FOOD STANDARDS AUSTRALIA NEW ZEALAND SAFE FOOD AUSTRALIA APPENDICES 226

Appendix 8: Template examples

The following templates are provided for information and can be adapted or combined to suit
specific business needs. Blank templates are also available on our website and from jurisdictional
food regulatory agencies.
Examples of what you might record are provided in each template in this chapter.
Template Description
1 – Supplier details Used to record your suppliers’ details and the
products they supply.
2 – Food receipt Used to record the condition of received goods.
3 – Cooking and cooling food Used to monitor the cooking and cooling times and
temperatures.
4 – Temperature record sheet: Used to monitor the temperature of foods, for
e.g. for food display example, being displayed.
5 – Log for 2-hour/4-hour rule Used to monitor food temperatures while they are in
the ‘danger zone’.
APPENDICES6 – Cleaning and sanitising Used to show what needs to be cleaned, the method, APPEN
procedure and who is responsible for cleaning and sanitising.
7 – Cleaning and sanitising Used to record your cleaning schedule (2 weeks). It
record may be useful to adapt this template for daily, weekly,
fortnightly and/or annual cleaning and sanitising
schedules and checklists.
8 – General temperature Can be adapted for multiple activities to record food
record temperatures (reheating, cooking, transport).

Appendix 8:Template 1 — Supplier details

Template examples Appen

AUSTRALIA NEW ZEALAND FOOD STANDARDS CODE CHAPTER 3 (AUSTRALIA ONLY)

227 APPENDICES FOOD STANDARDS AUSTRALIA NEW ZEALAND SAFE FOOD AUSTRALIA

Supplier agreement in Consider setting up supplier agreements or an app

place, check delivery
truck 1 x /month

Notes

Cheese, Sourdough
Foods supplied Maintain up-to-date records of your suppliers and the p

Reject suppliers that do not supply food th

/15 Lancaster Pl, Majura requirements.
with.
APPENDICES
4

Park, ACT
Address

Contact details
(02) AH 0444
6271 12345
2222
Appendix 8: Template examples

FS Food
Supplier Delivery
name products.

suitable

Template 2 — Food receipt

A GUIDE TO THE FOOD SAFETY STANDARDS FOURTH EDITION FEBRUARY 2023

 FOOD STANDARDS AUSTRALIA NEW ZEALAND SAFE FOOD AUSTRALIA APPENDICES 228

Goods received under agreed conditions. Frozen food

Checked
by
MR correctly labelled, correct temperature, date marki
Truck inspected – date).
action /clean,
Notes Determine if the received goods sho
temp OK
or
Corrective

APPEN
disposed.
°C Frozen
Package hard
intact,
Condition/
5
Tem
p
Product (name
Frozen spinach - Hot
Cold foods
foods should
should bebe kept
kept atat
5°C60°C or above
or below (u
(unle
alternative)
alternative)
validated
Cheese – 007 validated
. .
and lot)
P0P13
Appen
FS Food
Delivery
Supplier’s details included in shipment.
Supplier
Product name and lot identified.

Time08:00

23
/2/ Check:
Dat 3
e » » » » » »
Template 3 — Cooking and cooling food

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229 APPENDICES FOOD STANDARDS AUSTRALIA NEW ZEALAND SAFE FOOD AUSTRALIA

APPENDICES

Appendix 8: Template examples

Template 4 – Food temperature record sheet (multi use): e.g. for food display

A GUIDE TO THE FOOD SAFETY STANDARDS FOURTH EDITION FEBRUARY 2023

 FOOD STANDARDS AUSTRALIA NEW ZEALAND SAFE FOOD AUSTRALIA APPENDICES 230

APPEN

Appen

Template 5 — Log for 2-hour/4-hour rule

AUSTRALIA NEW ZEALAND FOOD STANDARDS CODE CHAPTER 3 (AUSTRALIA ONLY)

 231

APPENDICES
Foo Dat -
d e
Time )out of Activity (e.g. food prep, display, Time back Totaltime hr/4-hr action (re Staff
refrigeration transport.) in temp out refrigerate/ use/ or discard seeinitials
above 5°C control
) below)
2-
APPENDICES

( ≤5°C
(
Meat & salad 22 am Sandwich prep pm 30 min Back in fridge 1 MR
3 /11/ 10:30 11:00
sandwiches

Appendix 8: Template examples

noon Display for lunch on top of lunch pm 1 h 30 Put 10 sandwiches back in
12 1:30 prep=
counter + fridge 1 DC
302hr

pm Remain on display on top of lunch h 30 h limit, discarded left

3:30 4
counter 3 30 overs DC
+prep=4

4pm saved from lunch, pm 2hr +

4hhours Only one left, discarded
for quick 6:00
display
placed onsale
top at
of end of = 2h DC
the day
counter
10
-
Fresh cream 22 11am Buns from fridge to display table 3pm 4h Discarded remaining
filled buns 4 /11/ front of shop for quick sale AC
Sliced ham for 22 am Placed ham on bench for use for am 2h Wrapped portion left, marked SN
5 /11/ 8:00 10:00
croissants breakfast croissants with today’s date & noted 2
hours left for tomorrow, put

Template 6 — Cleaning and sanitising procedure

back in coolroom

Sliced ham for 22 am Placed ham on bench for use for 2h Discarded remaining SN

A GUIDE TO THE FOOD SAFETY STANDARDS FOURTH EDITION FEBRUARY 2023

6 /11/ 8:00 10am
croissants breakfast croissants – day 2
» If food is kept between 5°C and 60°C, this temperature mustrecorded
be monitored and
» Each time period that food is kept between 5°C and 60°C, add
. time.
up to reach a total
» Potentially hazardous food that has been kept between 5°C and 60°C for less than two hoursimmediately
must be refrigerated or used
» Potentially hazardous food that has been kept between 5°C and 60°C for longer than two hours. but less than four hours must be used immediately
and not put back inrefrigerator
the
» Potentially hazardous than four hours must be
. food that has been kept between 5°C and 60°C for longerdiscarded.
FOOD STANDARDS AUSTRALIA NEW ZEALAND SAFE FOOD AUSTRALIA
 Item/
equipmen How Cleaning method Sanitising method Responsibility Comment
e.g.Baint marie Daily often Turn off power, drain Mix 5ml concentrated Kitchen hand - MR s
Chemicals, cloths, and
out water, discard bleach in 10L warm gloves in cupboard
food left in trays. water in sink (use under sink.Make fresh
Remove trays and gloves). Soak trays bleach solution daily
grids and pre-rinse in sink for 5 mins.
them with warm Wet a clean cloth in
water. Wash in warm bleach solution and
soapy water (use wipe inside of bain
“Supersoap” detergent marie.Place trays
and scrubber). Rinse on clean tea towel on
in clean hot water. bench to air dry.
Wipe inside of bain
marie.

» Use warm to hot water to help remove grease etc.

» Use an effective detergent for your application (depends on residue/equipment).
» Ensure that the surface looks, feels, and clean.
smells
» Use a sanitiser after cleaning, for all food contact surfaces.

Template 7 — Cleaning and sanitising record (2 weeks)

» Follow the manufacturer’s instructions for all chemicals.
» Take care to not re-contaminate surfaces and equipment after sanitising.
cleaning and
FOOD STANDARDS AUSTRALIA NEW ZEALAND SAFE FOOD AUSTRALIA

AUSTRALIA NEW ZEALAND FOOD STANDARDS CODE CHAPTER 3 (AUSTRALIA ONLY)

APPENDICES
232

Appen
APPEN
 233

APPENDICES
22 /11/22
Area/ Frequency Person(s) Week starting date:
/11/ Week starting21date:
equipment responsible 14
Meat slicer Daily or WH, LK Sun Mon Tu We Thu Fr Sat Sun Mon Tu We Thu Fr Sat
APPENDICES

after each e d i e d i
use

refrigeration
Bain marie Weekly LK WH LK LK WH WH LK LK LK LK LK WH WH WH

Appendix 8: Template examples

AC

Stick After each KF AC A

blender use C
Benches Daily KF KF KF KF KF KF KF KF KF
X X X X X X
Food Daily when KF,
processo used WH
r

Supervisor to initial when task NG NG

completed to satisfaction. Use X when
not used.
Ensure that food preparation areas/ equipment are free from food waste, odoursdirt, grease,
and .
Follow the manufacturer’s instructions when cleaning
equipment

A GUIDE TO THE FOOD SAFETY STANDARDS FOURTH EDITION FEBRUARY 2023

specific .
Ensure staff have the knowledge and skills to effectively
sanitise.
clean
and
Don’t forget less obvious areas like extraction filters, cool room ceilings, plastic door strips, toilet doors, ceiling fans, and light
switches.
FOOD STANDARDS AUSTRALIA NEW ZEALAND SAFE FOOD AUSTRALIA

Template 8 – General temperature record (multi-use) e.g. cooking, reheating,

 FOOD STANDARDS AUSTRALIA NEW ZEALAND SAFE FOOD AUSTRALIA APPENDICES 234

AUSTRALIA NEW ZEALAND FOOD STANDARDS CODE CHAPTER 3 (AUSTRALIA ONLY)