This questionnaire aims to help growers document their practices for preventing the contamination of fresh produce and manage risks. No matter the size of your operation, an outbreak of pathogens like E. coli on one farm could affect the market for all farms in the region. When complete, this questionnaire can function as a farm food safety plan.
How to complete this questionnaire:
- To start, download this form and answer all questions based on your current farm practices. Please email us for downloadable Word or PDF versions of the questionnaire. You can enter answers on the computer, or print the form and fill it out by hand.
- Return to the beginning and review your answers in comparison with produce safety requirements (see text box to the right).
- Revise your practices and answers if needed. Help and additional samples/templates are available from the Desert Farming Initiative.
Sections referenced in this questionnaire refer to the Food Safety Modernization Act (FSMA) Produce Safety Rule (21 CFR 112) – although this Rule does not apply to all farms, it can be used as a guide for preventing contamination on all farms. The links in brackets throughout this questionnaire lead you to the relevant section of the Produce Safety Rule – please check these Rule sections so that you understand requirements (look out for the word ‘must’ – this indicates a requirement).
This comparison of Good Agricultural Practices (GAP) and Produce Safety Rule requirements may be useful if your farm is GAP certified.
Food Safety Planning – Questionnaire for Growers
Farm Name __________________________________________________________
Physical Address __________________________________________________________
[Please attach a map and diagram of farm facilities.]
Mailing Address __________________________________________________________
Date ________________________
Crops and Sales
This section helps to determine if your farm is covered under the Produce Safety Rule and must comply with its requirements. List the crops that you grow (add additional pages if you need more space). [112.2]
How much have your annual total food sales and produce sales amounted to on average over the past 3 years? See the decision trees link immediately below and the Record Keeping section of this questionnaire for a sales calculation worksheet. [112.4, 112.5]
☐<$25,000
☐$25,000-$250,000
☐$250,000-$500,000
☐>$500,000
Is your farm subject to the Produce Safety Rule? See the Produce Safety Alliance decision trees. If so, list required compliance dates. ☐Yes ☐No
____________________________________________________________________________
Produce Safety Training
Have you or would you be interested in having the Desert Farming Initiative help with completion of this questionnaire, produce safety planning or an informal on-farm readiness review to check existing produce safety procedures (this is not an audit or an inspection)? These services are offered at no cost. If you have already had an on-farm readiness review, please provide the date.
____________________________________________________________________________
Who is responsible for food safety on your farm? _____________________________________
Have farm team members completed a Produce Safety Alliance training? If yes, please list the name/date/location of the training(s). If not, indicate your plan for attending training (the Produce Safety Rule requires that at least one person be trained).
See https://producesafetyalliance.cornell.edu/training/ or http://agri.nv.gov/fsma/ for information on upcoming trainings. [112.31]
Team member(s) ____________________________________________________
Training name/date/location ____________________________________________________
Planned training ____________________________________________________
Water
NDA has compiled a List of Labs in NV and bordering states that indicate they conduct Produce Safety Rule water testing services (this list is not all inclusive). According to a February 2019 informal survey of labs in NV, the cost for testing one water sample for total coliform and/or E. coli is $25-50; labs often give discounts for multiple samples. This cost range does not include sample containers or postage if you request that containers be sent to you. [112.47, 112.49]
Focusing on water that comes into contact with produce, describe your water source(s) (groundwater – such as wells, surface water – such as ditch, or municipal water). Indicate whether you use different sources for irrigation, post-harvest washing and handwashing or restrooms. [112.42]
Describe when and how you inspect your water system (Produce Safety Rule requires this once per year). [112.42]
Describe water quality monitoring or testing and associated record keeping. For water applied directly to produce, the Rule currently requires:
- 20 samples in first year and 5 samples every year thereafter for untreated surface water
- 4 samples in first year and 1 sample every year thereafter for groundwater
- No sampling for municipal water sources
Note: requirements differ for sprouts. [112.41, 112.43, 112.44, 112.46] See Record Keeping section of this questionnaire.
What corrective actions do you take if water tests come back positive for microbial contamination? [112.45]
How do you ensure and monitor the quality of water during post-harvest washing? Do you sanitize wash water? Do you keep records of wash water treatment? See Record Keeping Section at the end of this questionnaire. [112.48]
Describe any adjacent land uses or activities that may affect the quality of your water sources. [112.42]
Describe your sewage system (septic, municipal, etc.) and other site drainage (such as from wash facilities). [112.131, 112.133]
Health and Hygiene
Why is health and hygiene important on the farm? Worker and visitor health and actions directly impact the safety of fruits and vegetables they harvest and pack. If workers are sick or injured, do not wash their hands properly, or are not aware of food safety risks and practices that reduce risks, they could contaminate fresh produce while they work and/or endanger their own health and safety.
Humans can carry and spread pathogens (bacteria, viruses and parasites) that are dangerous to consumers. Routes of contamination include: clothing, hands, footwear, tools and equipment and facility surfaces.
Describe types, locations and cleaning/maintenance of restroom and handwashing facilities. See Record Keeping section of this questionnaire. [112.129, 112.130]
What are your procedures for handling a septic or portable toilet leak or spill? [112.129, 112,131]
Describe employee health and hygiene policies (including procedures for illness and injury), employee training (including frequency) and associated record keeping (see Record Keeping section of this questionnaire). Describe visitor health and hygiene policies. Please include information about how training is provided if workers/visitors do not speak English. [112.21, 112.22, 112.31, 112.32, 112.33]
Soil Amendments
Describe biological soil amendments of animal origin (such as manure, agricultural tea, biosolids) that come into contact with produce. How are they stored? When do you apply the amendments and what is the time frame between application and harvest? [112.51, 112.52, 112.53, 112.54, 112.56, 112.60]
Do you produce your own compost? If so, describe your composting method, monitoring and record keeping. If compost is purchased, do you keep documentation from the supplier on microbial quality? See the Record Keeping section of this questionnaire. [112.55, 112.60]
Domesticated and Wild Animals
Animals can carry and spread human pathogens. Read more from UC Davis about pathogens associated with certain wildlife and crops, and their incubation period.
Describe policies for domestic animals on the farm and monitoring of wildlife (including indoor facilities). Describe pre-harvest risk assessment procedures to ensure that produce contaminated by wildlife is not harvested and associated training. For example, what is the time frame between harvest and allowed grazing in crop production areas (produce safety guidance recommends 90-120 days)? See the Record Keeping section of this questionnaire. [112.22, 112.30, 112.81, 112.83, 112.112, 112.127, 112.128]
Harvesting, Packing and Storage
Do you keep covered crops (those typically consumed raw) separate from others? This is of interest if the covered crops (such as lettuce) are not managed the same way as others (such as potatoes). [112.2, 112.111, 112.112]
When produce is dropped to the ground or floor, it can pick up pathogens (bacteria, viruses or parasites) that can make consumers ill.
Dropped produce can also have broken membranes or bruising that allow for/encourage pathogen growth.
Describe policies that ensure that contaminated produce, such as produce that has been dropped to the ground, is not harvested and associated training. [112.21, 112.113, 112.114]
Describe how containers and food packaging material is cleaned and sanitized or is designed for single use. [112.22, 112.116]
Does packaging allow for air flow? Allowing air flow prevents the formation of Clostridium botulinum toxin – this is of particular concern with mushrooms. [112.115]
Equipment, Tools, Buildings and Sanitation
Describe how food contact surfaces (equipment, tools, measuring instruments and facilities) are maintained and regularly cleaned and sanitized, and describe the associated record keeping. See the Record Keeping section of this questionnaire. Include discussion of how you prevent standing water and back splash from drains from contaminating produce. [112.123]
How do you dispose of food waste and trash to prevent contamination? [112.132]
How do you manage nonfood contact surfaces to prevent contamination (such as from chipping paint, loose machinery parts, etc.)? [112.126]
Which sanitizer(s) do you use? How do you ensure that sanitizers are used according to the EPA label? [112.43]
Produce Transport
How do you ensure that vehicles used to transport produce are clean? For example, do you use clean liners in multi-purpose vehicles when delivering produce? [112.125]
Traceability
Traceability records allow for recall in the event of an outbreak. The more specific farm records are; the lower the quantity of produce that needs to be recalled. Traceability helps limit farm liability and identify sources of contamination.
How do you keep track of crop harvest and pack dates, field of origin, delivery and responsible staff (such as by assigning lot numbers)?
Record Keeping
Provide a list of the records you keep related to produce safety and the associated schedule. See the Produce Safety Alliance list of required records and sample templates.
