Food Establishment Inspection Report |
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FOODBORNE ILLNESS RISK FACTORS AND PUBLIC HEALTH INTERVENTIONS |
Circle designated compliance status (IN, OUT, N/O, N/A) for each numbered item IN=in compliance OUT=not in compliance N/O=not observed N/A=not applicable Mark "X" in appropriate box for COS and/or R COS=corrected on-site during inspection R=repeat violation |
Risk factors are important practices or procedures identified as the most prevalent contributing factors of foodborne illness or injury. Public health interventions are control measures to prevent foodborne illness or injury. |
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GOOD RETAIL PRACTICES |
Good Retail Practices are preventative measures to control the addition of pathogens, chemicals, and physical objects into foods. Mark "X" in the box if the numbered item is not in compliance Mark "X" in appropriate box for COS and/or R COS=corrected on site during inspectionR=repeat violation |
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Food Establishment Inspection Report |
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Establishment: A JS | License/Permit #: 000635 | Date: 06/27/2025 |
Water Supply: Community Non-Community Licensed Non-Community Waste Water System: Community On-Site IEPA System |
Sanitizer: | Temperature Logs in Use: |
Location | Method | Sanitizer Type | Concentration (PPM) | Heat(F) |
CFPM Verification (name, expiration date, ID#): | |||
WILLIAM BACZEK 07/19/2026 21760624 |
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Presentation Type: | Number Attended: | 0 |
IL Requirements: | Use of non-latex gloves for food handling and preparation 410 ILCS 180/10. |
Appropriate default beverage for children's meal 410 ILCS 620/21.5. |
OBSERVATIONS AND CORRECTIVE ACTIONS |
P=Priority PF=Priority Foundation C=Core R=Repeat |
Item Number |
P/PF/C/R | Code Reference | Violations cited in this report must be corrected within the time frames below. |
52 | C | 5-403.12 |
Condensate drainage and other nonSEWAGE liquids and rainwater shall be drained from point of discharge to disposal according to LAW. Waste water is leaking in the walk-in cooler. Contact a licensed plumber to repair the leak. CORRECT BY NEXT ROUTINE INSPECTION |
55 | C | 6-201.11 |
Floors, floor coverings, walls, wall coverings, and ceilings shall be designed, constructed, and installed so they are SMOOTH and EASILY CLEANABLE. The floor in the walk-in cooler is made of plywood and is not smooth and easily cleanable. Repair or seal the floor in the walk-in cooler to be smooth and easily cleanable. CORRECT BY NEXT ROUTINE INSPECTION |
Inspection Comments |
Follow-Up Inspection. The facility manager has provided an active food protection manager certificate. The walk-in cooler interior has received cleaning. |
AMY WALTERS Person In Charge (Signature) |
Lacey Luther Inspector |
Follow-up: Yes No | Follow-up Date: |