Facility Report Sheet and Audit Agenda

Supply Chain Food Safety IFS

Printed: 9/1/2023 11:05:55 PM
Revision of audit plan: 9/1/2023 11:05:55 PM

Type of Audit: Registration

Customer Info:
Customer Name: Cooperativa Agroindustrial de Palmito APROPAL Ltda
Customer Address: Av. La Marginal Nro. 177 Bar. San Martin, San Martín 05142, Peru
Customer Number: C0207064
Customer Primary Sheila Becerra
Contact:
Customer Phone Number: 0051 964974119
Customer Email: [email protected]

Audit Standard: IFS Food Standard Version 7

Industry Code(s): 5. Fruits and vegetables
A. Sterilization with the purpose to destroy pathogens
C. Treatment of processed products to modify product and/or extend
shelf-life and/or reduce food safety hazards
D. Systems, treatments to maintain product integrity and or safety
F. Any other manipulation , treatment or processing
Product/Detail:
Scope of Registration: Peeling, cutting, blanching, acidification, and sterilization of heart of palm,
packed in tin cans and glass jars. Pelado, corte, escaldado, acidificación y
esterilización de palmito, empacados en latas y frascos de vidrio.
Exclusions: None
Audit Date(s): 18-SEP-2023 TO 19-SEP-2023
Remote Audit: ONSITE
Number of HACCP Plans: 0
Employee Count: 45
Number of Shifts: 1
Employees per Shift(s):
Shift Employee Count Shift Time
1 45 00:00 - 00:00
Facility Size: 10000 sq mt.
Audit Duration: 2 Day(s)
Working Language: SPANISH
Reporting Language:

Audit Team:
Lead Auditor: Maria del Carmen Rocha
Email: [email protected]
Phone Number: 593-9-9838 8450
Observer(s): Jose Luis Montero

Please list the total number of hours audited by each auditor (by name):
Name Hours
Lead Auditor: Maria del Carmen Rocha 16

Additional Agenda Items:

• List of Offsite Activities to be audited: None
Note 1: The audit plan is a guideline and the scope of the audit is defined by the current certificate. Adjustments can
be made as needed during the course of the audit to accommodate audit trails and customer availability as much
as possible.

This is a confidential document and may be reproduced only with the permission of NSF. Page 1 of 6
 Facility Report Sheet and Audit Agenda

EXAMPLES OF THE TYPES OF DOCUMENTATION WHICH MAY BE REQUIRED FOR REVIEW

SENIOR MANAGEMENT IMPROVEMENT – LEADERSHIP

• GLN number of the facility
• Identification of Product Safety and Quality Objectives
• Completed and filed minutes of Management Review meetings
• Records of Management Reviews with closure of action items and assignment of new
action items

HACCP
• Members of the HACCP team
• Current and verified product flows
• Current and validated Hazard Analysis for each HACCP plan
• Critical Limits for each CCP (if any) and monitoring criteria for each
• Identification of all current HACCP documents and their records

QUALITY MANAGEMENT SYSTEMS

• Copy of current Quality Manual – with identification of related Food Safety policies,
procedures and work instructions
• Procedure for conducting internal audits and identification records created
• Supplier approval program (including outsourced processes) and identification of
related records
• Identification of Quality documents with current revision numbers
• Document control procedures and example of document change records
• Identification of records and length of retention and location of secured storage
• Records of completed corrective actions
• Product mock recall records
• Records of customer complaints with corrective action resolution

SITE OPERATIONAL POLICIES

• Filter replacement schedules / identification of air quality monitoring records/ air filter
specifications
• Identification of water specification, policy, sampling and testing schedule
• Identification of preventative maintenance records for equipment
• Identification of foreign material monitoring/control program and related records
• Identification of the sanitation program in place with associated records
• Identification of Pest Control Program and related files and records/corrections
• Identification of transport control program including records, trailer cleaning records,
actions taken when issues encountered
• Identification of the Food Defence Plan for the facility and product with records

PRODUCT CONTROL
• Identification of monitoring records for CCPs or other Product Safety/Quality
• Identification of product release program
• Identification of non- conforming product program and records

PERSONNEL HYGIENE
• Identification of GMP training and new employee induction program

This is a confidential document and may be reproduced only with the permission of NSF. Page 2 of 6
 Facility Report Sheet and Audit Agenda

TENTATIVE ASSESSMENT SCHEDULE

DUE TO THE NATURE OF PROCESS AUDITING AND COMPLETING PROPER AUDIT TRAILS THE TIMES
ALLOCATED TO EACH PROCESS MAY CHANGE. (FOOD HYGIENE PRINCIPLES, RECORDS AND
DOCUMENTS AUDITED THROUGHOUT EACH PROCESS)

Day/Date Time Shift Activity / Process to be audited including linkages and/or Lead Auditor
interfaces to support locations Team
Auditor(s)
18/09/2023 8:30 1 Opening Meeting MR/JM
* Review of FRS/Application
* Review of Audit/Registration Process
* Initiate Traceability Exercise (review trace 4 hrs after)
Reunión inicial
* Incluyendo confirmación de alcance y detalles de la
empresa.
* Arrancar ejercicio de trazabilidad (máx. 4 horas).
9:00 Use of the Mark/Advertising of Certification MR/JM
Review the previous assessment report and corrective action
plan
Uso de la marca / publicidad de certificación
Revisar el informe de evaluación anterior y el plan de
acciones correctivas.
09:15 MANAGEMENT PROCESS MR/JM
1.1 Policy
1.2 Corporate structure
1.3 Customer focus (Current Customers and Requirements) IFS
1.3, 4.1, 5.8
1.4 Management review data (Overview of Processes and
Objectives)
PROCESO DE GESTIÓN
1.1 Política
1.2 Estructura corporativa
1.3 Orientación al cliente (Clientes actuales y requisitos)
1.4 Datos de revisión por la dirección (descripción general de
procesos y objetivos)
10:30 Facility Tour/interviews MR/JM
Visita a las instalaciones / entrevistas
IFS 2.2 (control y monitoreo de los PC y PCC), 4.2, 4.5, 4.9, 4.10,
4.11, 4.12, 4.13, 4.14, 4.15, 4.16, 4.17, 4.19, 4.20, 5.3, 5.4, 5.5, 5.6,
5.7, 5.10
13:30 Lunch MR/JM
Almuerzo
14:00 Facility Tour/interviews MR/JM
Visita a las instalaciones / entrevistas
IFS 2.2 (control y monitoreo de los PC y PCC), 4.2, 4.5, 4.9, 4.10,
4.11, 4.12, 4.13, 4.14, 4.15, 4.16, 4.17, 4.19, 4.20, 5.3, 5.4, 5.5, 5.6,
5.7, 5.10
15:30 FOOD SAFETY AND QUALITY MANAGEMENT SYSTEM MR/JM
2.1 Quality management
2.1.1 Document management
2.1.2 Records and documented information
2.2 Food safety management
2.2.1 HACCP plan
2.2.2 HACCP team

This is a confidential document and may be reproduced only with the permission of NSF. Page 3 of 6
 Facility Report Sheet and Audit Agenda

Day/Date Time Shift Activity / Process to be audited including linkages and/or Lead Auditor
interfaces to support locations Team
Auditor(s)
2.2.3 HACCP análisis
SISTEMA DE GESTIÓN DE CALIDAD Y SEGURIDAD ALIMENTARIA
2.1 Gestión de la calidad
2.1.1 Gestión de documentos
2.1.2 Registros e información documentada
2.2 Gestión de la inocuidad alimentaria
2.2.1 Plan HACCP
2.2.2 Equipo HACCP
2.2.3 Análisis HACCP
(incluye evaluación de los prerrequisitos, peligros alérgenos,
autenticidad y validación)
16:30 4.18 Traceability
Review of the Traceability exercise.
Revisión del ejercicio de Trazabilidad.
IFS 4.18
Control of suppliers of raw materials and supplies and MR/JM
subcontracted processes.
Control de proveedores de materias primas e insumos y
procesos sub contratados.
IFS 4.2, 4.4
17:30 End of Day / Fin del día 1 MR/JM
19/09/2023 7:30 1 Facility Tour/interviews MR/JM
Visita a las instalaciones / entrevistas
IFS 2.2 (control y monitoreo de los PC y PCC), 4.2, 4.5, 4.9, 4.10,
4.11, 4.12, 4.13, 4.14, 4.15, 4.16, 4.17, 4.19, 4.20, 5.3, 5.4, 5.5, 5.6,
5.7, 5.10
Plant visit - General tour, exterior and common areas. MR/JM
(gates, perimeter, internal traffic routes, service areas, staff
facilities, waste areas, pest control (exterior appearance),
food defense, storage, transport, and dispatch)
Visita a planta - Recorrida general, exterior y áreas comunes.
(porterías, perímetro, vías de tránsito interno, áreas de
servicios, instalaciones del personal, áreas de residuos, control
de plagas (aspecto exterior), food defense, almacenamiento,
transporte y despacho)
IFS 3.2, 3.4, 4.6, 4.7, 4.8, 4.9, 4.10, 4.11, 4.13, 6.1, 6.2, 6.3, 6.4
3.2 Personal hygiene (Control of the health status of the staff MR/JM
includes first aid room visit)
3.2 Higiene personal (El control del estado de salud del
personal incluye visita a la sala de primeros auxilios)
09:00 Maintenance and calibration MR/JM
Mantenimiento y calibración
IFS 4.16, 5.4
09:30 Quality Control - Laboratory Analysis - Calibration MR/JM
(analysis plan, calibration (as applicable), product release,
specifications, instrument calibration.
Control de Calidad – Análisis de Laboratorio - Calibración
(plan de análisis, calibración (según corresponda), liberación
de productos, especificaciones, calibración de instrumentos.
IFS 4.2, 4.9 (control de agua), 5.6, 5.7, 5.4, 5.8, 5.10
10:00 Product recall and incident management. MR/JM
Food Defense Plan
Retirada de productos del mercado y gestión de incidentes.

This is a confidential document and may be reproduced only with the permission of NSF. Page 4 of 6
 Facility Report Sheet and Audit Agenda

Day/Date Time Shift Activity / Process to be audited including linkages and/or Lead Auditor
interfaces to support locations Team
Auditor(s)
Plan de Defensa Alimentaria
IFS 5.9, 6.1 – 6.4
11:00 MEASUREMENTS, ANALYSES, IMPROVEMENTS
5.1 Internal audits
5.2 Site factory inspections
MEDICIONES, ANÁLISIS, MEJORAS
5.1 Auditorías internas
5.2 Inspecciones de fábrica del sitio
12:00 5.8 Management of complaints from authorities and
customers (Customer Satisfaction Data (e.g., Scorecards) //
IFS 1.3, 4.1
5.10 Management of non-conformities and non-conforming
products
5.11 Corrective actions (corrective and preventive actions)
5.8 Gestión de quejas de autoridades y clientes (datos de
satisfacción del cliente (por ejemplo, cuadros de mando)
5.10 Gestión de no conformidades y productos no
conformes
5.11 Acciones correctivas (acciones correctivas y
preventivas)
12:30 Human resources
Recursos humanos
IFS 1.2 (conciencia del personal, plan de cultura) 3.1, 3.3
(competencias, plan y registros de capacitación)
13:00 Lunch MR/JM
Almuerzo
13:30 Design and development MR/JM
Modifications of products and processes.
Labels and labels approval.
Allergens (documentary aspects)
Food Fraud
Diseño y Desarrollo
Modificaciones de productos y procesos.
Aprobación de rótulos y etiquetas.
GMO, Alérgenos (aspectos documentales)
Fraude Alimentario
IFS 4.2, 4.3, 4.19, 4.20
14:30 Review of prerequisites (documentary review) MR/JM
- cleaning
- Pest management
- Personnel hygiene
- Services (water, air, gases, etc.)
- Control of physical contamination
- GMO - Allergen Management - Food Fraud
Revisión de prerrequisitos (revisión documental)
- Limpieza - Gestión de plagas - Higiene del personal - Servicios
(agua, aire, gases, etc.) - Control de la contaminación física -
Gestión de Alergenos - Fraude Alimentario
IFS 3.2, 4.9, 4.10, 4.12, 4.13, 4.19, 4.20
15:30 Preparation for closing meeting MR/JM
16:00 Closing Meeting MR/JM

This is a confidential document and may be reproduced only with the permission of NSF. Page 5 of 6
 Facility Report Sheet and Audit Agenda

AGREEMENT TO NOT DISCLOSE AND NOT TO CONSULT

In consideration of my appointment as Auditor to represent NSF International LLC in

conducting food safety and related management system audits to a specified standard(s).

I, hereinafter referred to as the ‘Auditor’, agree to the following terms:

The Auditor will not at any time during or subsequent to this agreement disclose or use in
any way information of knowledge or data received or developed while providing auditing
service for NSF, including but not limited to, plans, lists, prospect lists, and trade secrets of
NSF or its Customers.

While representing NSF, the Auditor may have access to confidential business information
from NSF’s Customer and others, and may be authorized to handle this information in the
performance of those responsibilities. The Auditor will assume that this is proprietary
information of the customer or parties supplying it and will not reveal by to others outside
NSF as required in the execution of accepted audit activities. The Auditor agrees to
maintain this information in a secure manner so that any accidental disclosure is prevented.

The Auditor understands that unauthorized disclosure or handing of confidential business

information will result in immediate disciplinary action, which can and will include, but not
to be limited to, cancellation of the Auditor’s appointment to represent NSF and other
damages which may occur. Should the Auditor’s authorization to handle confidential
information to be revoked while appointed to represent NSF or as a result of cancellation of
that appointment to represent NSF, it is understood that this obligation not to reveal
confidential business information will still be remain in force.

Upon cancellation of this appointment to represent NSF for any reason, it is agreed to
promptly deliver to NSF all physical property, plans, designs, computer programs, computer
lists, prospect lists, records, letters, notes, reports, and all other materials relating to NSF
and/or its customers that are possession or control.

Furthermore, the Auditor, hereby attests not to have provided consultations or other
services to NSF’s customer for a period of at least two (2) years. To preclude any actual or
perceived conflict of interest, the Auditor also agrees to not enter into any agreement,
provide consultation or other services to NSF’s customer except for those services under
contract directly with NSF for an additional period of two (2) years after completion of
contracted services with NSF for this specific Customer.

This is a confidential document and may be reproduced only with the permission of NSF. Page 6 of 6