HomeMy WebLinkAboutYUMILICIOUS 2019.04.23tal Health Division
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:214-819-2868-II\----/'1
D~1,'7;11Z0~I Time OUt:~iccnse Permit ,1 (to\V'\-())J 1~Tt~i>'Calcgory Page _l of__£_-
Purpos oflnspe tion:I I I-Compliance I V,2-Routine I I 3-Ficld Inwstiglltion I I 4-Visit I I 5-0ther TOT ALISCORE
Establishmel~:~[mll'lrI ;-u'I contact/olln:r :--'allle:
I
*:\umber of Repeat Yiolalions:__(~./:\umber of Violation,COS:--
Physical d1 s/l+-~lda~-tt~coN':(.;\1')ILl gill ~~r~-=KirP Follon-up:Yes
;./0 (circle one)
-
"IO=noto~d R =repeat vio~n __/'Compliance Status:Out =not in compliance I:'J =in compliance :>IA=nOIapplicable COS =corrected on site
Mark the appropriale points in the OUT box for each nllmb<red ilem !'v1,rk../'.a checkmark IIIaporopriate box for 1:\.\'0.:\A.COS Mark an asterisk'*.in a,JIJI Vl.11;Ul•..uox:for R
Priority Items (3 Points)"ivlatiolls Re(/uire Immediate Cvrrecti"e Actiol1lwt IIIexceell3 dal'S
Compliance Status Compliance Statu,
0 ,N N C Time and Temperature for Food Safety II 0 ,~,"r R
U
N IJ'A 0 t;,";>A °Employee Health
T S (F =degrees Fahrenheit)T S\IV I.Proper cooling time and temperature V /"I~.'v1,lI1agemenl,load employees and conditional employees;
kilO"kdgc.resplll1sibilities,and reportinu
V //0 Proper Cold Holding tCmpCrdtUrc(.j I'FI 45°F,..I 13.Proper use of restriction and exclusion:No discharge from
/eves.nose.and mouth
V /3.Proller Hot Holding temperature(135°F);'Preventin!!Contamination by Hands
"11 4.Propcr cooking time and temperature V .11 14.Hands cleaned and properly washedl Gloves used properly
/II 5.Proper reheating proccdure for hot holding (165'F in ~&(15.No bare hand contact with ready to eat toods or appro\ed
Hours)alternate mcthod properll'follO\\ed (APPROVED y N )
II 6.Time as a Public Health Control:procedures &records Highly Suscelltiblc Populations
Approwd Source J/16.PasteuriLed foods used:prohibited food not offered
Pasteuri7cd eggs used when required
I 7.Food and ice obtained from approved source:Food in
good condition.sale.and unadultcrated:parasite /Chemicals
J destruction
/8 Food Reccived at proper temperature ;1/f 17.Food additi\es:approved and properly stored:Washing Fruits
&Vegetables
Protection from Contamination \,V 18.Toxic substances properly identilied.stored and used
/9.Food Separated &protected.pre\ented during food Waterl Plumbing
preparation.stora!!c.display.and tasting ,
~
10.Food contact surfaces and Returnables:Cleaned and I /19.Water from approved ,ource:Plumbing installed;proper
Sanitized at ppm/temperature back flow de\ice
I II.Proper disposition of retumecl.previously ser\'Cd or I 20.Approved Sewage/Wastewatcr Disposal System.proper
reconditioned disposal
Priority Foundation Items (2 Points violations R(',"ire Corrective Actioll withill 10days
0 ,N ~C
Demonstration of Kn~(;rsdn,1 1111f R 0 ')~C R
N 0 A 0 ~~A °food Temperature ControV Identification;r'j S T s
't I ~f~n In cl;~resent.demonstration of kno\\lledge.V 1/27.Proper cooling method used:Equipment Adequate to
nn duties 'ertified Food :Vlanager (CFyl)Maintain Product Tempcrature
V /22.Food Handler n~unauthorized persons personnel J /~8.Proper Datc Markin!!:and disposition
/\..'~.•,.•""~ecordkeeping and food Package 29.Thermometcrs provided,accurate.and calibrated;Chemicall
Labelin!!I /Thermal test strips
V 23.Hot and Cold Water available;adequate pressure.safe /Permit Rcquirc!lltn ,Prereq uiJitc for Operation
",V 24.Required records a,ailable (shellstock tags:parasite VI 30.Food Establishme~J ~Iqrr '0()'~Ddestruction):Packa!!ed Food labeled
Conformance with Approved Procedures Utensils,Eqt ipment:a Id Vending
f 25.Compliance \\ith Variance.Specialized Process,and 11 3 \~quate handwashing facil itie,:Accessible and properlyHACCPplan:Variance ohtained for specialized )~sup cd.usedproces:-,ing methods;manufacturer in~tructiollS
Consumer Advisory
V V V 32.Food and Non·food Contact surfaces cleanable.properly
,/deSigned.constructed.and used
l'26.Posting ofCOI1>umer Advisorics:rail or under cooked (/11'33.Warellashing Facilities;installed.maintained.usedl
foods (Disclosure'Reminder/Buffet Plate)1 Aller!:!en Label Sen icc sink or curb cleaning facility pro\ided
Core Items (1 Point)ViolatiollS Reqllire Corrective Acti(/II Not tv Exceed 90 Dal's or Nextlll.5pecti"".J"7,ic/,e"er Comes First
0 ,N "C II 0 I N :;C R
N 0 A 0 Prevention of Food Contamination l'..•0/0 Food Identific:ltionTSTS
...••V 34.No Evidence of Insect conlaminati0n.rodent/other V 41.0riginal container labeling (Bulk Food)
animals-35.Personal Cleanliness/catin~.drinkln!!or tobacco use Phvsical facilities...•.36.Wipin~Cloths:properly used and stored "J 42.Non-Food Contact surfaces clcan,37.Em irOnmel1l31 cont311linatlon '/}43.Adequate \,entilation andli!!htinu:desiunatecl areas used
II"38.Apprm ed thall in!!I11ctlllld "I 44.Garbage and Refuse properly disposed:tClcilities maintained
Proper lls('of l'tcnsils ~I 45.Ph"ieal t'lcilities installed.maintained.and clean
/39.L:tensib.equipment.&linen,:propcrl)used.stLlred.·I 46.Tllilet Facilities:properl)'cLlnstructed.supplied.and clean
""dried.&handledl In use utensils:properl,u,cd
./40.Single·ser ice &single'u,c articles:properly stored 47 .Other Violations
and used
Received by:.f'~~~~Print:1'/6c'Y/c>;e.S Title:Person In Chal'gel Owner
(signature)-/'1''
Inspect~~rt\li~:(-"'")~IV)Print:Husincs,Email:
(siullaturc'
Form EH-O~~9-2015)-I _.
TEMPERATURE OBSERVATIONS
Item/Location Item/Location Temp TempTempItem/Location
OBSERVATIONS AND CORRECTIVE ACTIONS
Item AN INSPECTION OF YOUR ESTABLISHMENT HAS BEEN MADE.YOUR ATTENTION IS DIRECTED TO THE CONDITIONS OBSERVED AND
Number N ELOW:
Sam les:Y N #collected
Title:Person In Charge/Owner