HomeMy WebLinkAboutCVS 2018.03.30Dallas County Health and Human Services -Environmental Health Division
Retail Food Establishment Inspection Report
2377;-';.STE:\I;\IO~S FR\VY ..R:\1607,DALLAS,TX 75207 21-t-819-2115 FAX:214-819-2868 .I
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I Time alit:j License!Permit #Est.Type I Risk Category Pagel of ~
Purp,se of In pection:I I I-Compliance IV)2-Routine I 3-Field Investigation I I 4-Visit I I S-Otllcr mTI\-L/S~RE
EstabliShttt1f=)I Contact!Owner Name:
I
*"umber of Repeat Violations:__10 )./"umber of Violations COS:--
PhYS3tTI·~HoCIA(n6 \()Il-{Ji Cr1Cnt~?£~\h /~-t,nn~"\Follow-up:Yes
:-;0 (circle one)\./
Compliance Statlls:O:~:in compliance IN =in compliance ~not observed NA =not applicable COS =corrected on site R =repeat violation
Mark the aoorooriate Doints in the OUT box aeh numbered item Mark ../.a check mark in appropriate box I()f 11\'.1\'0.NA.COS Mark an asterisk'*.in aoorooriate box for R
Priority Items (3 Points)violatiolls Re "ire Immediate Correetil'e Action 1I0t to exceed 3 dal's
Compliance Statlls Compliance Status
0 I N N C Time and Temperature for Food Safety R 0 I :-l ;0;C R
U 0 A 0 L N 0 A 0 Employee HealthT'"S (F =degrees Fahrenheit)T ./s
V I.Proper cooling time and temperature (/itl/12.:Vlanagemcnt,food employees and conditional cmployees;V ~kno\\ledge,responsibilities.and reporting
V 2.Proper Cold Holding temperature(41 °F/45°F)v 13.Proper use of restriction and exclusion;No discharge fromV[,0 .eves.nose.and mouth."~3.Proper Hot Holding temperature(135'F)V Prewnting Contamination bv HandsV4.Proper cooking time and temperature V "14.Hands cleaned and properly washed!Gloves used properly
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5.Proper reheating procedure for hot holding (165°F in 2 .~15.No bare hand contact with ready to eal foods or approved
Hours)alternate method properly followed (APPROVED y N ),6.Time as a Public Health Control:procedures &records Hil!hlv Susceptible Ponulations
Approved Source j/16.Pasteurized foods used;prohibited food not olTered
Pasteurized eggs used when required
V 7.Food and ice obtained Ii-om approved source;Food in
V good condition.safe.and unadulterated:parasite
/Chemicals~destruction
/8.Food Received at proper temperature '1 17.Food additives;approved and properly stored;Washing Fruits
/&Vegetables
7 Protection from Contamination .A 18.Toxic substances properlv identilied.stored and used
-/1/9.Food Separated &protected.prevented during food /Waterl Plumbing
preoaration,storage.display.and tasting
;/10.Food contact surfaces and Returnables:Cleaned and \/19.Watcr fi-OInapproved source;Plumbing installcd;proper
~Sanitized at ppm!temperature 11 back now device
•...V II.Proper disposition of returned.previously served or V 20.Approved Sewage!Wastewater Disposal System,proper
reconditioned disposal
Priority Foundation Items (2 Points violations Re,"ire Corrective Actioll withill 10days
0 t N N C R 0 I N N C R
U N 0 A 0 Demonstration of Knowledge!Personnel l,;Nl/A 0 Food Temperature Conlrol!ld('ntification
T ;.;T S
Iv 21.Person in charge prcscnt.demonstration of knowledgc.-27.Proper cooling method used:Equipment Adequate to1/and perform duties!Certified Food Manager (CFM)l/Maintain Product Temperature
I 22.Food Handler!no unauthorized persons!personnel J
...•28.Proper Date Marking and disposition
/Safe Water,Recordkeeping and Food Package .v 29.Thermometers provided,accurate,and calibrated;Chemical!
Labeling Thermal test strips
V 23.Hoi and Cold Water available:adl}r.:::-.IJ~"";~lIfjfW~_.I ./Permit ~equirement,Prerequisite for Operation
V 24.Required records available (shellstock tags:par<iSite
~30.Food ~lb s~e\mZ @tr~t &Valid)V destruction);Packaged Food labcled
Conformance with Appro,'ed Procedures -llensils,EqJipment,and Vending
~
25.Compliance with Variance.Specialized Process,and ,.
HACCI'pian:Variance obtained for specialized ~/31.Adequate handwashing facilities:Accessible and properly
orocessinl!methods:manufacturer instructions supplied.used
./
Consumer Advisory ,,/32.Food and Non-food Contact surfaces cleanable.properly
•designed.constructed.and usedy26.Posting of Consumer Advisories;raw or under cooked ,,/33.Warewashing Facilities;installed.maintained.usedl
foods (DisclosurelReminderfBuffet Plate)1 Allergen Label Service sink or curb cleaning facility provided
Core Items (I Point)Violatiolls Reqllire Corrective Actioll Not to Exceed 90 Dal's or Next Illspectioll,Whicllel'er Comes First
0 I N N C R 0 I N N C RUN0A0PreventionofFoodContaminationUN0-:,v~Food IdentificationT-S T
(/
I/'34.No Evidence of Inscct contamination,rodent/other ••••1/'41.0riginal container labeling (Bulk Food)
./animals
I.,..."/35.Personal Cleanliness/eating,drinking or tobacco use J Pbysical Facilities
V ./36.Wiping Cloths:properly used and stored V[/42.Non-Food Contact surfaces clean
.~./37.Em irot1mental contamination t/V 43.Adcquate ventilation and lighting:desitmated areas used•....38.Appro\ed tha\\ing method /V 44 .Garbage and Refusc properly disposed:facilities maintained
./PrODel'Use of Utensils V /45 .Physical facilities installed.maintained,and clean
./39.Utensils,equipment.&linens;properly used.stored.vi 46.Toilct Facilities;properly constructed.supplied.and clean
/dried.&handled!In use utensils:orooerly used
,/40.Single-service &lingle-use articles:properly storcd 47.Other Violations
and used '"Received bY:_n UllF tr;"'/\,~,Print:y t,..«Wi )/)11nCZh Title:Person In Chargel Owner
(signature),_I~
Inspec~~f"\~W)'l\it5J (r--f~-t hrL 1(..f-rrint:
'-/Business Email:
(signatur ).'v
Form EH-~ed b9-2015)'-..\