. STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION DIVISION OF HOTELS AND RESTAURANTS DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION (No - | O Kio Petitioner, vs. \ License No. 7403930 PJ'S DINER License Type 2010 Permanent Food Service Respondent. Case No. 2005061083 / ADMINISTRATIVE COMPLAINT The DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION, DIVISION OF HOTELS AND RESTAURANTS, (‘Petitioner’), files this Administrative Complaint against PJ'S DINER, ("Respondent"), and says: 1. Petitioner is the state agency charged with regulating the operation of public lodging establishments and public food service establishments, pursuant to Section 20.165 and Chapter 509, Florida Statutes, 2. Respondent is, and has been at all times material hereto, licensed by or subject to the jurisdiction of the Division of Hotels and Restaurants. The respondent's business address of record is 870 SAXON BLVD #41, ORANGE CITY, FLORIDA 327638209.The mailing address of record is PJ'S DINER, at 870 SAXON BLVD #41, ORANGE CITY, FLORIDA 327638209. 3. Inspection of this establishment conducted pursuant to Sec. 509,032, Florida Statutes, revealed violations of the provisions of Chapter 509, Florida Statutes, and / or the rules promulgated thereto governing operation of the establishment. The violation(s) found and applicable law are described in Exhibit "A," attached hereto and incorporated herein by reference. Inspection documents are attached as Exhibit “B’, incorporated herein by reference. | WHEREFORE, Petitioner respectfully requests entry of an Order imposing one or more of the following penaities: administrative fine not to exceed $1,000 per offense; mandatory attendance at Respondent's expense at an educational program sponsored by the Department's Hospitality Education Program; suspension, revocation, or refusal of a license issued pursuant to this Chapter, and/or any other relief authorized by Chapter 509, Florida Statutes, or the rules promulgated thereto. Signed November 30, 2005 _ of Upto ob eel Valerie Freeman, District Manager By delegation of the Director, or designee Division of Hotels & Restaurants Department of Business & Professional Regulation © COUNSEL FOR THE DEPARTMENT: Charles F. Tunnicliff, Lead Attorney Florida Bar No. 0153831 ; Department of Business & Professional Regulation 1940 North Monroe Street Tallahassee, Florida 32399-1007 CERTIFICATE OF SERVICE BY CERTIFIED U.S. MAIL, ARTICLE NUMBER: . | HEREBY CERTIFY that a true and correct copy of the foregoing ADMINISTRATIVE COMPLAINT has been hand served by me on this day of , 2005. Received by: Inspector's Signature . Operator's Signature Title : Title Case Number: 2005051083 ‘ Form revised 11.10,05 License Type: 2010 Permanent Food Service District Number: 04 License Number: 7403930 _ PJ S DINER License Number: 7403930 License Type: 2010 PERMANENT FOOD SERVICE Case Number: 2005061083 . Exhibit A “FC" as cited herein references specific provisions of the Food Code, Recommendations of the United States Public Health Service, Food and Drug Administration, incorporated by Chapter 61C, Florida Administrative Code. "NFPA" as cited herein references Specific provisions of the National Fire Protection Association Life Safety Code, incorporated by reference at Chapter 4A-3, "Fire Prevention, General Provisions", Florida Administrative Code, and 61C~1.004(5), Florida Administrative Code, It is alleged that on January 5, 2005, February 4, 2005 and September 13, 2005 the licensee was in violation of Florida Statute 509(FS) and/or the Rules of the Division of Hotels and Restaurants, Florida Administrative Code (FAC), in the following particulars. Copy(s) of the report(s) for the above referenced inspection(s) are attached hereto and incorporated by reference as Exhibit B. * 41. 53B-08-1 509.049 FAC: FOOD SERVICE EMPLOYEE TRAINING. THE DIVISION SHALL ADOPT, BY RULE, MINIMUM FOOD SAFETY PROTECTION STANDARDS FOR THE TRAINING OF ALL FOOD SERVICE EMPLOYEES WHO ARE RESPONSIBLE FOR THE STORAGE, PREPARATION, DISPLAY, OR SERVING OF FOODS TO THE PUBLIC IN ESTABLISHMENTS REGULATED UNDER THIS CHAPTER. THESE STANDARDS SHALL NOT INCLUDE AN EXAMINATION, BUT SHALL PROVIDE FOR A FOOD SAFETY TRAINING CERTIFICATE PROGRAM FOR FOOD SERVICE EMPLOYEES TO BE ADMINISTERED BY A PRIVATE NONPROFIT PROVIDER CHOSEN BY THE DIVISION, ANY FOOD SAFETY TRAINING PROGRAM ESTABLISHED AND ADMINISTERED TO FOOD HANDLER EMPLOYEES PRIOR TO THE EFFECTIVE DATE OF THIS ACT SHALL BE SUBMITTED BY THE OPERATOR TO THE DIVISION FOR ITS REVIEW AND APPROVAL. IT SHALL BE THE DUTY OF THE LICENSEE OF THE PUBLIC FOOD SERVICE ESTABLISHMENT TO PROVIDE TRAINING IN ACCORDANCE WITH THE DESCRIBED RULE TO ALL EMPLOYEES UNDER THE LICENSEE'S SUPERVISION OR CONTROL, THE LICENSEE MAY DESIGNATE A CERTIFIED FOOD SERVICE MANAGER TO PERFORM THIS FUNCTION AS AN AGENT OF THE LICENSEE. FOOD SERVICE EMPLOYEES MUST RECEIVE CERTIFICATION PURSUANT TO THIS SECTION BY JANUARY 1, 2001. FOOD SERVICE EMPLOYEES HIRED AFTER NOVEMBER 1, 2000, MUST RECEIVE CERTIFICATION WITHIN 60 DAYS AFTER EMPLOYMENT. CERTIFICATION PURSUANT. TO THIS SECTION SHALL REMAIN VALID FOR 3 YEARS. ' THERE WAS NO PROOF OF THE REQUIRED EMPLOYEE TRAINING. Case Number: 2005061083 Form revised 11.10.05 License Type: 2010 Permanent Food Service District Number: 04 License Number: 7403930 PJ'S DINER Pd AF Fa CfCrece DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ision of Hotels and Restaurants M) LICENSING ~, LEGAL NOTICE FOOD SERVICE INSPECTION REPORT = DISTRICT - “ = ai NAME I” Catering t a = \ - Vending : 7 Ns Kemer Veo. “ me | Cy i) op ey HUSINESSNAME im: MFOV a] PoOlomoe se: , . mm Cl. Theme Patk | p A\ pm ~ Food Cart 2) 2AGAas ae ADDRESS) = DBHOGBaeagg 3 . {2 Temporary 870 Suzrnr f Lol ma | (2) CEyCe) CE CE) ca Oey CEs) 7 7 “ISP prinaat } Tamp. Assoc. y ' $Qptinnaly w/Parm. Est, a!) BODO oo @ ol a mo G ww oe 7 " lo. of Seats RABAaAaa ae © General (8 Seating 3b, aE ASsoaae Qo EXHIBIT B ear ra f we | Manth Ki Fs) / Failure ta comply with this Notice may intl te an ? exe -. ate an a = u oP) = IQ-/o | 1 4 Routine administrative complalnt that may result in suspension or revocatio P § a, a} Pe . CO A fap 3 CQ Complaint i hor revocation of your license and tines ve 1} italy eae] 4 © Intormatian rs | @ we 53 Epldemisiogical 41 £) ANY VIOLATIONS noted herein must be ETT corrected by the NEXT ROUTINE INSPECTION. m| eB erat) v B 0 oo Dw 6 © Pending 2 WARNING: 7 Vielations in the oparation of your a oe aes establishment must ba corected by: ms | ee Bs Daves Tine: ——————— Bt Be Be a HACGP INSPECTION 38 ADMINISTRATIVE COMPLAINT recommended, m) i @ S mt | Go} oo fo & | 5 {) Seasonal a) GD EB {aE J [ ie] 6(1 EMERGENCY OADER recommended based upon 2 severe and immediale ) threat to the public. _| ia iE Ree ats tg i at MANAGE! Reece me Temperature. Faud Nana er Name Certificate Dnt ne LALE ern he “8 mare it See reverse side for explanation of citations, 7D E J ara A m ocilafs ‘orl 4 alt saCytaiefD '50f7 Hoye m fib (Clam? 1580 2a) aaa oT 51 ay f= cy oat veut} iC as eated) a2) seflj | a . . ClRCLED ITEMS ARE TR VIOLATION B sal suct 170} 26a ash 4a zs B " = = "oa C3 er sec) aq sap he . saws as) 18E5 a i . Sanilizing Concentration 2 ppm: A ee ww wel oe WO AC} Sanitizing Temperature_____________ degrees F. em ose} HO ez0a) 28 ae H8E? 589 x ‘oa( ‘tae A208) 308% aC) “47 sect COMMENTS ¥ at 2t) af 310 a wel xO 2 06) 1309 2 wo Bays sO E ! acknowledge receipt of this inspection form and comments. REMINOER: Your license expires _¢ Recapeynt + ‘Saume mae PRINT: + feepaa gy Satie PLEASE lan de "A Agvet a Les Com loan. = | CERES K & AOU BE Pec ttica Rtg Tah € os ya (. aok 1 BS — . - Heo tpas rs Showaty Pw Ps Nipentians A L Le ie aad ‘ede Lime Ei ___. State of Florida aon fa { Department of Business and Professional Regulation Division of Hotels and Restaurants www.hospitalityeducation.org EXHIBIT B COMMENTS SHEET “yet fi . Page_2_ of me f , af bo A CPL uy bt eps "EL. Ae DBPR Form HR 5022-042 MyFlorida.com 2001 November 61 . Page i STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION DIVISION OF HOTELS AND RESTAURANTS EXHIBIT B www. myflorida.com/dbpr CALLBACK INSPECTIGN REPORT LEGAL NOTICE Falliire to comply with this Notice may initiate an administrative complaint that may result in suspension or revocation of your licens and fines, 2/4/05 1:01:51 PM ‘ Werning SEA7403930 SEAT Callback Inspection Date and Time Inspection Reason Ucense Number Vi'S DINER INC [ADMINISTRATIVE COMPLAINT racommended, (804)775-2340 Owner Name Area Code/Telephone Number PJ'S DINER Business Name Inspection Result 36 01/05/2005 Number of Units Requested Callback Date/Time Tnitial Warning Date 00870 SAXON BLVD #41 ORANGE CITY FL 327638209 Address / City State / Zip / etc. Comments nly three employees on shift at time of Call Back Inspection, The Fallewing Item(s) have been recommended for Administrative Complaint: Violation: 53B-01 i no proof of required employee training. Employee training expired. This violation must be corrected by : 02/04/2005, The following item(s) are In compliance: [Meation: 124-03 o- AGL 2/4/05 Date Signature of Reciplent Inspector Signature Recipient: Shivan Dua For further Information please contact: . Terry R. Angel Title PIC Sanitation and Safety Specialist 400 West Robinson St Phone: 86-775-; Orlando, FL 32801 386-775-2340 407 B50 1395 DBPR Form HR 5022-005 Page 2 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL RE ‘eense Number sgaraosoa DIVISION OF HOTELS AND RESTAURANTS| IT B 4039) www. myflorida.com/dbpr Business Name CALLBACK INSPECTION REPORT PY'S DINER - LEGAL NOTICE Inspection Date 2/4/05 1:01:51 PM Fallire to comply with this Notice may Initlate an administrative complaint that may result in suspension or revocation of your licens: and flnes, baserved food employee engage In food preparation, handle clean equipment or utensils, or touch unwrapped single-service Items, without washing hands, ‘ Molation: 22-06 Pbserved soll buildup Instde fce bin. Molatlon: 23-01 bbserved heavy bulld-up of grease on nonfood-contact surface. Fryer. Violation: 32-02 bbserved lack of handwashing sign at a handsink used by food employees, Wait station, Molation: 36-03 lbserved grease accumulated on Kitchen floor under fryer. Motation: 37-02 . observed celling tile roissing, Kitchen. flolation: S3A-04 ployees engaged In food preparation, Five employees on shift at time of bserved no currently certified food service manager noted on duty with four or more emy inspection. This violation must be corrected. by + 02/04/2005, Only three employees on shift at time of Call Back inspection, DBPR Form HR 5022-005 STATE OF FLORIDA Page 1 DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION DIVISION OF HOTELS AND RESTAURANTS EXHIBIT B www. myilorida.com/dbpr FOOD SERVICE INSPECTION REPORT LEGAL NOTICE Falluré to comply with this Notice may tnitlate an administrative complaint that may result in suspension or revocallan of your license and fines. 415/05 9:58:39 AM Routine 7403830 SEAT Inspection Date and Time inspection Reason : License Number VJ'S DINER INC WARNING: Owner Name Violations In the operation of your (904)775-2340 PJ'S DINER establishment must ted by: Area Code/Telephone Number Business Name inspection Result 36 02/04/2005 08:00 AM 04/01/2005 Number of Units Callback Date/Time License Expiration 00870 SAXON BLVD #41 ORANGE CITY FL 327638209 Address / City / State / Zip / etc. ; a - ltem 03: Food Temperatures Item 53a: Cert. Food Managers tem 20: Warewashing Sanitization | tem 45: Fire Extinguishers and _ Fire Suppression Systems Dates Sankizer Type: Chlorine found at concentralion | A Class ABC lype Fire Extinguisher, ltundin/at Ground beel, reach in cooter, 43 Degrees F, Manager Name: Dua, Vijay Ceniication Date: Ham, reach In cooker, 41 Degrees F, G/a4/2003 Certllied by: Experbr Assessments of50 PPM, Dishmachine, dining room has 9 certificallan date of 08/2004 Sausage, reach h cooler, 41 Degrees F, . A Hood Suppression type Fre Exiinguisher, gravy, hat hetding, 147 Degrees F. found tn/alkitthen hag a certiicallon date af Potatoas, mashed, hot holding, 155 Degrees F. ‘OB/2004 ‘A Class 8C type Fre Extinguisher, fourd bat ‘Michen hes a certficalion date of 08/2004 NOTE: lems marked above with an asterisk (*) indicate a violation inspectors Comments OP for BHC. Water Source: Mun Ite: www. hospltalityeducation.org, cipal/Utility. Sewage:.Munlicipal/utility.. - - Employees trained by Food Safety Training Institute. —.Provided-Wab - tacknowledge recelpt of this inspection form and comments. Rp LAA Fa ee V45/05 Date Slgnature of Reciptent inspeclor Signature . = Reclplent: Agustin Escalante For further information please contact: é Tany R. Anget Title Cook Sanitation and Safety Specialist 400 Wesl Robinson SI Orland, FL Phone: 386-775-2340 coveto 1298 STATUS SOURCE STATUS T PHF TEMPERATURE CONTROL Yes *Ola Approved source Yes —feee Hot food at proper temperature Yes “0ib Wholesome, sound condition Yes "03c Foods properly conked/reheated Yes 02 Original contalner, properly labeled, date marking [Yes "03d Foods properly cooled STATUS . PHF TEMPERATURE CONTROL Yes “04 Facillilas to malntaln product temperature Yes "03a Cold food at proper temperatures during storage, Yes ‘05 Thermometers provided and conspicuously placed display, service, transport, and cold holding [Yes “06 Potentially hazardous foods properly thawed Violations marked with an aslerisk are crilical violations. tems marked YES are In compliance. tems Marked NO are violations. Specific details of violation are listed on subsequent pages. ltems marked N/A are Not Applicabte, tems Marked as N/O are Not Observed, and were nol being conducted at the time of inspection. DBPR Form HR 5022-015 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL R' ul DIVISION OF HOTELS AND RESTAURANTS RELL iT www.myflorida.cam/dbpr Page 2 ise Number SEAT 7403930 Inspection Date 1/5/05 9:58:39 AM FOOD SERVICE INSPECTION REPORT e LEGAL NOTICE Failure ta comply with thts Notlee may Initlate an administrative complaint that may result In suspension or revocation of your license and fines. STATUS PHF TEMPERATURE CONTROL I STATUS GARBAGE AND REFUSE DISPOSAL Yes "07 Unwrapped of potentially hazardous food not re-served [Yes 33 Containers covered, adequats number, insact and rodent Yes "08a Food protection during storage, preparation, display, _[proof, emptied at proper Intervals, clean service, transportation Yes 34 Outside storage area clean, enclosure properly a" n constructed Yes O8b Cross-contamination, equipment, personnel, storage | = - Yes "08c Potential far cross-contamination; storage practices; STATUS INSECT AND RODENT CONTROL damaged food segregated Yes 'a5a Presence of insects/rodents, Animals prohiblied Yes *09 Foods handled with minimum contact Yes "35b Outer openings protected from insects, rodent proof {Yes 10 In use food dispensing utensils properly stored STATUS FLOORS, WALLS, CEILINGS STATUS PERSONNEL No 36 Floors properly constructed, clean, drained, coved Yes "41 Personnel with infections restricted No 37 Walls, celllngs, and attached equipment, constructed, No "12a Hands washed and clean, good hygienic practices clean (observed), alternatlve operating plan Yes 38 Lighting provided as required, Fixtures shlalded Yes "(2b Proper hyglenie practices, eating/drinking/smoking Yes 39 Rooms and equipment- vented as required (evidence) STATUS OTHER AREAS Yes 13 Clean clothes, hair restralnis Yes 40 Employee lockers provided and used, clean STATUS FOOD EQUIPMENT AND UTENSILS Yes "41a Toxic items properly stared . Yes "41b Toxic Items labeled and used 14 Food contact surfaces designed, constructed, malntalned, Installed, located 45 Non-food contact surfaces designed, constructed, maintained, installed, located "16 Dishwashing facilities designed, constructed, operate 1, Wash 2, Rinse 3. Sanitize Yes *17 Thermometers, gauges, test kits 18 Pre-flushed, scraped, soaked Yes... 42 Premises maintained, free of litter, unnecessary arilcles, Cleaning and maintenance equipment properly stored, Kitchen restricted to authorized personnel P45 Fire extinguishers - proper and sufficient Yes 29 Plumbing Installed and mainiained Nes Yes 19 Wash, rinse water clean, proper temperatura Yes *46 Exiting system - adequate, good repair Yes 20a Sanitizing concentration Yes "47 Electrical witing - adequate, good repair Yes *20b Sanitizing temperature ‘ _lYes "48 Gas appllances - properly Installed, maintalned ‘Yes 21 Wiping cloths clean, used properly, stored Yes "49 Flammable/combustlble materials - properly slored No 22 Food contact surfaces of equipment and utensils clean STATUS GENERAL No 23 Non-food contact surfaces clean Yes 50 Current license properly displayed Yes 24 Storage/handiing of clean equipment, utensils Yes 51 Other conditions sanitary and safe operation STATUS SINGLE SERVICE ARTICLES Yes 52 False/mtsleading statements published or advertised es 25 Service lems properly stored, handled, dispensed | relating to food/baverage Yes 2§.Single service articles not re-used No "53a Food management certification valid STATUS : WATER AND SEWAGE/PLUMBING No "53b Employee training validation | *27 Water source safe, hot and cold under pressure Yes $4 Florida Clean Indoor Air Act Yes 28 Sewage and waste water disposed properly Yes 85 Automatic Gratuity Notice Wes 58 Copy of Chapter 509, Florida Statutes, available | jPSS__.__ {98 Copy of Chapter STATUS GENERAL facility clean, supplied wilh handsoap, disposable towels or hand drying devices, tissue, covered weste receplaclas ves "30 Cross-connection, back siphanage, backflow {_STATUS TOILET AND HANDWASHING FACILITIES Yes 57 Hospitality Education Program Information provided Yes "31 Tollet and handwashing facillties, number, convenient, jYes 58 Smoke Free designed, installed No 32 Restrooms with self-closing doors, fixlures operate properly, Total Number of COS Violations: 0 prot Number of Repeat Violations: 0 aut - Viplations marked with an esterisk are critical violations. Hems marked YES are in compitance. hems Marked NO are violations. Specific detalis of violation ara ‘isted on subsequenl pages. tlems marked N/A ave Not Apolicable. tems Marked as N/O are Nol Observed, and were nol being conducted at ihe time of inspection. DBPR Form HR 5022-D15 Page 3 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION — License Number Ex H ] B | DIVISION OF HOTELS AND RESTAURANTS SEAT 7408828 T B www. myflorida.com/dbpr Inspection Date : 4/5/05 9:58:39 AM FOOD SERVICE INSPECTION REPORT LEGAL NOTICE Fallure to comply with this Notice may inttiate an administrative complaint that may result In suspension or revocation of your license and fines, Warning(s); §34-04 - Observed no currently certifiad food service manager noted an duty with four or more employees engaged In food preparation. Five employees an shift at time of inspection, This violation must be corrected by : 02/04/2005. 53B-01- Observed no proof of required employee training. Employee training expired, This violallon must be corrected by : 02/04/2005. Violalian(s): 124-03 - Observed food employee engage in food preparallon, handle clean equipment or utensils, or louch unwrapped single-service lems, without washing hands. 22-06 - Observed soil bulldup inside Ice bin. 23-01 - Observed heavy bulld-up of greasa on nonfond-contact surface, Fryer. 32-02 - Observed tack of handwashing sign sta handsink used by food employaes. Wall station, 36-03 - Observed Grease accumulated on kitchen flaor under fryer. 37-02 - Observed calling tile missing. Kitchen. hd DBPR Form HA 5022-015

Docket for Case No: 06-001086