HomeMy WebLinkAboutCASA BLANCA # 4 2021.06.16<1')'~,...'"2377 N.STE:vI!VIONS FRWY.,R'\1607,DALLAS,TX 7S~i Z~i-'-2ryt~;.3-819-2868o1~~·or"'i·"f.,I
ore:I Iv tG~l I Time out:')t .1~c~enJ{#I Est.Type I RIskCalegory Page~_of _j,i?tT ")...~'!'Ir
PUFpose of Inspection:I I l-ComDlilince I /l 2-Rouline I I 3-Field Investi2ation I I 4-Visit I I S-Other TO~ORE
Establishment..N(.'lle:-.!'On --:11.Y I ContactJOwner Name:I
*Number of Repeat Violations:__(uj,••~-I))'.-01 "..:-;umber of Violations COS:--\.I .".-,
~ys.ical Address:'.(_L1"'(itt.\.(\Jc~c°ti V ZiP~"2~~ne:I Follow-up:YesLU~\.'L',"\I'"):..?'\·rL..1 No (circle one)
Co,"~nce Status:Out:not Incompliance I"IIIcompliance NO -not observed NA -not applicable COS -corrected onsite R ~repeat ,~olation
\1arlc the annmnriate P<llIllSInIheOUT box for eachnumbered Item Mark ,-.',3checlunarkin annrnnnate box for IN,NO.NA,COS Mark an asterisk.'*'in boxfor R
Priority Items (3 Points)violationsRe uire ImItI~di4t~Co"ectiv~Aclion "0110 excud J tUn'S
ComDlla~Stahl.ComoUance SlalUs
0 I N N C Time and Temperature for food dety R 0 I N N C R
U 0 A 0 U ..•..0 A 0 Employee Bealttl
T s (F =degrees Fahrenheit)T S
/'•...I.Proper cooling time and temperature 12.M.anagement,food employees and conditional employees;/1--"knowledge,responsibilities.and reporting~2.Proper Cold Holding temperature(41°F/45°F)/13.Proper use of restriction and exclusion;No discharge from
.•.•..'"eyes.nose,and mouth~-3.Proper Hot Holding temperature(135°F)Preveatial!ContalDinatloD bv Huds
./4.Proper cooking time and temperature /14.Hands cleaned and properly washed!Gloves used properly.."5.Proper reheating procedure for hot holding (165°F in 2 1 15.No bare hand contact with ready to eat foods or approved
Hours)alternate method properlv followed (APPROVED y N )
"6.Time as a Public Health Control:procedures &records HiI!b]y Susceotlble PooalatlollS
Approyed Source
~
16.Pasteurized toods used;prohibited toad not ofTered
Pasteurized eggs used when required
)/'7.Food and ice obtained from approved source:Food in
good condition.safe,and unadulterated;parasite CkmIcall
destruction
,..V 8.Food Received at proper temperature /1 17.Food additives;approved and properly stored;Washing Fruits
&Vegetables
Protection from Contamination ./18.Toxic substances properly identilied.stored and used
/'9.Food Separated &protected,prevented during food Waterl PlambiJtg",.preparation.storage,display.and tasting,IO.Food contact surfaces and Returnables;Cleaned and /19.Water from approved source;Plumbing installed;proper
Sanitized at ppm/temperature backllow device
/'J I.Proper disposition of returned.previously served or /20.Approved SewageIWastewater Disposal System,proper
reconditioned disposal
Priority Foundation Items (2 Poillu ••iollllkll6 Jt.t1111in COITttCthrActitHtI<IItIrIlt 1,.•••.•..
0 I !II !II C R 0 I N N C R
U N 0 A 0 Demonstration of Knowledgel Personnel u N 0 A 0 Food Temperature Cootrollldeolificatioll
T s T S
_.....V 21.Person incharge present.demonstratIon of knowledge./27.Proper cooling method used;Equipment Adequate to
and perform duties/Certified Food Manager (CFM)Maintain Product Temperature
....v 22.Food Handler!no unauthorized persons!personnel ./2S.Proper Date Marking and disposition
Safe Water,Recordkeeping and Food Package .../29.Thermometers provided,accurate,and calibrated;Chemical/
LabeUnl!Thermal test strips.-V ?'Hot and Cold Water a"allable:adequate pressure,safe r -"'et:mlt ptequlnmetlt,Prerequhite for Operatloft_J.
./24.Required records available (shc1lstock tags:parasite
30.fO~~!f~~~~&'Y1ev'(e'n~Valid)destruction);Packaged Food labekd
Conformance with Approved Procedures --UtenJu.l,Eqaipment,&lid Vendlnir25.Compliance with Variance,Specialited Process.and r'31.Adequate handwashing facilities:Accessible and properlyHACCPpian;Variance obtained for specialized
processing methods;manufacturer instructions II supplied.used
Consulllt'r Advisol)'/32.Food and Non-food Contact surfaces cleanable,properly---designed.constructed.and used
--('26.Posting of Consumer Advisones;ra"or under cooked /33.Warewashll1g Facilities;installed,maintained,used!
foods (Disclosure/Reminder/ButTet Plate)/"lIcr~en Lanel ,Savice sink or curb cleaning facility provided
Core Items (l Point)Violations Rrilui,.~CorTl'cliveAction N«UIExce~4 '10D.}"Sor IVe:cJItISD«titHI,Witkluvtr C_Fim
0 I N ••C R 0 I N N C R
U 0 A 0 Prevention of Food Contamination u 0 A 0 Food Ideatificatioo
T s T s
{,/34.]\;0 Evidence of Insect contamination.roden~other V 41.0riginal container laheling (Bulk Food)
./animals ./•..-35 Personal Ckanlinessleating.drinkll1Cor tobacco use PlIyskal Facilities.-~36.Wiping Cloth,;properly used Jnd qored r 42.Non-Food Contact surfaces ckan...-37.EnVironmental contamination "43.Adequate ventilation and lIghting;designated areas used_,..,.-r 38..\pprol'ed tha"ll1gmethod .,44.Garnaac and Refuse properly disposed;facilities maintained
Proper Use of Uten5i1s /-'5 PI1\"ical tnctiitles llIstalleJ.tnaintall1ed,and clean
,/3').Ctenslb.CLJUIJlll1cnt,&linen>;propcrl)u'ed.stured.i r /46.Toilet Factlitles;properly constructed,supplied.and clean
dned.&h:lndled!In usc utensils:eroecrl:lJ~cd
~/.:10.Sll1gle·service &single-use artIcles;prnperly -tored 47.Other \/wlations
and used
Received by:'._!(/r/.,.I~-/,Prin ty-:--.'.
'~/1 dJ '/---I Title:Person In Charge/Owner(signature).,/\~;I /r/I'/-\(///?//$
III~~7~\~A L \--N 1-,vr+1<VL I \(~
Print:I Business Email:
(Slgl
Form E~ised 0~·'201S)-,-
Dallas County Health and Human Services -Environmental Health Division~L\w"..
Retail Food Establishment Inspection Report (,./v-~(...~~e._