HomeMy WebLinkAboutBELOW 40 POKE 2021.06.10Dallas County Health and Human Services -Environmental Health Division
Retail Food Establishment Inspection Report
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I Time out:1License/Permit #
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Risk Cal~gory Page -of t:.-
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Purnose of nsnection:I I l-rnnHlliance 1"'-I 2-Routine I 3-Firld luvcsti!'atioll I I 4-Yisit I I 5-0ther TOTA..1"""CORE
Establl~t tan;c:\-fGh "I Contactl~"ner Name:1 *\"lIlllhcr of [{('peat \'iolations:__75\\:./~lIl11hcr of Yiolations COS:--,'Loo";,.''';
Phy ice 6fc!k~\-iii II((I ~,\.-~t CitY,COlC'\-p I Zi~_l)P~~I Follow-up:Yes
No (circle OIlC).....,-repeat violatio~Compli'"lce Slatu.:Out not 10 compliance IN -=in compliance :-.;0 -not ob,en-ed NA 111'1applicabJr (,OS corrcct('d on site R
Mark the aoorooriale DoinlS in the OUT bo,for each nllmbered ilcm Mark .,/,a checlmark ill aODrooriale box for t'\'.1'0.I'iA.COS Mark an asteri,k .*.in aoorooriate box for R
Priority Items (3 Points)violations Reluirl!IlIIlIIeiliate Correctit'e Actiol1l1ot to exceed 3 IItIYS
Comulianc('Status ('oll1tlliancr Status
0 II:.."C Time and Temperature for Food Safety R 0 I N "C RUN0A0UN()A 0 Emplo~ee HealthTjS(F =degrees Fahrenheit)T /SI,I.Proper cooling time and temperature /I~.Management.food employees and conditional employees;
knowledge.responsibilities.and reponing!/2.Proper Cold Holding temperatllre(41°F/45'F)J 13.Proper lise of restriction and exclusion;No discharge from,J eve.,.nose,and mouth
7,3.Proper Hot Holding temperature(13S0F)./I'rcvcntin!!Contamination bv Hands/1/4,Proper cooking time and temDerature 14.Hands cleaned and properly washed/Gloves used orooerlvV5.Proper reheating procedure for hot holding (165°F in ~//IS.No bare hand contact with ready to eat foods or approved
Hours)alternate method Droperlv followed (APPROVED Y N )I 6 Time as a Public Health Control:nrocedurcs &records Hi!!hlv SUscclltible Ponulations
'\pprO\ed Source
~16.Pasteurized foods used;prohibited food not offered
Pasteurized elIas used when required1/7.Food and ice obtained from approved sOllrce;Food in,;good condition.safe.and unadulterated:parasite Chemicals
destruction ,/,/8,Food Receivcd at proper temperature 7 17.Food additi,es;approved and properly stored:Washing Fruits
&Veaetables
Protection from Contamination ,/18 Toxic substances properlv identified,stored and uscd
II,9.Food Separated &prolected.prevented during food Water/Plumbing
Drwaratien.stora>!e,disDlay.and tasting ,
./10.Food eontacts..rfa/~~)~~,tr;abks;Cleaned and I /19,Water Ir0111appro,ed source;Plumbing installed:proper
Sanitizcd at ----,tem'I.u&:~VI I'\IL d back flow device
_"V II.Proper dispositiotl OTreturned,previously sened or /20.Approved Se"age/Wastcwater Dispo>al System.proper
reconditioned disposal
Priority Foundation Items (2 Points vio/atilllls Re,uire Correctit'e Actioll withi"10 day.~
()I "N C R 0 I N "C RUN0A0DemonstrationofKnowledge/Personnel l'"0 i\0 Food Temperature Con troll IdentificationTSTS
,,-21.Person in charge present.demonstration of knowledge./•....27.Proper coolll1g method used;Equipment Adequate to
and Derform duties/Certified Food Manager (CF:>!)~laintain Product Temperature1/22.Food Handler/no unauthorized nersons/nersonncl /'28.Proner Date i'vlarking and disposition
Safe Water,Recordkccping and Food Package ~2'J.Thermometers prol'ided.accurate.and calibrated:Chemical/
Labclinl!1/Thermal test strips'/~3,Hot and Cold Water available:adequatc pressure,safe Permit Requirement,Prerequisite ror Operation
/v 24.Required records available (shellstock tags;parasite /f 30.Food Establishment Permit (Current &Valid)destruction):Packa~ed Food labeled
Conformance with Appro\'ed Procedures Utcnsil~,Equipment,and Vcnding,y!/~5,Compliance with Variance,Specialized Process,and 1~31.Adequate handwashing facilities:Accessible and properlyHACCPplan;Variance obtained for specialized
supJ}(_(cd.used \I(Ii,I \(~~'i['1L)orocessin!!methods:manuf:1cturer instructions J
Consumer Advisory /32.FCfudand Non-food Cdntact surfaces clea-;I;ble,properly~designed.constructed,and used-=r 26.Posting of Consumer Advisories:ralV or under cooked /33.Warewashing Facilities:installed,maintained.used/
foods (Disclosure/ReminderiBu!Tet Plate)/Allergen Lahel Sen icc sink or curb cleanin<!facility providcd
Core Items (I Point)ViollltifJIIs ReQllire Corrective A£'ti{)ll /\ot til Exceed 90 Days or 1\'exIIIIS{lecrioll •Whid,e"er Climes First
0 I i'"X C n 0 I N "C nu"0 A n Prevcntion of food Contamination t:N ()A ()food IdentificationTl-S T .~
V l/34.No Evidence of Insect contamination.rodenlJother I 41.0riginal container labeling (Bulk Food)V animals.."v 3S.Personal Cleanliness/eating.drinking or tohacco usc Phvsical Facilities_,V 36.\vipin.!;Cloths:properlv used and stored ..4".Non-Food Contact surfaces clean,V 37.Environmental contamination V <13.Adcllllate Ientilation and lighting;desi~nated areas used./38,Approved thalVing method ./44,Garbage and Refuse J)roperlv disJ)osed:facilities maintained
Proper Use of Utcnsils .v 4S.Phvsical f',cilitie:.installed.maintained.and clean\./39.(;telbils,equipment.&linens:prope~~,sed.stored./46.Toilet Facilities:properly constructed.supplied.and clean
./dried.&handled/In usc ulcnsi Is;croper!L1sed
I 40.Single-sen ice &singlc-usc articles;-propcrl)stored 47.Othcr Violations
and used
Received v:p~:print:~,AC~'1':__h :Title:Person In Charge/Owner(<;Ignaturef ,-r=-\_V\v'')0
~~,itedl Y:y)\\(j f,~r+f:\II .rr \.Print:Blisinc~s Email:
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F~6 Revised 09-2 --015)
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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TEMPERATURE OBSERVATIONS
ltemILocation Temp.ltemILocation Temp.ltemiLocation Temp.
OBSERVATIONS AND CORRECTIVE ACTIONS
Item AN INSPECTION OF YOUR ESTABLISHMENT HAS BEEN MADE.YOUR ATTENTION IS DIRECTED TO THE CONDITIONS
Number OBSERVED AND NOTED BELOW:
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Received by:C-~_--Print:.I I .Title:Person In Charge/Owner(signature).n ~~,........./,..I),~,,'\.~\..,._)"/V~~(:;
I~:t by:nl('\I )<:C~(/,rHrtl,~~rint:
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(sign I(.Samples:Y N #Collected
Form EH·06 Revised 09·2015)