Franklin County Public Health Food Safety Program

280 East Broad Street

Columbus, Ohio 43215-4562
HACCP Review
(614) 525-3160
Franklin County
Public Health
www.myfcph.org

In order for your HACCP Plan to be meet all requirements, all fields and attachments must be completed. If
you have questions regarding this form, or the approval process, please contact our office by emailing
[email protected].

According to 3717-1-03.4(L), additional scientific data or other information may be request to ensure that food
safety is not compromised by the processes occurring in the HACCP Plan.

Food Service/Food Establishment Name

Food Service/Food Establishment Street Address

City State Zip Code

Name of Primary Contact Email Address Phone

Please refer to sections 3-502.12 and 8-201.14 of the FDA Food Code 2013 for the requirements for conducting
Reduced Oxygen Packaging (ROP). Additionally, refer to section 3717-1-03.4(K) in the Ohio Uniform Food Safety
Code for more information regarding HACCP Plans, ROP, and Sous Vide.

NOTE: According to the Ohio Uniform Food Safety Code, placing food in a bag and sealing it immediately prior
to or after cooking, cooling, or reheating does not require a HACCP plan as long as:
• The Product is labeled with the time and date the product is placed in the bag; and
• The product is removed from the bag within 48 hours of the time the product was placed in the bag

For Office Use Only

Primary Reviewer Secondary Reviewer

Date Approved
Approved Denied
Special Considerations for Approval:
 Section 1: Overview

1. Please check which method you’ll be using to package your foods using reduced oxygen packaging
(ROP):

Cook/Chill - Cooked food is hot filled into impermeable bags which have the air expelled and are then
sealed or crimped closed. The bagged food is rapidly chilled and refrigerated at temperatures that
inhibit the growth of Clostridium botulinum and Listeria monocytogenes pathogens.

Sous Vide - raw or partially cooked food is vacuum packaged in an impermeable bag, cooked in the
bag, rapidly chilled, and refrigerated at temperatures that inhibit the growth of Clostridium botulinum
and Listeria monocytogenes pathogens.

Vacuum packaging cold foods (41°F or below) or frozen foods.

2. According to the Ohio Uniform Food Safety Code, if cook/chill or sous vide were not checked above,
please identify which food standard below will be met:
□ The food item has an a w (water activity) of 0.91 or less.

□ The food item has a pH of 4.6 or less.

□ Is a meat or poultry product cured at a food processing plant regulated by the Ohio Department of
Agriculture under Chapter 918 of the Revised Code or USDA using substances specified in 9 C.F.R.
424.21, and is received in an intact package.

□ Raw meat, raw poultry, or raw vegetables, which are foods that have a high level of competing
organisms in them.

□ Fish that is frozen before, during, and after packaging.

□ Commercially manufactured cheeses produced in a food processing plant that meet the standards of
identity as specified in 21 C.F.R. 133.150, 21 C.F.R. 133.169 or 21 C.F.R. 133.187. No additional ingredients
will be added in the food service operation or retail food establishment.

□ Other: If the food item does not meet one of the previously listed standards, it may be unsafe to
vacuum package. Please contact your food inspector for guidance in this scenario.

Department Comments/Concerns:
3. Name the menu item(s), ingredients, special processes, and all materials and equipment involved in the
processes, for which the HACCP plan is being submitted:

**NOTE: Only Fish and Seafood that is frozen BEFORE, DURING, and AFTER may be packaged using ROP**

Menu Item Process Ingredients Equipment Used

Beef filet, water, salt, pepper, Sous vide bags, circulator,
Example: Beef Filet Cook Sous Vide
sugar, paprika food grade tape
4. Describe the intended consumer (check all that applies):
NOTE: Please note that food cooked using sous vide or cook-chill must be prepared and consumed on
the premises with no distribution or sale of the packaged product to another business location or the
consumer.

On-site consumption, general population

Institutional

Elderly adults, immunocompromised persons, or pre-school aged children

Other:

5. Please list the equipment, including make and model numbers for all equipment used in the ROP/Cook-
Chill/Sous Vide Process:

EQUIPMENT DESCRIPTION MANUFACTURER MODEL NUMBER

Example:
Immersion Circulator Sammic 1180002
Section 2: Identifying Critical Control Points (CCPs):

According to the Ohio Uniform Food Safety Code, a CCP is defined as “a point or procedure in a specific
food system where loss of control may result in an unacceptable health risk”.

If all three questions below are answered with a “Yes”, then the step would be defined as a CCP Step:

• Are the Identified hazards likely to occur?

• Are there preventative measures for each hazard?
• Is this the last point in which control measures can be applied to prevent, reduce or eliminate hazards?

Please utilize the flowchart below determine the appropriate CCP steps for EACH food product that will
undergo Cook-Chill, Sous Vide or ROP.
1. Insert or attach flow charts by menu item or specific food /category type identifying CRITICAL CONTROL POINTS (CCPs). Start the flow
chart from when the food is received into your facility and end when food is served to the consumer.

Example:

Insert CCP Flow Chart(s) here:

Insert CCP Flow Chart(s) here:
Insert CCP Flow Chart(s) here:
Section 3: Creating the Hazard Plan Summary and Hazard Analysis Workflow

Hazard Analysis- List all CCPs and the corresponding Hazards, Critical Limits, Monitoring Procedures, Corrective Actions, Record Keeping and
Verification Procedures. Please use additional charts if necessary

Hazards: a significant hazard that can cause harm and that is reasonably likely to occur if not controlled.
Critical Limit (CL): A maximum or minimum value to which a biological hazard must be controlled to prevent, eliminate, or reduce (to an acceptable
level) the occurrence of the identified food safety hazard.
Monitoring Procedures: The method and frequency for monitoring and controlling each CCP by the employee designated by the Person-In-Charge
Corrective Actions: Action to be taken by the person in charge if Critical Limits are not met.
Record Keeping: Records to be maintained by the person in charge to demonstrate that the HACCP plan is properly operated and managed.
Verification: The method and frequency for the person in charge to routinely verify that the food employee is following standard operation
procedures and monitoring CCPs
Records: ALL RECORDS MUST BE KEPT FOR A MINIMUM OF SIX MONTHS AND MADE AVAILABLE TO THE LICENSOR PER 3717-1-03.4(K)(4)(c)

EXAMPLE HAZARD PLAN SUMMARY FORM:

Facility Name Product Description

FCPH’s Kitchen of Excellence Sous Vide or Cook/Chill: Pork Tenderloin

(1) (2) (3) Monitoring (4) (5) (6) (7)

Critical Control Significant Critical Limits

Point (CCP) Hazard(s) For each Preventive A B C D Corrective Verification
Measure Action(s) Records
(keep records
What How Frequency Who for minimum
of 6 months)
Cooking Pathogens Cook Product to Internal Metal Probe Each Manager Continue Daily Cooking
165°F Product Thermometer tenderloin or Cooking until Calibration of logs and
Temp. Designee Critical Limit is thermometer thermometer
Reached calibration

Cooling Pathogens Cooled to 38°F Temp. and Metal Probe Each Manager If product is Daily Cooling Log,
within 24hrs of Time Thermometer Tenderloin or found to be Calibration of thermometer
reaching 41°F and Designee out of thermometer calibration
held at 38°F compliance log, product
for cooling, it destruction
will be log
destroyed

Signature: Date:
Facility Name Product Description

(1) (2) (3) Monitoring(4) (5) (6) (7)

Critical Control Significant Critical Limits (A) (B) (C) (D) Corrective Verification Records
Point (CCP) Hazard(s) For each Preventive Action(s) (keep records
Measure for minimum of
What How Frequency Who
6 months)

Signature: Date:
Facility Name Product Description

(1) (2) (3) Monitoring(4) (5) (6) (7)

Critical Control Significant Critical Limits (A) (B) (C) (D) Corrective Verification Records
Point (CCP) Hazard(s) For each Preventive Action(s) (keep records
Measure for minimum of
What How Frequency Who
6 months)

Signature: Date:
Section 4: Sous Vide or Cook/Chill Cooking and Cooling Information

Sous Vide or Cook/Chill (If you are not performing these activities, proceed to the next step)

1. Describe how all sous vide or cook/chill foods are cooked, to what specific temperatures, and for how long:

Food items must be placed in a package with an oxygen barrier and sealed before cooking, or placed in a
package and sealed immediately after cooking and BEFORE reaching a temperature below 135°F

All parts of the food item must meet the specific cooking temperature for the specified amount of time

2. After food is cooked then rapidly cooled in the bag/package from 135°F to 70°F in 2 hours then from 70°F to
41°F in an additional 4 hours, choose your method of final cooling and cold storage:

 Cooled to 34°F within 48 hours of reaching 41°F and held at that temperature until consumed or
discarded within 30 days after the date of packaging

 Held at 41°F or less for no more than 7 days, at which time the food must be consumed or discarded

 Held frozen with no shelf life restriction while frozen until consumed or used

3. Describe how you will comply with the following cold holding requirements:
Food must be held in a refrigeration unit that is equipped with an electronic system that continuously
monitors time and temperature and is visually examined for proper operation twice daily:
Section 5: Labels

Packages must be labeled on the principal display panel with a “use-by” date that does not exceed 30 Days
from the day of packaging OR the original manufacturer’s “sell-by” or “use-by” date, whichever occurs first.
Food must be discarded after 30 days only if the product has been held at or below 34°F the entire duration.

a. All labels must include product name, packaged date, and use-by date.
b. You must submit a sample label for EACH product that you will be cooking using Sous Vide or
Cook/Chill

If products are not labeled properly, they may be subject to destruction!

Are all sample labels attached for all food products? Yes No

For Office Use Only Approved Denied

Sanitarian Signature Date

Section 6: Operation Procedures

According to section 3717-1-03.4(K)(e), all HACCP Plans must include operation procedures. Using the space
provided, please describe how you will comply with the following provisions:

1. Prohibit bare hand contact with ready-to-eat foods

2. Identify a designated work area AND the method by which physical methods of separation of raw foods
and ready-to-eat foods; and how access to the processing equipment is limited to responsible trained
personnel familiar with the potential hazards of the operation
3. Describe in detail the cleaning and sanitizing procedures for all food contact surfaces used in these
processes

Section 7: Training Protocols

According to section 3717-1-03.4(K)(f), the facility must have a training program that ensures individuals
responsible for the ROP understands:

• The concepts required for safe operation;

• Equipment and facilities; and
• Procedures specified in Section 6 of this guide (3717-1-03.4(K)(e)); and
• Must specify how the person-in-charge will verify that food employees are following the standard
operating protocols and that they are adequately monitoring all critical control points.
•
You must utilize the space below, or attach a training plan that specifically address all of the area outlined
above.

Is the training plan attached for review? Yes No

For Office Use Only

Recommended Denied

Sanitarian Signature Date