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<br />I
<br />j.,
<br />
<br />State of Florida
<br />
<br />Department of Business Regulation I Department of Health and Rehabilitative Services
<br />Division of Hotels and Restaurants Health Program Office
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<br />.............
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<br />HRS PASCO COUNTY PUBLIC HEALTH UNIT
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<br />FOOD SERVICE / FOOD OUTLET ESTABLISHMENT INSPECTION REPORT
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<br />
<br />OWNER
<br />
<br />MO DAY YR
<br />
<br />TELEPHONE
<br />
<br />INSPECTION
<br />DATE
<br />
<br />\ \ 1 i I
<br />
<br />'~C~
<br />
<br />0 WARNING MGR.
<br /> Minor and/or major violations in the operation of your establishment must
<br /> be corrected by
<br />~EXT ROUTINE ---
<br /> SPECTION OR Dsy MO DAY YR
<br /> REASON 1 2 3 4 5
<br /> RESULT 1 2 3 4 5
<br /> GRADE MAXIMUM SCORE 100
<br /> (A- LESS VIOLATIONS - -a
<br /> INSPECTION SCORE \0 (j
<br />
<br />Maj / Min FOOD
<br />0 0 .01 Source: sound condition, no spoilage 5 0
<br />0 0 02 Original container: properly labeled 1 0
<br /> FOOD PROTECTION
<br />
<br />o
<br />o
<br />o
<br />o
<br />o
<br />o
<br />o
<br />o
<br />o
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<br />'03 Potentially hazardous food meets temperature requireme,-,ts during 5
<br />storage, preparation, display. ser;.vice, transportation
<br /> ...
<br />.04 Facilities to maintain product temperature 4
<br />05 Thermometers provided and conspicuous 1
<br />06 Potentially hazardous food properly thawed 2
<br />'07 Unwrapped and potentially hazardous food not re'served 4
<br />.07 Reconditioned food. cross contamination
<br />08 Food protection during storage, preparation, display, service 2
<br />Og Handling of food (ice) minimized . -. ~-., 2'
<br />10 In use, food (ice) dispensing utensils properly stored 1
<br />
<br />o
<br />o
<br />o
<br />o
<br />o
<br />o
<br />o
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<br />o
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<br />PERSONNEL
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<br />o
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<br />o . 11 Personnel with infections restricted
<br />o * 12 Hands washed and clean, good hygienic practices
<br />
<br />5
<br />5
<br />
<br />NOTICE OF INTENT
<br />TO FILE
<br />ADMINISTRATIVE
<br />CHARGES
<br />
<br />no
<br />FOOD OUTLET
<br />
<br />Maj / Min WATER
<br />o 0 '27 Water source, safe: hot & cold under pressure
<br />
<br />5
<br />
<br />o
<br />
<br />SEWAGE
<br />o ~ Sewage and waste water d.sposal
<br />PLUMBING
<br />
<br />4 I
<br />
<br />o
<br />o
<br />
<br />
<br />5
<br />
<br />TOILET & HANDWASHING FACILITIES
<br />
<br />o 0
<br />o 0
<br />
<br />'31 Number, convenient, accessible, designed, installed 4
<br /> Toilet rooms enclosed, self-closing doors, fixtures, good repair, clean; 2
<br />32 hand cleanser, sanitary towels/tissues/hand-drying devices provided,
<br /> proper waste receptacles
<br />
<br />GARBAGI; & REFUSE DISPOSAL
<br />
<br />o
<br />o
<br />
<br />~~\~jr,.:~Su~~~~~~~IeS, covered: adequate number, insect/rodent 2
<br />
<br />33
<br />
<br />34
<br />
<br />OutsKJe storage area enclosures properly constructed, clean: controlled
<br />incineration 1
<br />
<br />INSECT, RODENT, ANIMAL CONTROL
<br />
<br />o
<br />
<br />Presence of insects/rodents - outer openings protected, no birds,
<br />turtles, other animals
<br />
<br />4
<br />
<br />o .35
<br />
<br />FLOORS, WALLS & CEILINGS
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<br />o
<br />o
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<br />36 Fklors contructed, drained, clean, good repair, covering installation, 1
<br />dustless cleaning methods
<br />37 Walls, ceiling, attached equipment: constructed, good repair, clean 1
<br />surfaces, dustless cleaning methods
<br />
<br />o
<br />o
<br />
<br />-0-
<br />
<br />LIGHTING
<br />
<br />o G Lightll1!tt'ft)Ylded 8S reQUired, fixtures shielded
<br />
<br />VENTILATION
<br />
<br />" 1
<br />
<br />o
<br />
<br />o 39 Rooms and equipment - vented as required
<br />
<br />DRESSING ROOMS
<br />
<br />o
<br />
<br />o 40 Rooms clean, lockers provided, facilities clean, located, used
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