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    HACCP and preventive control monitoring log template

    This is the sheet where you write down, every time you check it, the actual value of a critical control point (CCP) or other preventive control, such as a cooking or refrigeration temperature. Facilities subject to FDA's preventive controls rule (21 CFR 117, subpart C) need it, because the rule requires them to document the monitoring of preventive controls (21 CFR 117.145(c) and 117.190(a)(2)). The columns follow what every record under that rule must include (21 CFR 117.305).

    How to use this template

    1. Use one sheet per preventive control or CCP. At the top, write the facility name, its location, the product and the period the sheet covers.
    2. Copy the controlled parameter and the limit (minimum or maximum value) from your food safety plan; process controls must include those parameters and values (21 CFR 117.135(c)(1)).
    3. Monitor at the frequency your written procedure sets and record the actual value at the time, with date, time and initials (21 CFR 117.145(a) and 117.305).
    4. If a value is outside the limit, write the corrective action or correction and document it in your corrective action record (21 CFR 117.150(d)).
    5. Hand the sheet in for review: the reviewer signs and dates the verification line (21 CFR 117.165(a)(4)(i)).
    • FDA's rule calls "preventive controls" what many know as HACCP; they include controls at critical control points, if there are any, and other controls appropriate for food safety (21 CFR 117.135(a)(2)).
    • If your activity is subject to the seafood HACCP rule (21 CFR 123) or the juice HACCP rule (21 CFR 120) and you comply with it, subparts C and G of Part 117 do not apply to that activity (21 CFR 117.5(b) and (c)).
    • For refrigeration temperature of food that needs time/temperature control, the record may be affirmative (showing temperature is controlled) or an exception record (showing loss of control) (21 CFR 117.145(c)(2)).
    • Every Part 117 record must include information to identify the plant or facility (name and, when necessary, location), the date and, when appropriate, the time of the activity, the signature or initials of the person performing it and, where appropriate, the product identity and lot code (21 CFR 117.305(f)).
    • The record must contain the actual values and observations obtained during monitoring, be accurate, indelible and legible, and be created concurrently with the activity (21 CFR 117.305(b) through (d)). Write in ink, not pencil, and do not fill it in from memory at the end of the shift.
    • Monitoring and corrective action records must be reviewed within 7 working days after they are created, by (or under the oversight of) a preventive controls qualified individual (PCQI), or within a reasonable timeframe if the PCQI prepares a written justification for a longer one (21 CFR 117.165(a)(4)(i)).
    • Keep the records at the facility for at least 2 years after the date they were prepared. They may be stored offsite (except the food safety plan) if they can be retrieved and provided onsite within 24 hours of a request for official review; electronic records accessible from an onsite location count as onsite (21 CFR 117.315(a)(1) and (c)).

    Form preview

    PDF ready to print on landscape letter paper, with the instructions on page two. Excel to fill in on a computer.

    HACCP and preventive control monitoring log template

    Sheet ____ of ____

    Company / facility:
    Location (address):
    Product / area / line:
    Period (from / to):
    #DateTimePreventive control / CCPParameter and limitActual value observedWithin limit? (Y/N)Product and lot codeCorrective action or correctionInitials
    1
    2
    3
    4
    5
    6
    7
    8
    9
    10
    11
    12
    13
    14
    15
    Monitored by (name):
    Reviewed by (PCQI or under PCQI oversight): signature and date:

    Free template from stratumpr.com. Adapt it to your food safety plan; it does not replace it. 21 CFR 117.135 · 21 CFR 117.145 · 21 CFR 117.150

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