and other gases.
6.6 Lighting
7 Clause 7 Waster disposal
7.1 General requirements.
7.2 Containers for waste and inedible or hazardous substances
7.3 Waster management and removal
7.4 Drains and drainage
8 Clause 8 Equipment suitability, cleaning and maintenance
8.1 General requirements.
8.2 Hygienic design
8.3 Product contact surfaces
8.4 Temperature control and monitoring equipment
8.5 Cleaning plant, utensils, and equipment
8.6 Preventive and corrective maintenance
9 Clause 9 Management of purchased materials
9.1 General requirements.
9.2 Selection and management of suppliers
9.3 Incoming material requirements (raw/ingredients/packaging)
10 Clause 10 Measures for prevention of cross contamination
10.1 General requirements.
10.2 Microbiological cross-contamination
10.3 Allergen management
10.4 Physical contamination
11 Clause 11 Cleaning and sanitizing
11.1 General requirements.
11.2 Cleaning and sanitizing agent and tools
11.3 Cleaning and sanitizing programs
11.4 Cleaning in place (CIP) system
11.5 Monitoring sanitation effectiveness
12 Clause 12 Pest control
12.1 General requirements.
12.2 Pest control programs
12.3 Preventing access
12.4 Harbourage and infestations
12.5 Monitoring and detection
12.6 Eradication
13 Clause 13 Personnel hygiene and employee facilities
13.1 General requirements
13.2 Personnel hygiene facilities and toilet
13.3 Staff canteens and designated eating areas
13.4 Workwear and protective clothing
13.5 Health status
13.6 Illness and injuries
13.7 Personnel cleanliness
13.8 Personnel behaviour
14 Clause 14 Rework
14.1 General requirements
14.2 Storage, identification and traceability
14.3 Rework usage
15 Clause 15 Product recall procedures
15.1 General requirements
15.2 Product recall requirements
16 Clause 16 Warehousing
16.1 General requirements
16.2 Warehousing requirements
16.3 Vehicle, conveyances, and containers
17 Clause 17 Product information and consumer awareness
17.1 General requirements
18 Clause 18 Food defense, biolvigilance, and bioterrorism
18.1 General requirements
18.2 Access control
 Today :
SUMMARY No. of Action Items : 4
HYGIENE AND SANITATION INSPECTION No. of "OPEN" Status : 2
PT.NHM - Mattat Camp No. of "CLOSED" Status : 2
Progress Achievement Score : 50%

LOCATION CAMP MATAT

INSPECTOR Mulki Hadi ( Medic), Rafles ( Supervisor), Fathur ( Cook ), Giri ( Geologis)
PERIOD OF INSPECTION May-21
WHEN

AGING
(Days)
STARTING TARGET PROGRESS SUPPORTING PICTURES
NO WHAT WHERE HOW WHO DATE DATE STATUS CORRECTIVE ACTION
/ DOCUMENTS

Ditemukan produk indomie dengan tanggal

kadaluarsa yang sudah dekat

Pakai terlebih dahulu bahan makanan yang Pisahkan bahan yang mendekati tanggal
1 Tempat penyimpanan bahan makanan kering Staff Kitchen 10-May-21 30-May-21 Open
mendekati tanggal expired terlebih dahulu kadaluarsa untuk di masak terlabih dahulu

Terdapat sayuran yang sudah membusuk

Segera pisahkan sayuran busuk dengan yang

lain supaya bakteri dan microorganisme tidak
2 Penyimpanan bahan sayuran di dapur Staff Kitchen 10-May-21 30-May-21 closed 1 Segera pisahkan sayuran busuk dengan yang lain
mencemari ke sayur lainnya dan sayur yg
busuk segera di buang

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 Sampah sisa makanan sudah tertutup dan selalu
segera di buang

selalu tutup sampah bekas sisa makanan

3 DAPUR Staff Kitchen 10-May-21 30-May-21 closed Pertahankan kebiasaan yang baik ini
basah

Tagging Kabel sudah over due

kordinaskan dengan tim elektrik terkait tagging NHM (explorasi Segera berkordinasi dengan tim elektrik di
4 Semua area camp 10-May-21 30-May-21 open
kabel listrik &electric) gosowong

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 8

10

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 11

12

13

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