Mandatory Appendices Table of Contents

Form 1: Kitchen Facility Maintenance Internal Audit Checklist

Form 2: Standards Maintenance Internal Audit Checklist

Form 3: Temperature Monitoring Record – Food Storage

Form 4: Temperature Monitoring Record – Cooking/Reheating

Form 5: Temperature Monitoring Record – Cooling of Foods

Form 6: Temperature Monitoring Record – Food Display

Form 7: Temperature Monitoring Record – Dish & Glass Washer

Form 8: Temperature Monitoring Record – Outdoor Catering

Form 8a: Take Away Food Product Waiver (Request for Leftover Goods)

Form 9: Hotel Food Suppliers Site Questionnaire

Form 9a: Hotel Supplier Approval Application

Form 9b: Supplier Approval Letter

Form 9c: Approved Site Food Product Suppliers List

Form 10: Food Product Receival Record

Form 10a: Food Product Monitoring Record

Form 10b: Food Product Delivery Record

Form 10c: Food Product Rejection Record

Form 10d: Food Product Defrost/Thawing Record

Form 11: Shift Pre Start Condition Checklist

Form 12: Cleaning Schedule Record

Form 13: Alleged Foreign Material/s Contamination Record

Form 14: Allegation Record (Food Poisoning) Instructions

Form 15a: Allegation Record (Food Poisoning) Incident

Form 15b: Allegation Record (Food Poisoning) Guest

Form 15c: Allegation Record (Food Poisoning) Associate

Form 16: Food Poisoning Materials Contamination (Initial Response Letter)

Form 17: Food Poisoning Materials Contamination (Investigation Conclusion Letter)

Form 18: Pesticide Use Record

Form 19: Approved Pesticide List

Form 20: Monitoring Equipment Gauge Calibration Record

Form 21: Associate Training Records Matrix

Form 22: Hotel Incident Management Structure (HIMS)

Form 23: Associate Sickness Register

Form 24: Implementation Process for Identifying Food Allergens

Form 1: Kitchen Facility Maintenance Internal Audit Checklist

Satisfactory (S) Unsatisfactory (U) and complete corrective action/comments/staff & date columns

Completed By: / Date: / Kitchen Name:
Item / S/U / Corrective Action/Comment / Date
Due / Staff
Responsible / Actioned
Date
Processing Areas
Ceiling, walls and floors free clean & no cracks or other signs of damage
Food processing benches free from rust, damage and deterioration
All food contact equipment free from rust, damage and deterioration
Other fitting and fixtures in good condition and in working order
Dishwasher levels @ 55 °C for wash cycle & 77°C for rinse cycle
Are cleaning materials stored correctly
Are cleaning materials clean, hygienic & in good condition
Cleaning schedules available for all fixtures & fittings
All wooden products removed
All glass products removed or minimized
Lights above processing area covered, clean & in good condition
All sinks (including hand washing basins) accessible and in working order
All hand washing basins have warm water/soap/paper towel access
Designated hand washing basins only used for hand washing
Are cutting board racks supplied?
Are color coded cutting boards utilized?
Are staff utilizing the correct color cutting board for each food type
Are bins with lids supplied?
Cool rooms/Refrigerators/Freezers/Ice Rooms
Are designated cooling locations available?
Walls, floors and ceiling clean and in good condition
Shelving free from rust and kept cleaned
Lights covered
Door seals clean and in good condition
Cooling units free from rust and corrosion
Coolrooms & refrigerators operating at or below 5°C
All freezers operating at or below -18°C
Are staff cooling foods per standards?
Storage Areas
All foods labelled
All foods due/date coded
All stored foods in date
Raw foods stored separately or below cooked/ready to eat food products
All fruits and salad products chlorinated are at between 100 ppm to 200 ppm
Chemicals stored separately to food and packaging material
Chemicals correctly labelled & labels in good condition
All food and packaging material covered/stored in a manner to prevent contamination
Temperature/Thermometer
Are records completed correctly with black or blue pen?
Are records measured to the decimal point?
Cooking/reheating temperature records available
Cooling temperature records available
Temperature records for coolrooms, refrigerators, freezers and ice rooms available
Are milk & dairy products stored at correct temperatures (including bars)?
Temperature records for glass & dishwashers available & completed daily
Temperature records for thermometers available
Is at least 1 x probe thermometer available?
Sterilizing wipes for thermometers available
Bars
For garnishes are green cutting boards supplied & utilized?
Are raw egg ingredients used for cocktails?
Are snacks in date & stored correctly?
Are snacks labelled correctly (with allergen warnings)?
Are glasses cleaned & polished?
Are straws individually wrapped/protected?
Is sterilizing gel supplied?
Associate Amenities
Staff amenities kept clean and tidy
Hand washing facilities accessible and in good order
Associate Standards
Have all staff competed the Initial Associate Safe Food & Hygiene Declaration?
Have all staff been trained in Safe Food & hygiene in the previous 12 month period?
Is clean clothing/uniform supplied?
All head/beard coverings supplied
Are gloves utilized correctly?
Adhesive strips (blue) available & used
Pest Control
No sign of pest/s within processing area, storage area or staff amenities
Rodent and insect bait stations maintained and correctly situated

Comments/Further Action:

Form 2: Standards Maintenance Internal Audit Checklist

Satisfactory (S) Unsatisfactory (U) and complete corrective action/comments/staff & date columns

Form completed by:______Date:______Site Name: ______

Item / S/U / Corrective Action/Comment / Date
Due / Staff
Responsible / Actioned
Date
Management Responsibility
Are the members of the Hotel Food Safety Team (HFST) team still current?
Is the scope and purpose still current?
Is the Safe Food & Hygiene Standards Manual still current?
HACCP Plan
Are the manuals procedures still valid?
Is the associate position (chain of command) flow chart still followed?
Premises & Equipment
Has the Bi Annual Kitchen Facility Maintenance Internal Audit been completed?
Have the Temperature Monitoring Sheets been completed & withstand inspection?
Supplier Approval Program
Is the supplier list up to date?
Food Handling Procedures
Is the Treatment Register Sheet up to date?
Has the Fish Treatment procedures been followed?
Have the Product receival records been completed?
Testing & Calibration
Have all water & ice tests been completed?
Have all results within the Starwood Standard been recorded as required?
Have any results which exceed the Standards been reported to the HFST?
Have all thermometers and temperature gauges been calibrated as required?
Cleaning & Sanitation
Has the MSDS register been updated?
Are the chemicals listed still used?
Pest Control
Are the procedures still correct?
Are external pest company records submitted or available?
Personal Hygiene
Have all staff been briefed on personal hygiene?
Are Initial Information Declarations available for all kitchen staff and stewards?
Product Identification and Traceability
Is the list of suppliers up to date?
Are invoices for each sale available?
Associate Training
Is the training matrix up to date?
Are staff safe food & hygiene work requirements part of their HR position description?

Comments/Further Action:

CONFIDENTIAL & PROPRIETARY: Copyright © 2016 Starwood Hotels & Resorts Worldwide, Inc. v1.1. All Rights Reserved.

May not be reproduced, disclosed or distributed without the express written permission of Starwood Hotels & Resorts Worldwide, Inc. Authorized By: R Stevens Issue Date: 26/01/2016. Created for and on behalf of Starwood Hotels & Resorts Worldwide, Inc. Page 1

Form 3: Temperature Monitoring Record – Food Storage

1:Temperature for each area is recorded twice daily when being used

2: All refrigeration/cool rooms/freezer units to be temperature checked using a probe thermometer & temperature testing the water or the cooking oil

containers within the cold storage units

3: Refrigeration units and coolrooms are to be at 5C or below. Freezers are to be -18C or colder*

4:Associates are to record the exact temperature taken with the probe thermometer including the decimal point

5:If there are temperature issues contact the Executive Sous Chef/Executive Chef (who in turn should contact the Chief Engineer immediately)

Start Date / Facility
Area / Temperature (°C) / Corrective Actions/Comment / Initial
Mon / Initial / Tue / Initial / Wed / Initial / Thu / Initial / Fri / Initial / Sat / Initial / Sun / Initial
AM
PM
AM
PM
AM
PM
AM
PM
AM
PM

*If a site has limitations or circumstances that do not allow a temperature of -18 deg. C to be attained -15 deg. C will be accepted if product held is frozen dry, solid and shows no signs of previous thawing or re-freezing. Please note however, that -18 deg. C is the Starwood AP standard.

Form 4: Temperature Monitoring Record – Cooking/Reheating

1:Three (3 x) foods that have been either cooked or reheated are to be recorded per service

2:Final cooking temperatures are to be at 75C or above. Reheating temperatures are to be at 75C or above for 2 minutes, then reduced to 60C

3:For some cuts of meat, e.g. rare beef, rare lamb and fish, cooking temperatures of 75C or below are accepted

4:Associates are to record the exact temperature taken with the probe thermometer

Start Date / Facility
BREAKFAST
PERIOD / Process / Food Product / TempC / Corrective Action/s / Sign
Cook / Reheat
LUNCH
PERIOD / Process / Food Product / TempC / Corrective Action/s / Sign
Cook / Reheat
DINNER
PERIOD / Process / Food Product / TempC / Corrective Action/s / Sign
Cook / Reheat

Form 5: Temperature Monitoring Record – Cooling of Foods

1:Cool food as quickly as possible & divide large quantities into shallow containers

2:Food is to commence cooling when it reaches 60C

3:Food must cool from 60C to 21°C within 2 hours, then from 21C to 5°C or below within the next 4 hours = total 6 hours

4:Associates are to record the exact temperature taken with the probe thermometer including the decimal point

Start Date / Facility
Date / Food / Start Time / Start Temp
C / Temp after 2 x hours / Temp after 6 x hours / Corrective Action/s / Signature

Form 6: Temperature Monitoring Record – Food Display

1:Record the temperatures of two (2 x) hot foods and two (2 x) cold foods that are potentially hazardous and on display per service

2:Hot food display temperature is to be at 60C or above and cold food display temperature is to be at 5C or below

3:Associates are to record the exact temperature taken with the probe thermometer including the decimal point (using only black or blue pen)

Associate & Date / Facility
A.M.
HOT FOODS
BREAKFAST / Time / Food / TempC / Corrective Action/s / Sign
A.M.
COLD FOODS
BREAKFAST
HOT FOODS
LUNCH / Time / Food / TempC / Corrective Action/s / Sign
COLD FOODS
LUNCH
P.M.
HOT FOODS
DINNER / Time / Food / TempC / Corrective Action/s / Sign
P.M.
COLD FOODS
DINNER

Form 7: Temperature Monitoring Record – Dish & Glass Washer

Dishwasher Y/N / Site Location
Glasswasher Y/N / Date

1.All dish or glass washer cycles are to be at or above 55C

2.All rinse cycles are to be at or above 77C

3.All records shall be recorded once (1 x) per day

4.Associates shall record the exact temperature (including any decimal point using only black or blue pen)

Wash
Cycle
Temp / Rinse
Cycle
Temp / Day / Corrective Actions/Comments / Sign / Wash
Cycle
Temp / Rinse
Cycle
Temp / Day / Corrective Actions/Comments / Sign
1 / 17
2 / 18
3 / 19
4 / 20
5 / 21
6 / 22
7 / 23
8 / 24
9 / 25
10 / 26
11 / 27
12 / 28
13 / 29
14 / 30
15 / 31
16 / Rotate to new month

Form 8: Temperature Monitoring Record – Outdoor Catering

1:Record the temperatures of all foods that are potentially hazardous and transported, held and then served

2.Hot food display should be steaming and temperature is to be at 60C or above

3.Cold food display temperature is to be at 5C or below

4.Associates are to record the exact temperatures taken with the probe thermometer including the decimal point

Date (of event) / Manager
Name of Event / Event Number
Location / Duration
Temperature of Vehicle (C)
Event Food / Temp Leaving Hotel (C) / Temp Arrival - Venue (C) / Temp Before Service (C)

CONFIDENTIAL & PROPRIETARY: Copyright © 2016 Starwood Hotels & Resorts Worldwide, Inc. v1.1. All Rights Reserved.

May not be reproduced, disclosed or distributed without the express written permission of Starwood Hotels & Resorts Worldwide, Inc. Authorized By: R Stevens Issue Date: 26/01/2016. Created for and on behalf of Starwood Hotels & Resorts Worldwide, Inc. Page 1

Form 8a: Take Away Food Product Waiver (Request for Leftover Goods)

*Instruction: Once a request is made, copies of Form 8a must be supplied to the individual (requestor). Describe the documents intent to the individual. Once read, understood and signed by both the individual and the associate, copies must be assigned to both the individual and the hotel.

Forms Supplied to: / 8a Forms (waivers) to be provided to;
1: Requesting individual
2: The hotel
Hotel copies must be maintained on a hotel register
Who This Applies to: / Individual guests/diners that have dined at hotel outlets or events
Individual guests/attendees that have participated in hotel events (with hotel food served)
Relevant Products: / This waiver is relevant to any and all food products served at hotel restaurants and hotel functions/events and includes doggy bag requests
Non Relevant Products: / Any and all hotel buffet food products

Requestor:

This document certifies that I (insert guest name)______have made a request to hotel management to remove food from the hotel/event premises, with the intent for the food to be consumed by myself and/or other individual’s offsite.

The food that I the undersigned have personally requested to take away/remove from the premises/event/function was delivered from the following entity:

  1. Hotel Restaurant
  2. Hotel Based Event/Function

Please check all that apply:

 I am a registered hotel guest

I am an event attendee

 I am the event organizer

 I am a (local) resident

In making this request to the hotel, I do so in the full knowledge that there may be an element of food safety risk involved and I assume complete and personal responsibility for this request.

For good and valuable consideration I the undersigned hereby indemnifies and saves harmless both (insert hotel name) ______, Starwood Asia Pacific Hotels and Starwood Hotels & Resorts Worldwide and its Affiliates and their respective trustees, beneficiaries, directors, officers, employees and agents, and the successors and assigns of each of the foregoing (collectively, referred to as the indemnified Parties)from and against any and all claims, demands, actions, suits, losses, costs, charges, expenses, damages and liabilities whatsoever which the Indemnitee may pay, sustain, suffer or incur by reason of or in connection with the supply of leftover food products from the indemnified parties premises, including, without limiting the generality of the foregoing, all costs and expenses (including legal expenses) incurred in connection with any such loss or damage.

I have read and understood this document and I understand and agree with all the terms stated within this document. I acknowledge that I am being supplied a copy of this signed document.

Requestor:

Guest Check In Date / Check Out Date
Room Registration Name / Room Number
Requestor Name / Signature
Food Consumed #1 / Food Consumed #2
Food Consumed #3 / Food Consumed #4
Date Consumed / Time Consumed
Staff Reported To / Department/Site

Associate:

Print Name: / Signature:
Position: / Date:

Form 9: Hotel Food Suppliers Site Questionnaire

This questionnaire is designed to allow food suppliers to demonstrate to [Insert Hotel Name] their proactive commitment to food safety and for [Insert Hotel Name] to assess whether the business is exercising due diligence as defined by the provisions of the Starwood Standard and associated Legislation/Regulations. As such it is an important form which should be completed by a manager with direct responsibility for food safety standards.

Supplier Company
Hotel Supply Category
Foods Supplied
Associates Visiting
Completed By
Signature
Position
Date
Supplier Name
Signature
Date

Legend:

Please apply yes for any affirmatives, no for any negatives, not applicable for areas outside of scope and comment where required in supplied spaces.

Yes No N/A

Ensure any media is attached to the file when emailing through and that images are referenced in the doc (i.e. Image 1 issue/location etc.).

1.Insurance Details

Does the Company hold any of the following insurances?

Product Liability Yes No NA

Public Liability Yes No NA

Other (Please Specify) Yes No______

2.Quality Assurance

Does the Company operate to any approved quality management system or belong to a nationally recognised accreditation scheme?

Accreditation Body: ______

Scheme Title:______

Registration Date:______

Does the Company have a quality assurance manual? Yes No NA

3.HACCP PLAN

Please attach a copy of your HACCP plan for the products supplied

Date of HACCP Plan: ______

Author of HACCP Plan:______

Planned Review Date:______

4.Food Safety Documentation

Does the Company keep food safety documentation for the following controls?

Food Policy Statement (please attach) Yes No NA

Temperature Control Records Yes No NA

Food Risk Assessment Yes No NA

Pest Control Records Yes No ______

Sampling Records Yes No NA

Cleaning Schedule Yes No NA

Staff Medical Surveillance Records Yes No NA

Calibration test certificates for equipment Yes No NA

5.Food Premises Details

Provide brief details of the facilities provided for the storage, handling, preparation and packaging of food items supplied:

6.Food Safety Regulations

Do premises comply with the Regulations in the following areas?

Food Contact Surfaces Yes No NA

General Repair Yes No NA

Pest Control Measures Yes No NA

In what year were the premises constructed? ______