Food Establishment Inspection Report |
||||||||||||||||||||||||||
Page 1 of ????????? | ||||||||||||||||||||||||||
|
|
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. |
|
|
GOOD RETAIL PRACTICES |
Good Retail Practices are preventative measures to control the addition of pathogens, chemicals, and physical objects into foods. Mark "X" in box if numbered item is not in compliance Mark "X" in appropriate box for COS and/or R COS=corrected on site during inspectionR=repeat violation |
|
|
IOCI 17-356
![]() |
Food Establishment Inspection Report |
|
Page 2 of ?????? | |
Establishments: TEA ROOM AT THE DEPOT | Establishment #: 1495 |
Water Supply: Public Private Waste Water System: Public Private | ||
Temperature Documentation: NO | License Posted: NO | Complaint Number: |
Sanitation Information | ||
Name: Teresa Golden | ||
Name: JULIA KEENE | ||
Name: Emily Thompson |
SANITIZER OBSERVATIONS |
|||||
Location | Location Desc. | Method Used | Chemical Sanitizer Used | PPM | Water Temp |
Sanitizer Bucket | Chemical Sanitizer | Chlorine | 200.00 | 0.00 | |
Sanitizer Bucket | Chemical Sanitizer | Chlorine | 100.00 | 0.00 | |
Dish Machine | Hot Water | 0.00 | 160.00 |
TEMPERATURE OBSERVATIONS |
Item/Location |
Temp |
Item/Location |
Temp |
Item/Location |
Temp |
sliced tomato/prep table middle | 39.50°F | Beef/prep table middle | 41.00°F | fluff/prep table middle under | 41.50°F |
Chicken/prep table side | 38.50°F | grape tomato/prep table side | 38.50°F | peanut butter pie/dessert cooler | 39.50°F |
air temp/dessert freezer | -20.00°F | air temp/walk-in freezer | -2.50°F | Cheese/walk-in cooler | 39.00°F |
coconut pie/walk-in cooler | 36.50°F | broccoli soup/reheat for hot holding | 165.00°F |
OBSERVATIONS AND CORRECTIVE ACTIONS |
Item Number |
Violations cited in this report must be corrected within the time frames below. |
16 |
*** Sanitizer bucket was 200 ppm. *** COS A chlorine solution needs to be between 50 to 100 ppm. Employee diluted the sanitizer bucket to 100 ppm. I suggested that they write and post a procedure on the wall of how to make a sanitizer solution to the correct concentration so all employees make it the same way. - 4-501.114 (A): (A) A chemical SANITIZER used in a SANITIZING solution for a manual or mechanical operation at contact times specified under ¶4-703.11(C) shall meet the criteria specified under §7-204.11 Sanitizers, Criteria, shall be used in accordance with the EPA- registered label use instructions, and shall be used as follows: (A) A chlorine solution shall have a minimum temperature based on the concentration and pH of the solution as listed in the following chart in the Food Code. - V,COS |
HACCP Topic: sanitizer concentrations |
Person In Charge (Signature)Emily Thompson |
Date:08/15/2023 |
InspectorEmerson Roden |
Follow-up: Yes No Follow-up Date: |