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HACCP Vended or Satellite Production Record

1.Site Name:

3. Circle Grade Group: Lunch 4. Circl

Breakfast 5

6 7 8 9 10 11 12 13

HACCP # of # of # of

Recipe/Product Process* Portion Portion Portions Portions Portions

Menu Item (Name or #) NC/SD/C Size Tool Prepared Leftover Used

15. Total Milk Usage: *HACCP PROCESS: CCP:Cri t ical Control Pts. CL:Cri t ical Limits SOPs# 1/2 HACCP NC - No Cook Cold Holding 41F or #2;#7;#13

pints temp. Cooking #2;#3

1% White Hot Holding #7;#13

Fat Free Chocolate Cooking #2;#3

Fat Free Strawberry Cooling #4

Skim

Lactaid Reheating #12

Other __________ Hot Holding #7;#13

16. Preparation School Signature: _________________________ 17 Receiving School Signature:_______________________________

C - Complex

SD - Same Day

Hold at 135F or

Ck. Temp. & Time to Right

Hold at 135F or

To 165F or for 15 seconds

Cool to 70F w/in 2 hrs. then to

41F or w/in an add'l 4 hrs.

Ck. Temp. & Time to Right

K-5

K-12 Pre-K

6-8 K-8 9-12 Pre-K

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HACCP Vended or Satellite Production Record

LING

K

Time & Temp

___________

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Instructions for HACCPVended/Satellite Production Record

1. Site Name - Record the name of the site or school.

2. Date - Record the date.

3. Grade Group Circle the appropriate grade group used for meal planning.

4. Meal Type Circle the meal type (breakfast or lunch).

5. Total Number of Reimbursable Meals Served - Record the total number of reimbursable meals(Free, Reduced, and Paid) served for breakfast or lunch.

6. Menu Item - List each menu item offered as part of the reimbursable meal.

7. Recipe or Product Name or Number - Record the standardized recipe number used (i.e. recipe

#28). All local recipes must be assigned numbers. For purchased food items that are notrecipes, list the brand name of product (i.e. Goldkist Chicken Nuggets) purchased.

8. HACCP Process Indicate the process category used for each menu item: No Cook (NC), SameDay Service (SD), or Complex Food Preparation ( C ).

No Cook (NC) No cooking at allSame Day (SD) Cooked and served the same dayComplex (C)- Cooked one day and served another day

9. Portion Size For each menu item, record the planned individual portion size. Example: 5chicken nuggets, cup peas, 2 tacos or 1 hamburger on bun. Use volume measurements (i.e. cup, cup) for fruits and vegetables.

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10. Portion Tool (Optional) For each menu item, identify portion control to

specific size if appropriate, i.e. cup ladle, #8 scoop, etc. Bulk feeding sshould indicate portion tool.

11. Number of Portions Prepared - For each menu item, record the numindividual portions prepared.

12. Number of Portions Leftover - For each menu item, record the numindividual portions leftover.

13. Number of Portions Used - For each menu item, record the total numindividual portions used.

Number of Number of Num

Portions Prepared

Portions Leftover = Portion(11) (12) (13)

14. Monitoring - Record time and temperatures taken during the preparatpotentially hazardous menu items and during the cooking, holding and cprocess.Monitoring must be done by the vendor/central kitchen and by the receiving kitch

At a minimum:Cooking: The Central Kitchen/Vendor: Must record temperatures of pothazardous items prior to sending meals to the receiving site.

Holding: If menu items are not served immediately, the receiving kitchenmust record temperatures between serving periods. The receiving schoo

record temperature of all items upon delivery.

Cooling: If keeping leftovers, the receiving kitchen (RK) musttemperatures during cooling process.

15. Total Milk Usage - Record, by type, the total number of 8 ounce portionpints of milk used. At a minimum, record temperature at least once pserving.

16. Preparation School Signature Signature of person preparing or packimeals at the central kitchen/vendor.

17. Receiving School Signature - Signature of person receiving the meal

receiving site/school.

18. Verified by - Signature of manager verifying correct completion of the re

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