FOOD FACTORY ASSESSMENT

Costco Wholesale
SUPPLIER INFORMATION
SUPPLIER NAME FACILITY NAME(if different from supplier)
SUPPLIER ADDRESS FACILITY ADDRESS
SUPPLIER ADDRESS FACILITY ADDRESS
CITY, ST ZIP CITY, ST ZIP
COUNTRY COUNTRY
KEY CONTACT PHONE
TITLE FAX
PHONE # EMERGENCY CONTACT
E-MAIL ADDRESS EMERGENCY CONTACT MOBILE PHONE #

Products Produced in Facility

Does the facility hold any certifications such as

Are any of the 8 major allergens of concern (peanuts, tree nuts, soy, milk, egg, wheat, fin fish & crustaceans SQF, BRC?
If yes, list which ones.

Approximate % of Annual Sales for Costco # of Years in business

Size of Processing Area # of Employees
FDA Registration Number # of production Shifts per Day
Is facility registered with iCiX?Yes or No Factory Representative Receiving Report

AUDIT INFORMATION
Auditor Date of Audit
Auditor Phone Auditor E-mail
Date Started Date Ended
Time Started Time Ended
Date of Last Audit Auditing Company

Signature of Technical Reviewer Date Reviewed

SGS Work Order Number

SCORING SUMMARY
Overall Score %: 100 Number of Critical Violations 0
Overall Grade: Excellent Number of Major Violations 0
Number of Minor Violations 0

COSTCO EXECUTIVE SUMMARY FOR iCiX DESCRIPTION COSTCO EXECUTIVE SUMMARY FOR iCiX
1. HACCP 100% Auditor 0
Products 0
2. QUALITY 100% Phone 0
3. GROUNDS & EQUIPMENT 100% Size of Processing Area 0 Email 0
4. PEST CONTROL 100% # of Employees 0 Date In 0-Jan
5. EMPLOYEE PRACTICES 100% # of Production Shifts per Day 0 Time In 0:00
6. RECEIVING, STORAGE & SHIPPING 100% Approximate % Annual Sales for Costco 0 Date Out 0-Jan
7. PLANT SANITATION 100% # of Years in Business 0 Time Out 0:00
8. FOOD DEFENSE 100% Audit Type GMP
9. PROCESSING 100%

Total 100%

Page 1 of 24 Costco FFA 2-9-09

 AUDIT SECTION SUMMARY

Section Number of Number of Number of Number of Not Number of Non-compliant Items Section Score
Section Points Section Points Compliant Items Applicable
Achieved Possible Items MINOR MAJOR CRITICAL % Grade
1.0 Administration & Regulatory Compliance 380 380 19 0 0 0 0 100% A
2.0 HACCP/Food Safety System 160 160 8 0 0 0 0 100% A
3.0 Process/Product Controls 360 360 18 0 0 0 0 100% A
4.0 Recall/Traceability 140 140 7 0 0 0 0 100% A
5.0 Sanitation 380 380 19 0 0 0 0 100% A
6.0 Worker Health & Hygiene 260 260 13 0 0 0 0 100% A
7.0 Physical Plant & Equipment 580 580 29 0 0 0 0 100% A
8.0 Grounds & Maintenance 180 180 9 0 0 0 0 100% A
9.0 Pest Control 200 200 10 0 0 0 0 100% A
10.0 Operational Practices 220 220 11 0 0 0 0 100% A
11.0 Food Security/ Emergency Preparedness 280 280 14 0 0 0 0 100% A
12.0 Testing 240 240 12 0 0 0 0 100% A
13.0 Food Allergens/ Labeling 180 180 9 0 0 0 0 100% A
14.0 Transportation 60 60 3 0 0 0 0 100% A

Total 3620 3600 181 0 0 0 0

Total number possible for entire audit 3620
Each item in the audit report is to be given a score based on the following:

20=Compliance= fully meets criteria; effective; verified Overall Score %: 100

10=Minor Non-compliance= criteria met but not fully effective & not verified; opportunity for improvement; Overall Grade : Excellent
0=Major Non-compliance= criteria not met, effective or verified; much opportunity for improvement

0=Critical Non-compliance= observation of conditions and/or practices that could constitute a health hazard or food safety risk; imminent health hazard

SCORING
EXCELLENT 95-100%
GOOD 90-94.9%
FAIR 85-89.9%
NEEDS IMPROVEMENT <84.4%

Page 2 of 24 Costco FFA 06-02-08

1. Administration & Regulatory Compliance
Non-Conformance
Section Question Audit Guidance SCORING Compliant N/A MINOR MAJOR CRITICAL
1.1 Does the facility have a written Quality & Food Safety Policy This should include the facility’s commitment to quality and
that is communicated to all levels of the organization? food safety and an outline of working practices and methods. 20

1.2 Has the owner or Senior Management demonstrated the Based upon observations while on site, the auditor must make
commitment to make resources available to implement and an evaluation of the commitment of Senior Management to
maintain quality and food safety? providing the necessary resources for maintaining the quality 20

and safety of products produced.

1.3 Does the Quality and Food Safety Policy include documented
procedures, methods and practices to achieve recognized food 20

safety & quality standards?
1.4 Does the facility have a documented training program on food Documentation must be provided showing evidence that all
safety & quality for all associates including upper individuals involved with food safety have had the appropriate
management? training. For example, all individuals involved with HACCP must 20

have completed a HACCP training course.

1.5 Does the facility have written and documented Good

Manufacturing Practices (GMP's)? 20

1.6 Do all contractors undergo documented GMP training prior to
entry into the facility as appropriate? 20

1.7 Does the facility operate in accordance with the Quality and
Safety policy? 20

1.8 Is the Quality & Safety Policy readily available to relevant
personnel? 20

1.9 Does the facility have a documented procedure for the review
and verification of the Quality & Safety Policy on an annual 20

basis?
1.10 Does the facility have a process to objectively evaluate the
results of planned verifications of the Quality and Safety 20

Policy?
1.11 Are the verification results documented and communicated to
the appropriate personnel having the responsibility to take 20

actions?
1.12 Is the Quality & Safety Policy reviewed on a regular basis to
determine the effectiveness of the procedures and methods? 20

1.13 Does the facility have a current organizational chart which The chart must indicate the reporting structure of all individuals
shows all individuals responsible for food safety and quality? responsible for food safety and quality to upper management 20

and their relationship to each other.
1.14 Does the facility have a designated Quality Assurance or Food
Safety Manager? 20

1.15 Are all required licenses present and current? This refers to licenses issued by local, state or federal
governments. 20

1.16 Does the facility have a system in place to correct all violations
noted on regulatory & third party inspections? 20

1.17 Does the facility have a written records management policy? The policy must include all aspects of record management
including identification, collecting, filing, retention time & 20

disposition.
1.18 Does the facility have a written and documented customer The program must be documented and must include protocols
complaint program? for handling complaints including the identification of parties
responsible for the investigation, time frames for resolution,
follow-up notification to the customer and procedures for 20

closing out the complaint. In addition, corrective actions must
be documented and trend analyses conducted.

1.19 Has the facility completed the required registration with the Auditor must not the FDA registration number on the cover
U.S. Food and Drug Administration (FDA) in accordance page of this report. 20

with the FDA Bioterrorism Act Regulations?

Section Score 380 19 0 0 0 0

Section Score % 100
Section Grade A

Page 3 of 24 Costco FFA 06-02-08

2. Hazard Analysis Critical Control Point (HACCP) / Food Safety System
Section Question
2.0A Is the facility required to have a HACCP Plan either by
government regulation or by the client?
2.0 B If No to Question 2.0 A, do they have a HACCP Plan?
2. Hazard Analysis Critical Control Point (HACCP) / Food Safety System
Section Question
2.1 Does the facility have a HACCP/ food safety team?
2.2 Does the facility have a written Hazard Analysis Critical
Control Point (HACCP) plan?
2.3 Have all critical control points (CCP), critical limits,
monitoring procedures and corrective actions been
correctly identified, documented and implemented?
2.4 Is the HACCP plan or food safety system based on hazard
analysis or assessment of risk?
2.5 Has the HACCP plan or food safety system been
scientifically validated with the supporting documents in
place and available for review?
Audit Guidance YES NO
If NO, Please tick No and Move to Question 2.0 B. If YES,
please tick yes and answer all questions in the HACCP
Section ( 2.1- 2.9). The HACCP Section will be scored if the
facility is required to have a HACCP program in place per
FDA or USDA regulations (all meat, poultry, fish, shell fish,
low acid canned foods, and juice facilities). If the facility is
not required by regulation to have a HACCP plan and the
audit is a first time Costco audit, the following statement
applies."Facilities receiving an initial Costco audit that are
not regulated to have a HACCP program will not fail the
audit on this alone, but will be required to have a full
HACCP program with at least 3 months documentation Answer HACCP
within one year of the audit."Costco believes that a well Section 2.1 - 2.9


implemented HACCP program is a key part of a food safety
program. The auditor must note on the comments page of
this report that the requirement was discussed with the
facility. If on the anniversary date of the audit, this HACCP
requirement is not met, then the plant will receive a critical
non-conformance on question 2.3 and automatic failure.
If the answer is YES, Please tick YES and complete all
Answer HACCP
questions in this section. If no, please tick NO and move to
Section 2.1 - 2.9


Process-Product Controls 3.0
Non-Conformance
Audit Guidance SCORING Compliant N/A MINOR MAJOR CRITICAL
The team should be comprised of key personnel with
adequate training and experience. At least one member 20

must show documentation of HACCP training or the
equivalent.
The HACCP plan must be based on the principles of Codex
Alimentarius or the National Advisory committee on
Microbiological Criteria for Foods (NACMCF). The HACCP
plan must include process flow, Critical Control Points 20

(CCP’s), critical limits, monitoring activities, corrective
actions and verification procedures.
Monitoring procedures must be identified for each CCP &
must include detailed instructions, frequency and
designation of responsibility. Corrective actions for each
CCP must also include detailed instructions, how out of 20

spec product is identified, segregated and handled
(disposed of, reworked, etc.)
The identification of potential hazards and the conduction
of a risk assessment must be conducted & documented by
the HACCP/ food safety team. All potential hazards which 20

may be reasonably expected to occur throughout
processing must be identified.
Documentation must be present for all products produced
(existing and new). Validations must be complete prior to
implementation of the plan and repeated when there is a
change in processing equipment, critical limits or
processing parameters. The validations must demonstrate
20

the overall effectiveness of the plan by measuring the
hazard reductions at each intervention step and
cumulatively over the production process.
Page 4 of 24 Costco FFA 06-02-08
2. Hazard Analysis Critical Control Point (HACCP) / Food Safety System
Non-Conformance
Section Question Audit Guidance SCORING Compliant N/A MINOR MAJOR CRITICAL
2.6 Is the HACCP plan/food safety system verified on a routine Verification may include internal audits, review of records,
basis by established procedures & documented? testing, sampling, etc. 20

2.7 Is the HACCP plan/ food safety system reviewed by
management on an annual basis or when there are process 20

changes?
2.8 Are the HACCP/ food safety system records maintained for at
least one year or as required by legislation? 20

Section Score 160.0 8 0 0 0 0
Section Score % 100
Section Grade A

Page 5 of 24 Costco FFA 06-02-08

3. Process / Product Controls
Non-Conformance
Section Question Audit Guidance SCORING Compliant N/A MINOR MAJOR CRITICAL
3.1 Does the facility maintain product specifications for all raw Specifications may include physical, microbiological,
materials, ingredients & packaging which is available to all chemical and shelf life parameters etc. Supplier test results
relevant personnel? must include lab used, sampling plans, tests performed,
methodologies, etc. Specifications must be readily 20

available & accessible to personnel when needed.

3.2 Are incoming raw materials purchased and received according Raw material specifications must be maintained and available
to written specifications? for review by necessary personnel including receiving staff. 20

3.3 Is there a written & documented program in place to verify raw Verification may include physical checks, microbiological &
materials for compliance to specifications? analytical testing, chemical residue analysis, etc. Raw material
verification must be documented. 20

3.4 Does the facility have a vendor approval process for all
packaging materials, ingredients, services and other items 20

which may impact food safety?
3.5 Does the facility require and maintain letters of guarantee or
Certificates of Analysis (COA) for incoming raw materials, 20

ingredients & packaging?
3.6 Does the facility maintain finished product specifications
which include microbiological, chemical & quality
parameters and are they readily available to relevant staff?
20

3.7 Does the facility have a written and documented inbound Procedures must be in place for examination & documentation
material inspection program? of incoming materials ncluding raw materials and packaging.
Examination must include checks for evidence of pests,
temperature abuse and any other contamination. Records must 20

include corrective actions & disposition of rejected product.

3.8 Does the facility have an internal audit system in place to audit
systems and procedures which are critical to food safety? 20

3.9 Are packaging materials appropriate for the intended use and
purchased according to written specifications? 20

3.10 Does the facility have a written process for changes in The procedure must identify the process in which vendors are
specifications? notified of spec changes and have approved the changes. 20

3.11 Does the facility have a written inventory control procedure to
insure all materials and product are used in the correct order
and within the shelf life parameters? 20

3.12 Are the inventory control procedures being followed? All raw materials used in production must be with-in shelf
life parameters and in proper rotation. 20

3.13 Does the facility have and operate in accordance with a written This section is to be used only if HACCP is not legally required.
& documented food safety system which includes detailed
procedures, instructions and reference documents which cover
all processes critical to product safety & quality?
20

3.14 Are temperatures being properly maintained for potentially Potentially hazardous foods must be maintained at proper
hazardous foods at all times? temperatures at all times including during receipt, storage
and transit of final product. Refrigerated potentially
hazardous foods must be maintained at 41°F or below and
frozen potentially hazardous foods at 0°F or below at all 20

times. Other food products must be maintained at the
appropriate temperatures to maintain product quality.

3.15 Does the facility have written process control procedures? Procedures should describe activities used to monitor
production processes and compliance to product specifications
i.e. Temp., flow rate, viscosity, weights, and other specification 20

parameters

Page 6 of 24 Costco FFA 06-02-08

3. Process / Product Controls
Non-Conformance
Section Question Audit Guidance SCORING Compliant N/A MINOR MAJOR CRITICAL
3.16 Are the process control procedures available to all necessary
personnel? 20

3.17 Does the facility have procedures & systems in place to prevent Examples of systems and procedures would include physical
cross contamination between raw materials, packaging and separation, separate restrooms, color coded uniforms, use of 20

finished products? foot baths, positive air pressure, etc.
3.18 Is there any observation of actual product contamination? Contamination may include cross contamination, foreign
objects, insects, rodent droppings or rodent damage, etc. 20

Section Score 360 18 0 0 0 0
Section Score % 100
Section Grade A

Page 7 of 24 Costco FFA 06-02-08

4. Recall / Traceability
Non-Conformance
Section Question Audit Guidance SCORING Compliant N/A MINOR MAJOR CRITICAL
4.1 Does the facility have a written recall plan which is updated The recall plan must detail how product is identified, traced,
annually, for all products? retrieved, stored and disposed of in the event of a recall. It
must also include the definitions of the types of recalls (Class 1,
2 or 3), a list of key personnel, responsibilities, contact
20

information and storage of recall records.

4.2 Is the recall plan tested and documented at least twice a year? A mock recall must demonstrate the facility’s ability to recall
100% of the product within 4 hours. While on site, the auditor
must conduct a mock recall to test product traceability. Please 20

refer to the Costco SOP's for further instruction.

4.3 Is finished product coded appropriately to allow for full Full traceability must include lot or batch numbers of
recall and traceability? raw materials linked to final product and reworked 20

product.
4.4 Did the on-site recall demonstrate the facility's ability to
recall 100% of the product within 4 hours? 20

4.5 Is rework or carry-over product minimized, documented and
addressed in the recall plan?
20

4.6 Does the facility have a designated secure storage area for
recalled product?
20

4.7 Does the facility's traceability include the processes and Product recovery must account for batch systems, continuous
procedures necessary, such as personnel and communications, processes, product on hold, product destroyed, product in-
for rapid and effective product recovery? transit, shared systems, product returned to the supplier, 20

product sold through alternate channels, donated product and
partially used materials.
Section Score 140 7 0 0 0 0
Section Score % 100
Section Grade A

Page 8 of 24 Costco FFA 06-02-08

5. Sanitation
Non-Conformance
Section Question Audit Guidance SCORING Compliant N/A MINOR MAJOR CRITICAL
5.1 Does the facility have a Master Sanitation Schedule (MSS)? The MSS must show cleaning frequencies, list of all
equipment and areas to be cleaned and to whom those 20

responsibilities are assigned.
5.2 Does the facility have written Standard Sanitation SSOP’s must include standard cleaning methods
Operating Procedures (SSOP’s (chemicals to be used, chemical concentrations, contact
time, temperatures, frequency, rinsing procedures & re-
20

cleaning procedures)
5.3 Do records and inspections indicate that the MSS is being Auditor should inspect equipment (food & non-food) and areas
properly executed? for cleanliness and examine records for proper sign-off & 20

execution.
5.4 Does the facility have measures in place such as a pre- Facility should have a pre-operative inspection program to
operative inspection program, to verify that cleaning verify the effectiveness of cleaning methods. It should
methods are effective and that equipment is in good describe procedures used, methods of verification (rapid
repair? test kits, audits, etc.) and corrective actions. Pre-op
program must also include visual checks of equipment for
20

loose, missing & damaged parts, wear, excessive grease or
scale.

5.5 Does the facility conduct regular, documented sanitation Training should be conducted with sanitation workers at
training? initial hire and at least annually thereafter. 20

5.6 Is there a procedure in place to insure that Clean-in- Place Procedure should be documented and verified to insure
(CIP) product lines are flushed prior to start-up? that no chemical residues remain in the lines prior to start 20

of production.
5.7 Does the facility have a non-food chemical control The program must list all approved cleaning chemicals,
program? proper usage & storage. Chemicals must be properly
labeled and used in accordance with the label.
20

5.8 Are Material Safety Data Sheets (MSDS) available for all non- MSDS must be readily available for review by all
food chemicals used in the facility? associates. 20

5.9 Are test kits available to monitor the concentrations of Documentation must include the type of sanitizer used,
sanitizers used on equipment and are the concentrations concentration, target range and any corrective actions.
monitored and documented?
20

5.10 Is there a system in place for the prevention of cross A program must be in place to insure that cleaning
contamination with cleaning equipment & tools, such as equipment & tools are used only for their intended
labeling or color coding? purposes & on the equipment for which it was intended.
20

5.11 Is all food contact equipment clean and properly stored in a
sanitary manner and re-sanitized prior to use? 20

5.12 Are all hoses stored off of the floor in a sanitary manner to
prevent the contamination of food, food contact surfaces & 20

materials?
5.13 Are all non-food contact areas such as floors, walls, ceilings,
fans, blowers, racks, carts, etc. clean? 20

5.14 Are all floor drains clean and covered with grates?
20

5.15 Is all garbage, trash and other waste materials disposed of in
identified, covered containers? 20

5.16 Are all pallets spaced an adequate distance from walls to
facilitate cleaning and monitoring for pests? 20

5.17 Are wooden pallets prohibited from wet areas?
20

5.18 Are waste containers clearly identified as to their intended
purpose? 20

5.19 Is waste removed from processing areas on a regular basis?
20

Section Score 380 19 0 0 0 0
Section Score % 100
Section Grade A

Page 9 of 24 Costco FFA 06-02-08

6. Worker Health & Hygiene
Non-Conformance
Section Question Audit Guidance SCORING Compliant N/A MINOR MAJOR CRITICAL
6.1 Does the facility have a written personal hygiene policy that is The policy must be reviewed & documented by all associates
adopted by all personnel, including visitors? upon initial hire and by visitors upon entering the facility. The
policy must addresses protective clothing, hair restraints, hand
washing, jewelry, gloves, etc.
20

6.2 Are plant employees wearing company issued, clean uniforms, Clothing, including shoes, must be appropriate for the work
smocks or other protective clothing that is free of buttons & conditions. Dedicated footwear and smocks or uniforms is 20

outer pockets above the waist? required in all ready-to eat & raw areas.
6.3 Are smocks, uniforms or other protective clothing removed prior Smocks, uniforms and other protective clothing such as aprons,
to breaks or entering restrooms and stored in a sanitary must be properly stored on racks in the processing area.
manner? Protective clothing may not be stored in locker rooms. 20

6.4 Are employees following the personal hygiene policy Auditor should observe handwashing practices before
regarding handwashing? starting work, during production, after breaks, sneezing,
after using the restroom or other unsanitary practices. If
sanitizing hand dips are used, the concentration must be
20

checked and documented on a routine basis.

6.5 Are handwashing signs posted above all handsinks in the Handwashing signs must instruct employees to wash hands
facility? after breaks, using the restroom, etc. 20

6.6 Are employees properly wearing hairnets and beard nets when
working around exposed product, packaging and ingredients? 20

6.7 Are employees observed wearing jewelry, nail polish, long or Jewelry, except for plain wedding bands, should not be worn.
fake fingernails? Watches, long fingernails and fake fingernails are also not 20

permitted.
6.8 Are eating, drinking, chewing gum or tobacco and smoking
prohibited from production and warehouse areas? 20

6.9 Do employees have a designated break area with refrigeration Associates may not store food items in locker rooms, restrooms,
for storage of personal food items away from food production warehouse or coolers. 20

and storage areas?
6.10 Are employees with symptoms of illness or open wounds The facility should have a medical screening procedure for
excluded from working in processing areas or around associates and visitors that have access to these areas.
exposed product or packaging? The procedure must describe how supervisors manage
employee health issues. Auditor should look for signs of
20

illness or open wounds.

6.11 Is there a written glove use policy that prohibits bare hand The glove use policy should address the types of gloves
contact with ready-to eat foods? permitted and proper use. Gloves must be in good
condition, clean and sanitary. Disposable gloves must be
worn with ready-to eat foods and are intended for single 20

use. Non-disposable gloves must be properly maintained to
prevent contamination.

6.12 Are gloves being properly worn by employees?
6.13 Are restrooms & break areas adequate, properly stocked and
all fixtures functioning properly?
Associates must be wearing gloves as required and
changing gloves as required or needed. For example,
gloves must be changed after each activity.
20

Restrooms and break areas must have adequate handwashing
facilites with hot and cold or tempered running water.
Handwashing stations must be adequately stocked with soap &
disposable towels. Restroom doors must be self-closing and 20

cannot open into production areas.

Section Score 260 13 0 0 0 0

Section Score % 100
Section Grade A

Page 10 of 24 Costco FFA 06-02-08

7. Physical Plant & Equipment
Non-Conformance
Section Question Audit Guidance SCORING Compliant N/A MINOR MAJOR CRITICAL
7.1 Is the exterior of the facility including the grounds, parking lot & The grounds and parking lots must be graded to prevent
dumpster areas maintained in a clean and sanitary manner? standing water. Vegetation next to the building should be
minimal and must be properly maintained to prevent harborage 20

of pests.

7.2 Is the facility designed, constructed and maintained to control Flow of product and materials through the facility must be
the risk of product contamination? designed to minimize the risk of cross contamination. 20

7.3 Are there an adequate number of accessible handsinks at the Handsinks must be convenient & accessible to employees.
entrances of and in food handling and processing areas? Handsinks may not be blocked by equipment or used for 20

storage.
7.4 Are all handsinks in processing and food handling areas Handsinks in food processing areas must be operable with a
supplied with hot & cold (or tempered) water under pressure foot pedal, electronic sensor or knee pedal or some other 20

and “hands free”? method to allow for “hands free” operation.
7.5 Are walls properly designed, constructed, finished and Walls must be constructed of durable, cleanable materials and
maintained? in such a manner to prevent the accumulation of dirt & mold 20

and to facilitate cleaning.
7.6 Are the floors properly designed, constructed, finished and Floors must be constructed of durable, impervious materials
maintained? and designed to meet the needs of the process & properly
drained. Floor wall junctures should be properly coved to 20

facilitate cleaning.

7.7 Are all floor drains properly constructed, easily cleaned Floor drains must be of sanitary construction, provided with
,covered with a removable grate and functional? traps and vented to the outside. 20

7.8 Are ceilings provided in all processing areas and properly Ceilings must be constructed of proper materials to prevent the
designed, constructed, finished and maintained? accumulation of dirt, mold, condensation and to facilitate 20

cleaning.
7.9 Are all external doors tightly self closing and adequately Dock levelers must also be tight with no openings to the
proofed against flies and vermin? outside. 20

7.10 Are all windows that are designed to be opened, adequately
screened to prevent the entry of pests? 20

7.11 Is there adequate lighting throughout all areas of the facility to
facilitate cleaning & sanitation?? 20

7.12 Are all lights in throughout the plant shielded or shatter proof? Lights must be shielded or shatterproof in all production and
storage areas including receiving, docks and storage areas. 20

7.13 Is the facility properly ventilated and is the system properly Adequate ventilation must be provided throughout the facility
maintained? including processing areas to properly exhaust all steam, heat,
fumes, etc. to the outside. Ventilation systems must be properly
designed and easily maintained.
20

7.14 Is the water supply to the facility and water used for Water must be tested for potability on a regular basis and
processing, steam & ice adequate & potable? results must be available for review by the auditor. The
volume of water must be sufficient to allow for times of 20

maximum production capacity.

7.15 Is ice made from a potable water source and stored in a clean
& sanitary manner? 20

7.16 Are all water systems protected from back flow and cross Back flow prevention devices must be installed on all hose
connections? Are all back flow devices checked on a routine bibbs: water lines & equipment must be protected from cross
basis to verify functionality? connections, submerged inlets, etc. Facility must maintain
inspection and test records of all backflow devices.
20

7.17 Are there any treatment systems on water lines such as filters, Auditor should examine the maintenance records of any water
chlorination systems, softeners, etc. and if so, are they treatment systems. 20

maintained on a routine basis?
7.18 Are all food contact surfaces designed for the intended purpose Food contact equipment must be durable, cleanable and
and made of materials appropriate to the application? designed in such a manner as to minimize the risk of product
contamination. Surfaces must be smooth, impervious, non- 20

toxic, non-absorbent and durable.

7.19 Is all food contact equipment clean and in good repair with no
temporary repairs that may affect food safety and quality? 20

7.20 Is broken and malfunctioning equipment identified and tagged
or removed from the floor? 20

Page 11 of 24 Costco FFA 06-02-08

7. Physical Plant & Equipment
Non-Conformance
Section Question Audit Guidance SCORING Compliant N/A MINOR MAJOR CRITICAL
7.21 Are reusable containers clearly marked or color-coded for their Re-usable containers would include rework, edible product,
designated purpose? bulk storage bins, etc. 20

7.22 Is all non-food contact equipment clean and in good repair?
20

7.23 Is all equipment installed in a manner to facilitate maintenance
and cleanability? 20

7.24 Are all ladders, bridges and walkway that span exposed
product areas, shielded to prevent product contamination? 20

7.25 Does the facility have a metal detection or foreign material The facility should have a written program that identifies all
program? metal detectors or foreign material control devices
(screens, filters, sieves, etc.) and their location. Costco's
preferred method of foreign material detection is X-ray.
However, at a minimum, a metal detection system should
be utilized and installed as close to final packaging as
possible. The metal detection system must be calibrated at
least hourly with sizes defined in the product
specifications using ferrous, non-ferrous and stainless
steel #304 standards. Calibration checks must be 20

documented and corrective action procedures must also
be implemented and documented. The auditor must note
the type of foreign material detection used in the facility. IF
the facility is not using X-ray or metal detection, then the
audtor must follow the further instructions in the Costco
SOP's.

7.26 Does the facility have a written & documented glass and brittle The facility must have written glass breakage procedures
plastic control policy and breakage procedure? including instructions for line stoppage, segregation of product,
clean-up, inspection and re-start. 20

7.27 Does the facility have a written & documented wood control All wood used in the facility must be documented (pallets,
policy? building materials, etc.). Wood control programs must also be
documented & implemented (i.e., slip sheets, pallet controls, 20

etc.)

7.28 Are all refrigeration units maintaining proper temperatures Freezers used for the storage of potentially hazardous
according to product type and equipped with foods must maintain 0°F (-17.8°C) or below and coolers
thermometers? 41°F (4.5°C) and below. Thermometers must be present in
all refrigeration units and the temperatures recorded in a
20

log, at least twice a day.

7.29 Does the sewage disposal system properly and effectively Auditor should look for evidence of an active sewage back-
dispose of all sewage and waste water? up in food processing and storage areas. 20

Section Score 580 29 0 0 0 0
Section Score % 100
Section Grade A

Page 12 of 24 Costco FFA 06-02-08

8. Grounds & Maintenance
Non-Conformance
Section Question Audit Guidance SCORING Compliant N/A MINOR MAJOR CRITICAL
8.1 Does the facility have a written preventive maintenance The program must include the list of equipment, maintenance
program which covers all equipment and facilities to keep them frequencies, documented training for personnel &
in a sanitary and operative condition? accountability. Maintenance records must also be maintained
and emergency maintenance logged, for the duration of the
20

shelf life of products produced.

8.2 Does the maintenance program insure that all outside

contractors engaged in work in any food storage or production
area, are aware of the company’s processing and personal 20

hygiene policies?

8.3 Are outside contractors provided with protective clothing as

required? 20

8.4 Do outside contractors notify maintenance personnel when
work has been completed and in the event of any breakage or 20

damage that may affect product?
8.5 Does the maintenance program limit work to non-processing
times as much as possible? 20

8.6 Does the maintenance program include a temporary repair Auditor should note any temporary repairs in the facility and if
policy? present, they may not interfere with sanitation, potentially
contaminate product or provide pest harborage. 20

8.7 Does the maintenance program include an inventory for parts & Inventory controls must exist to reconcile parts and tools
tools to insure that are parts are accounted for following repairs following maintenance or repairs. 20

or maintenance?
8.8 Following maintenance or repairs, is the equipment cleaned
and sanitized and the task documented, before being returned 20

for use in food production?
8.9 Are all food contact lubricants and process aides of food
grade,properly labeled and used? 20

Section Score 180 9 0 0 0 0
Section Score % 100
Section Grade A

Page 13 of 24 Costco FFA 06-02-08

9. Pest Control
Non-Conformance
Section Question Audit Guidance SCORING Compliant N/A MINOR MAJOR CRITICAL
9.1 A written pest control program has been established. It Program must include service reports, identification of
must include a designated pest control operator (internal or target pests, list of pesticides used, map of facility showing
an outside service), scheuled frequency of service, and a the location of all pest control devices, MSDS sheets and
current map, updated, annually, showing the locaiton and specimen labels. All pest control records must be available
type of all pest control devices (internal and external). and maintained. All pesticides must be used in accordance 20

Ensure that there is no evidend of, spiders, rodents or with label instructions.
birds on or in any food ingredients, product or packaging
material.

9.2 If the facility is serviced by an outside provider, is a copy of the If in-house services are used, the responsible parties must be
technician’s license on file? If performed by in-house identified and licensed/ certified. It is also acceptable for those
personnel, are they properly licensed and trained? parties to be under the direct supervision of someone who is 20

licensed or certified.

9.3 Do pest control records indicate noted activity, deficiencies in

the plant or structure that may lead to a pest problem and 20

corrective actions?
9.4 Are there an adequate number of rodent control devices in the Interior rodent control devices should be spaced along exterior
facility? walls and on either side of exit doors. 20

9.5 Are there an adequate number of exterior bait stations? Bait stations must be secured and placed around the exterior of
the facility. The stations must be clean, baited, locked and in
good repair. Bait stations are not permitted in the interior of the 20

facility.

9.6 Are flying insect traps properly located near exterior doors? Only non-electrocuting devices are permitted in food
processing and storage areas. 20

9.7 If pesticides are stored on site for an in-house program are they
properly stored & labeled in a designated, restricted and locked 20

area?
9.8 Is the pest control program effective? Evidence of decomposed pests (rodents), and droppings,
anywhere in the interior of the facility, including pest control
devices, is evidence that the pest control program is not
effective. In addition, any observation of ingredients, product or
packaging that is observed to be contaminated with insects, 20

spiders, rodents or birds is also evidence of non-compliance to
this question.

9.9 Are domestic animals prohibited from the premises?

20

9.10
There is no evidence of insects, spiders, rodents or birds on or 20

in any food ingredients, products or packaging materials.
Section Score 200 10 0 0 0 0
Section Score % 100
Section Grade A

Page 14 of 24 Costco FFA 06-02-08

10. Operational Practices
Non-Conformance
Section Question Audit Guidance SCORING Compliant N/A MINOR MAJOR CRITICAL
10.1 Does the facility have a written inbound receiving program The program must include documentation & acceptable
for all food and packaging materials? parameters of trailer conditions, condition of product,
temperatures & code dates. The written program must be 20

available for all receiving personnel.

10.2 Does the facility have a written procedure for handling rejected Procedures must describe how rejected products will be
inbound products? protected from contamination or segregated to prevent 20

contamination.
10.3 Are inbound bulk raw materials protected from Transfer hoses must be capped and stored in a sanitary
contamination during unloading? manner. Connection ports must be capped when not in 20

use.
10.4 Does the facility have a pallet management program including Pallets should be inspected for cleanliness and physical
specifications for pallets? condition upon receipt and prior to reuse. Wooden pallets
should be examined for cleanliness, splintered wood and loose 20

nails.

10.5 Does the facility have a program to check tanker logs to Previous loads must not have been anything other than a
verify that the 3 previous loads were acceptable food grade commodity. For example, it is unacceptable for
commodities? the tanker to have been used for wastewater prior to 20

carrying a food grade commodity.

10.6 Are receipt dates clearly marked on all incoming materials?

20

10.7 Are all packaging materials, raw materials and finished All packaging materials, raw ingredients and finished
product stored properly in a manner to protect from product must be stored off of the floor and away from walls
contamination and to preserve quality? and ceilings.
20

10.8 Does the facility have a written procedure & documentation Instruments must be checked for accuracy on a frequent
for routine calibration of all measuring devices including basis. Calibrations must be recorded and the records kept
thermometers and other instruments used in production? on file.
20

10.9 Are all processing chemicals food grade and used at the
proper concentrations and only for their intended purpose? 20

10.10 Are all processing chemicals properly labeled and stored? Processing chemicals must be stored separately from
production and food storage areas. 20

10.11 If re-circulated or batch washing systems are used, are the The concentrations or ORP (oxygen reduction potential) of
disinfectant levels properly maintained and documented in disinfectants or anti-microbials must be monitored and
order to reduce the potential of cross contamination? documented.
20

Section Score 220 11 0 0 0 0
Section Score % 100
Section Grade A

Page 15 of 24 Costco FFA 06-02-08

11. Food Security / Emergency Preparedness
Non-Conformance
Section Question Audit Guidance SCORING Compliant N/A MINOR MAJOR CRITICAL
11.1 Does the facility have a written Food Security Program The facility must show documentation of the methods and
based on a food security risk assessment? tools used to perform the food risk assessment. The
program must include the names of persons responsible 20

for the food security program.

11.2 Has the risk assessment been utilized to implement the food
security program? 20

11.3 Are emergency contact numbers for management, law
enforcement and regulatory agencies posted and maintained? 20

11.4 Does the facility restrict access to all areas of the plant
including receiving, manufacturing, and storage areas to only 20

authorized personnel?
11.5 Is visitor access (including off duty personnel, contractors, and Visitors must be provided with identification and accompanied
regulatory inspectors) strictly controlled? at all times by plant personnel. 20

11.6 Are screening processes used for new/potential employees to Background checks should be performed on all new employees
determine suitability? including part time and temporary. 20

11.7 Is the food security program reviewed and updated on a regular
basis? 20

11.8 Is documented training of all personnel regarding the food
security program conducted on a regular basis? 20

11.9 Are incoming materials (packaging, food) inspected for Inbound freight must have tamper evident indicators such as a
evidence of product tampering? seal or standard operating procedures to detect product 20

tampering or unusual events.
11.10 Are outbound shipments secured with means to detect Outbound trailers for example, must be locked & sealed.
evidence of product tampering? 20

11.11 Does the facility have an emergency preparedness plan to Examples of an emergency or natural disaster would be power
identify food handling & storage procedures during an outages, sewage back-ups, lack of potable water, hurricanes, 20

emergency or natural disaster? floods, etc.
11.12 Do the supplier's security measures address the security of
external storage vessels such as flour silos, water tanks, oil 20

tanks etc.?
11.13 Does the supplier's security measures include mail handling
procedures? 20

11.14 Does the supplier's security measures include actions plans to
be initiated if security is compromised? 20

Section Score 280 14 0 0 0 0
Section Score % 100
Section Grade A

Page 16 of 24 Costco FFA 06-02-08

12. Testing
Non-Conformance
Section Question Audit Guidance SCORING Compliant N/A MINOR MAJOR CRITICAL
12.1 Does the facility have a written microbiological testing The program must include target organisms, testing
program (if applicable)? frequency, sampling procedures, monitoring methods,
acceptable limits, re-sampling procedures, corrective
actions, etc. for raw materials, finished product,
20

environmental monitoring and sanitation.

12.2 Does the facility monitor and track trends of microbial test
results? 20

12.3 Does the facility have a written analytical testing program Analytical testing for food safety systems includes pH,
as part of their HACCP or food safety system (if pesticides, heavy metals, water activity, salt, etc. 20

applicable)?
12.4 Is the validity of the laboratory results (in –house or GLP’s must include trained laboratory personnel,
contracted) assured through the use of Good Laboratory documented quality control procedures, use of recognized
Practices (GLP’s) or other recognized practices? methodologies, and participation in a check sampling
20

program.
12.5 If the facililty has an in-house laboratory, does the supplier
have documented procedures for approving and validating 20

laboratory methods?
12.6 Does the facility have documented procedures for the
calibration and scheduled maintenance of all testing 20

equipment?
12.7 Does the facility have written protocols for the handling of Protocols must include the handling & disposition of product.
ingredients or products that are not with-in specifications? 20

12.8 Does the facility have a written and documented environmental
monitoring program using the appropriate indicator organisms
and/or pathogens where appropriate? 20

12.9 Are shelf life samples held and evaluated?

20

12.10 If the facility has an in-house laboratory, is it adequately In-house laboratories should not be located near production
segregated with limited access to prevent cross contamination areas. Access to laboratories should be limited to laboratory
from processing areas? personnel only.** Auditor must note the types of testing
performed in house including pathogen testing (in-house or
20

outside lab).

12.11 Are procedures in place to insure that laboratory personnel To avoid the risk of microbiological or chemical contamination,
remove their frocks before leaving the laboratory? frocks worn in the laboratory should not be worn outside the 20

lab.
12.12 Does the facility have documented procedures to prevent the Procedures must include segregation of non-conforming
shipment of non-conforming product? product from acceptable product to ensure that it is not
shipped. Procedures must also be in place to monitor, track 20

and dispose of such product.

Section Score 240 12 0 0 0 0

Section Score % 100
Section Grade A

Page 17 of 24 Costco FFA 06-02-08

13. Food Allergens / Labeling
Non-Conformance
Section food2ndffa Audit Guidance SCORING Compliant N/A MINOR MAJOR CRITICAL
13.1 Are food allergens & sensitizing ingredients used in the facility Allergens include the 8 major allergens of concern recognized
clearly identified? by FDA and Codex. They are: peanuts, tree nuts, soy, milk,
egg, wheat, fin fish and crustaceans. Sensitizing ingredients
such as sulfites and Yellow #5 must also be identified if
applicable. Allergens and sensitizing ingredients from
20

incidental additives must also be identified.

13.2 Does the facility include allergen and sensitive ingredient

assessment as part of the HACCP assessment? 20

13.3 Does the facility have written allergen control procedures in Procedures must address product flow throughout the
place to prevent the cross contamination of non-allergic plant, storage, equipment cleaning, dedicated utensils,
ingredients with allergens? changeover, rework, etc.
20

13.4 Does the facility have written labeling and packaging Documented procedures must insure that all allergens are
procedures to insure that labels are correct in regards to declared on the label. 20

allergens?
13.5 Is there any evidence of potential or actual allergen cross
contamination?
20

13.6 Is the allergen control program monitored and reviewed for Auditor should request evidence from the facility that customer
effectiveness? complaints are investigated and changes made as necessary 20

regarding allergen issues.
13.7 Does the facility have a documented procedure for the The procedure must describe how label information is obtained
development, review and approval of labels? and verified to insure it complies with regulatory requirements. 20

13.8 Does the facility have a documented label control program to The program must describe the handling of labels including
insure the proper labeling of products on production lines? changes during production. 20

13.9 Is all Costco product properly labeled? Auditor must randomly check some Costco products while on
site for product name, name of manufacturer, presence of
nutritional information, ingredient statement and Country of
Origin Labeling (COOL) (if applicable). NOTE : COOL applies 20

to beef, pork, lamb, perishable agricultural commodities and
peanuts.

Section Score 180 9 0 0 0 0

Section Score % 100
Section Grade A

Page 18 of 24 Costco FFA 06-02-08

14. Transportation
Non-Conformance
Section Question Audit Guidance SCORING Compliant N/A MINOR MAJOR CRITICAL
14.1 Are all outbound trailers in good repair, clean, inspected and if
refrigerated, pre-chilled prior to loading? 20

14.2 Are records of trailer conditions (cleanliness, temperature, etc.)
accessible and available for review? 20

14.3 Are temperatures of refrigerated trailers monitored and
documented during transit with records available for review? 20

Section Score 60 3 0 0 0 0
Section Score % 100
Section Grade A

Page 19 of 24 Costco FFA 06-02-08

 COMMENTS

1. Administration & Regulatory Compliance

2. Hazard Analysis Critical Control Point (HACCP) / Food Safety System

NOTE: In the event that the plant does not have a functioning HACCP plan for Costco products, the auditor must give notification to the plant regarding the Costco
requirements. Refer to question 2.0 A and the Costco audit SOP's. The auditor and the supplier representative must both sign that notice was given and understood. Auditor
signature: Signature of Supplier representative:

3. Process / Product Controls

4. Recall / Traceability

5. Sanitation

6. Worker Health & Hygiene

7. Physical Plant & Equipment

Page 20 of 24 Costco FFA 06-02-08

 COMMENTS

8. Grounds & Maintenance

9. Pest Control

10. Operational Practices

11. Food Security / Emergency Preparedness

12. Testing

13. Food Allergens / Labeling

14. Transportation

Page 21 of 24 Costco FFA 06-02-08

 CORRECTIVE ACTIONS

Audit Required Date

Question Detail of Non-compliance Items Corrective Actions to be Taken of Completion

Page 22 of 24 Costco FFA 06-02-08

 COSTCO AUTOMATIC FAILURES

Note: the failure of any one of these questions is cause for automatic failure of the audit. These questions
are in bold type and highlighted in yellow on the checklist. Please notify the SGS Costco Acct. manager
within 24 hours of completion of the audit if there is a failure of any one of these questions.

Reference Description

1.5 Does the facility have written and documented Good Manufacturing Practices (GMP's)?

Has the facilty completed the required registration with the U.S. Food and Drug Administration (FDA) in accordance with the FDA
1.19
Bioterrorism Act Regulations?
Have all critical control points (CCP), critical limits, monitoring procedures and corrective actions been correctly identified, documented
2.3
and implemented?

3.18 Is there any observation of actual product contamination?

4.3 Is finished product coded appropriately to allow for full recall and traceability?

Are employees with symptoms of illness or open wounds excluded from working in processing areas or around exposed product or
6.10
packaging?

7.14 Is the water supply to the facility and water used for processing, steam & ice adequate & potable?

A written pest control program has been established. It must include a designated outside service pest control operator, scheuled
frequency of service, and a current map, updated, annually, showing the locaiton and type of all pest control devices (internal and
9.1 external). Ensure that there is no evidence of, spiders, rodents or birds on or in any food ingredients, product or packaging material.

9.10 There is no evidence of insects, spiders, rodents or birds on or in any food ingredients, products or packaging materials.
Does the facility have written allergen control procedures in place to prevent the cross contamination of non-allergic ingredients with
13.3
allergens?

Page 23 of 24 Costco FFA 06-02-08

 SIGNATURE PAGE

Attendees of Closing Meeting

Auditor(s) Facility Representatives

Page 24 of 24 Costco FFA 06-02-08