HomeMy WebLinkAboutCVS PHARMACY 2018.07.25¥\'NAL-\50-~\\ ~1Q;
Dallas County Health and Human Services -~r....-:~nt'll-'i7h-A.nnwntal Health Division . (
Retail Food Establishment I~pectio~~ Rpo t onolhl0
2377 N. STEMMONS FRWY., RM 607, DALLAS, TX 75 7 214-819-2115 FA :214-819-2868 ~)"'-''.
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~'2 ::/?w rt in: I Time out: J License/Pen~ 0( C{ -() '006Tcte I Est Type I Risk Category Page -1-of-t
Purpo e oflr#.ipection: l J 1-Compliance f ~ 2-Routine f l 3-Field lnvesti2ation r l 4-Visit f l 5-0tber TOTAUSCORE
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Compliance Status: Out= not in co;;;piiance IN = in compliance NO = not 4served /NA =not applicable COS = corrected on site R =repeat violation
Mark the appropriate points in the OUT box for each numbered item Mark'../' a chec ;,C · ..,..(.;ropriate box for IN, NO, NA. COS Mark an asterisk' * 'in appropriate box for R
Priority Items (3 Points) violations Re uire Immediate Corrective Action not to exceed 3 days
Compliance Status
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Time and Temperature for Food Safety
(F =degrees Fahrenheit)
I. Proper cooling time and temperature
2. Proper Cold Holding temperature(41 °F/ 45°F)
/ p. Proper Hot Holding temperature( I 35°F)
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/ 4. Proper cooking time and temperature
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5. Proper reheating procedure for hot holding (I 65°F in 2
Hours)
6. Time as a Public Health Control; procedures & records
Approved Source
7. Food and ice obtained !rom 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
I U( Food contact surfaces and Returnables ; Cleaned and ~anitized at ppm/temperature
1 I. Proper disposition of returned, previously served or
reconditioned
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Compliance Status
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Employee Health
I 2. Management, food employees and conditional employees;
knowledge, responsibilities, and reporting
I 3. Proper use of restriction and exclusion; No discharge from
eyes, nose, and mouth
Preventino Contamination by Bands
I 4. Hands cleaned and properly washed/ Gloves used properly
15. No bare hand contact with ready to eat foods or approved
alternate method properly followed (APPROVED Y N )
Hi2hly Susceptible Populations
16. Pasteurized foods used; prohibited food not offered
Pasteurized eggs used when required
Chemicals
I 7. Food additives; approved and properly stored; Washing Fruits
& Vegetables
I 8. Toxic substances pr<>perl.)' identified, stored and used
Water/ Plumbing
I 9. Water from approved source; Plumbing installed; proper
backflow device
20. Approved Sewage/Wastewater Disposal System, proper
disposal
Priority Foundation Items (2 Points violations Re 11ire Corrective Action within 10 days
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N N
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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
lv 24. Required records available (shellstock tags; parasite
destruction); Packa2ed Food labeled
iJ Conformance wilh Approved Procedures
Y 25. Compliance with Variance, Specialized Process, and
HACCP plan; Variance obtained for specialized
processing methods; manufacturer instructions
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Food Temperature ControU Identification
27. Proper cooling method used; Equipment Adequate to
Maintain Product Temperature
28. Proper Date Marking and disposition
29. Thermometers provided, accurate, and calibrated; Chemical/
Therrna I test strips
Permit Requirement, Prerfquisite fo Operation
30. Food Establishment Pe(y/ ~ Fqct{J I 'I
Utensils, Equiplru$t, an"'e-ding "'
3 I. Adequate handwashing facilities: Accessible and properly
supplied, used
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V Consumer Advisory 32. Food and Non-food Contact ~f?~1s..;)ean'l_b11e, proP.srly •. 1 , ~ ,~
destgned, constructed, and used \ar Jl('UJ, 1111~ l'J..J l[J't~U l 01\i
26. Posting of Consumer Advisories; raw or under cooked V 33. Warewashing Facilities; installed, maintained, used/ I ~
foods (Disclosure/Reminder/Buffet Plate)/ Allergen Label / Service sink or curb cleaning facility provided 1--
Core Items (1 Point) Violations Require Corrective Action Not to Exceed 90 Days or Next Inspection, Whichever Comes First
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0 s Prevention of Food Contamination
34. No Evidence of Insect contamination, rodent/other
animals
35. Personal Cleanliness/eating, drinking or tobacco use
36. Wiping Cloths; properly used and stored
/ 37. Environmental contamination
;/ 38. Approved thawing method
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Proper Use of Utensils
39. Utensils, equipment, & linens; properly used, stored,
!¥-ied, S.,handled/ In J.l'll! utensils; prQPerly used
1/AO. sjll'g1e-service &/s}ftgle-use artjCI¢s; properly stored Van~d 1 V I J /
Received by: .f~ ~ II LA I /IJJ11v
(signature) ~/J( / L_--t;:l r. '-/" v• ~
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Inspr-~ . ·~ I / ·-, v . 1 ...!. LA 1f ~
Csigl)lllure) J1 "-M \ \c:;<N_ r-J.--111.-tfm l \ It'--<'
Form~ ~a 09-2015) _. '
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Print:
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0 A 0 s Food Identification
4 I .Original container labeling (Bulk Food)
Physical Facilities
42. Non-Food Contact surfaces clean
43. Adequate ventilation and lighting; designated areas used
44. Garbacre and Refuse properly disposed: faci lities maintained
45. Physical facilities installed, maintained, and clean
46. Toilet Facilities; properly constructed, supplied, and clean
4 7. Other Violations
Title: Person In Charge/ Owner
I Business Email:
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