HomeMy WebLinkAboutROLY POLY 2017.01.18Dallas County Health and Human Services-Environmental Health Division
Retail Food Establishment Inspection Report
2377 N. STE:\L\'IONS FRWY., R.\1607, DALLAS. TX 75207 214-819-2115 FAX: 214-819-2868
Dt:;_/ I>""} t---1 Time in: I Time out: ~ License/Permit # 7 SO(, I Est. Type I Risk Category
'Purp_oseoflnspection: I ~ompliance r -..., 2-Routine r ~3-Field lnvestieation r l 4-Visit r l 5-0tber
Establ~_.;n\f./~lle: J1 j I Cont~~r N~ . ..J r I *Number of Repeat Violations: __ n (/) {.,'1 nJ tJ-1 _/_{!__'/ ru u IJ CN .,. Number of Violations COS:--
PageL of 2_
TOTAUSCORE
-Compliance Status: Out= not in compliance I =in compliance 0 =not observed NA =not applicable COS = corrected on site R =repeat violation
Mark the appropriate points in the OUT box for each numbered item Mark 'v"' a checkmark in appropriate box for IN, !'10, NA, COS Mark an asterisk' * 'in appropriate box for R
Compliance Status
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Inspected by:
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Priority Items (3 Points) violations Re uire Immediate Correctit•e Action 11ot to exceed 3 days
Time and Temperature for Food Safety
(F =degrees Fahrenheit)
I. Proper cooling time and temperature
2. Proper Cold Holding temperature(41 °F/ 45°F)
3. Pro]Jer Hot Holding temperature( 135°F)
4. Proper cooking time and temperature
5. Proper reheating procedure for hot holding (165°F in 2
Hours)
6. Time as a Public Health Control: procedures & records
Approved Source
7. Food and ice obtained from approved source; Food in
good condition, safe, and unadulterated: parasite
destruction
8. Food Received at proper temperature
Protection from Contamination
9. Food Separated & protected, prevented during food
preparation. storage, display, and tasting
10. Food con~~,s~ac~~etumables ; Cleaned and
Sanitized at ~ ~~1perature
II. Proper disposition of returned. previously served or
reconditioned
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Priority Foundation Items (2 Points
Demonstration of Knowledge/ Personnel
21. Person in charge present. demonstration of knowledge,
and perform duties/ Certified Food Manager (CFM)
22. Food Handler/ no unauthorized persons/ personnel
Safe Water, Recordkeeping and Food Package
Labeling
23. Hot and Cold Water available; adequate pressure, safe
24. Required records available (shellstock tags; parasite
destruction); Packa.ged Food labeled
Conformance with Approved Procedures
25. Compliance with Variance, Specialized Process, and
HACCP plan; Variance obtained for specialized
processing methods; manufacturer instructions
Consumer Advisory
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Compliance Status
0 I N N C
U N 0 A 0
T S
I Vf I
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Employee Health
12. Management, food employees and conditional employees;
knowledge, responsibilities, and reporting
1 13. Proper use of restriction and exclusion; No discharge from
eyes, nose, and mouth
Preventing Contamination by Hands
14. Hands cleaned and properly washed/ Gloves used properly
15. No bare hand contact with ready to eat foods or approved
altemate method properly followed (APPROVED Y N )
Highly Susceptible Populations
16. Pasteurized foods used; prohibited food not offered
Pasteurized eggs used when required
Chemicals
17. Food additives; approved and properly stored; Washing Fruits
& Vegetables
18. Toxic substances properly identified, stored and used
Water/ Plumbing
19. Water from approved source; Plumbing installed; proper
back flow device
20. Approved Sewage/Wastewater Disposal System, proper
disposal
violations Re~ 11ire Corrective Action withi11 10 daJ'S
0 I N N C
u N 0 A o Food Temperature Control/ Identification
T S
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27. Proper cooling method used; Equipment Adequate to
Maintain Product Temperature
28. Proper Date Marking and disposition
29. Thermometers provided, accurate, and calibrated; Chemical/
Thermal test strips
Permit Requirement, Prerequisite for Operation
30. Food Establishment Permit (Current & Valid)
Utensils, Equipment, and Vending
31. Adequate handwashing facilities: Accessible and properly
supplied, used
~~· Food and Non-food Contact surfaces cleanable, properly
designed, constructed, and used
26. Posting of Consumer Advisories; raw or under cooked ., / 33. Warewashing Facilities; installed, maintained, used/
foods (Disclosure/Reminder/Buffet Plate)/ Allergen Label Service sink or curb cleaning facility provided
Core Items (1 Point) Violations Require Corrective Action Not to Exceed 90 Days or Ne:ct Inspection, Whichever Comes First
Prevention of Food Contamination
34. No Evidence of Insect contamination, rodent/other
animals
35. Personal Clcanliness/eatinK. drinking or tobacco use
36. Wiping Cloths: properly used and stored
37. Environmental contamination
38. Approved thawing method
Proper Use of Utensils
39. Utensils, equipment, & linens: properly used. stored,
dried. & handled/ In use utensils: properlv used
40. Single-servic~ single-usc articles; properly stored
and used / _r-v
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R 0 I N
~ N 0
Print:
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0 s Food Identification
4l.Original container labeling (Bulk Food)
Phvsical Facilities
42. Non-Food Contact surfaces~
43. Adequate ventilation a~C!l:Th!11ti~esignated areas used
44. Garbage and Refuse properfy disposed; facilities maintained
45. Physical facilities installed, maintained, and clean
46. Toilet Faci lities: properly constructed, supplied, and clean
47. Other Violations
Title: Person In Charge/ Owner
0
Business Email:
Form EH-06 (Revised 09-~015) / I I I
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Dallas County Health and Human Services -Environmental Health Division
Retail Food Establishment Inspection Report
2377 N. STEMMONS FRWY., RM 607, DALLAS, TX 75207 214-819-2115 FAX: 214-819-2868
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I I TEMPERATURE OBSERVATIONS
Item/Location ..... Temp Item/Location Temp Item/Location
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OBSERVATIONS AND CORRECTIVE ACTIONS
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Item AN INSPECTION OF YOUR ESTABLISHMENT HAS BEEN MADE. YOUR ATTENTION IS DIRECTED TO THE CONDITIONS OBSERVED AND Number NOTED BELOW:
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Received by:. 'f,...;::;J lf71ll ~~:_) Print: Title: Person In Charge/ Owner
(signature) · r:JlU;J
Inspected by:'-'/1 _j ·
(signature) , ~~!A~ Print: {)x~ {.-1Jn.~.J DC Samples: Y N #collected
Form EH-06 (Revisecf 0~ I I I