OT 08d STATE OF FLORIDA O7FEB IS PMI2:45 DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION DIVISION OF HOTELS AND RESTAURANTS DIVISION OF DEPARTMENT OF BUSINESS AND AG TRATIVE PROFESSIONAL REGULATION HEARINGS Petitioner, vs. . . License No. 6307448 HAMPTON INN CONTINENTAL BREAKFAST License Type 2010 Respondent. Case No. 2006066176 ADMINISTRATIVE COMPLAINT The DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION, DIVISION OF HOTELS AND RESTAURANTS, (‘Petitioner’), files this Administrative Complaint against HAMPTON INN CONTINENTAL . BREAKFAST, (“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 202 CYPRESS GARDENS BLVD, WINTER HAVEN, FLORIDA 33880.The mailing address of record is HAMPTON INN CONTINENTAL BREAKFAST, at 202 CYPRESS GARDENS BLVD, WINTER HAVEN, FLORIDA 33880. 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 penalties: 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 chapiyr r, and/or any other relief authorized by Chapter 509, Florida Statutes, or the Signed December 06, 2006 fel Erdman, Deputy 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 Certified Article Number Tallahassee, Florida 32399-1007 . CERTIFICATE OF SERVICE BY CERTIFIED U.S. MAIL, ARTICLE NUMBER: SENDERS RECORD | HEREBY CERTIFY that a true and correct copy of the foregoing ADMINISTRATIVE COMPLAINT has been hand served by me on this day of , ; Received by:, Inspector's Signature : . Operator's Signature Title Title Case Number: 2006066176 : District Number. 03 License Number: 6307448 2010 . Form revised 10.10.06 * HAMPTON INN CONTINENTAL BREAKFAST Exhibit A License Number: 6307448 License Type: 2010 PERMANENT FOOD SERVICE Case Number: 2006066176 “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. - “* denotes a critical violation. Itis alleged that on October 4, 2006, November 16, 2006 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. * 4.16-09-1 . 4-301.12 (A) FC:: (A) EXCEPT AS SPECIFIED IN PARAGRAPH (C) OF THIS SECTION, A SINK WITH AT LEAST 3 COMPARTMENTS SHALL BE PROVIDED FOR MANUALLY WASHING, RINSING, AND SANITIZING EQUIPMENT AND UTENSILS. NO THREE COMPARTMENT SINK PROVIDED, OBSERVED UTENSILS BEING WASHED IN A 2 COMPARTMENT SINK WITHOUT SANITIZATION. * 2,08A-21-1 3-306.11 FC:: FOOD DISPLAY. EXCEPT FOR NUTS IN THE SHELL AND WHOLE, RAW FRUITS AND VEGETABLES THAT ARE INTENDED FOR HULLING, PEELING, OR WASHING BY THE CONSUMER BEFORE CONSUMPTION, FOOD ON DISPLAY SHALL BE PROTECTED FROM CONTAMINATION BY THE USE OF PACKAGING; COUNTER, SERVICE LINE, OR SALAD BAR FOOD GUARDS; DISPLAY CASES; OR OTHER EFFECTIVE MEANS. SELF SERVICE BREAKFAST BUFFET LACKING ADEQUATE SNEEZE GUARD OR OTHER PROPER PROTECTION FOR ALL FOOD PRODUCTS. Case Number: 2006066176 District Number: 03 License Number: 6307448 2010 Form revised 10.10.06 HAMPTON INN CONTINENTAL BREAKFAST . BMHIBNB py 1 Korihes fatns... . DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION DBPR . . Division of Hotels and urate, i 4 (1 2040 Permanent Food Service ection Rep 2 2042 Theme Park Food Cart (2) 2013 Catering | (2) 2044 Mobile Food Dispensing Vehicie 1 2015 Vending Machine C1 Complaint Fut (COMP) aia (2) Complaint Partial (CPAR} al 2 Disaster Response (DSTR) fed 1 Epkiemiological (EP!) , : , . “| [2 Service Request (SERV) _Visitine (21 Quality Assurance (QA) [Month Gay Vea} Stat Eng Cg aN) ito [oy Log [50 [ote | he 8 item indicate that item's status at the time of Inspection Mark °X” in appropriate box for COS andior R IN = in complianca_ OUT =notin compliance NIO = not observed NIA = not applicatile . COS = corrected on-site during inspection R = repeat vdlation COMPLIANCE STATUS : _ ‘ CN ] | ta Approved Source (in) NiO. O1b LIN | our | NiO [NA [02 + Consumer advisory on rawlundercooked aysiers IN | OUT | CNA Consumer Advisory IN| OUT Sie Consumer. advisory on rawlundercooked animal products Cold food at proper temperatures during storage, display, GC) —_— Potentially u OUT |p Wa | —~b and cold holdin Hazardous Food (IN| ouT [NO] N/A |” 036 | Hot food at proper temperature : Timeffemperature =| IN | OUT. a Foods pi tS _ Protection from Food protection during storage, preparation, display, service, transportation — Contamination [ (iN) | Cross-contamination, equipment, personnel, storage (in | Food contact surfaces clean and sanitized ota OUT Personnel with infections restricted . _ . (1) | our snort pian and clean, good hygienic practices (observed), alfemative / rating plan Personnel i) OUT b Proper glen prac + ° = covered wasta receptacles | : A | ye | OUT oo Toxic substances properly stored ri Chemical Zin? | OUT Toxic substances properly labeled, used r__| Demonstration of " [IND| OUT [| Food management certification valid ty Roewne |W | 6" [Ene tr etn | 2 H sett Pee eae Dak ‘| Fe aes RC rece fy cook Cream hea le £2 a ne ca Fraoaik eens Marre Fr 7) HA amantatih y €fD F7- [PT ~ ; . byw 0 — | PRY P eee — re a ine 2 eee aN nepector’s Telephon 2006 May 2 OBPR Form HR 5022-015 www.MyFlorida.com/dopr i i a Pi Food Service Inspection Report J 05 _ Thermometers provided and con a Cl “EY 06 Potentially hazardous foods properly thawed “17386 Suter openings pro fected from insects, rodent proo (27 *08c Polentlal for cross-contamination, storage practices; damaged t TJ 36 Physical faxilties floors properly constructed, clean, drained, | food segregated coved | 10 In use food dispensing utensils properly stored = 37 Physical Tacos wal, callings and atlached equipment, 13 Clean clothes harestsins cemsinied.clean 14 Food contact surfaces designed, constructed, maintained, TET 38 Lighting provided as required. Fictures shielded — . installed located = fo Read Rooms and equipment - vented as required (1 15 Non-food contact surfaces designed, constructed, maintained, H 39-Bcoms ad eavpv- vel sented | TC installed, located a ( 42 Premises maintained, no unnecessary articles. Cleaning & iby 16 Dishwashing facilities designed, constructed, operated maintenance equipment properly stored. Kitchen restricted, 4.Wash 2.Rinse 3.Sanize ate separation from ving jeeping area, iy a 47 Thermometers, gauges, test kis provided y Bare Clean and solled linen segregated and prope : 18 Preflushed, scraped, soaked [145 Fire extinguishers — proper and sufficient i ___ FIRE EXTINGUISHERS: Dato(s) SUPPRESSION SYSTEMS: Datos) . m etre f8C~ 07-0 ¢ 23 New food conta surfaces ay nna] “46 Exiting system — adequate, qoodrepair ling of clean ecuipen utensils i (1°47 Electrical wiring - adequate, good repair” t d __ [)*48_ Gas appliances — proper! afe, hot and cold under pressur csi ees a . 51 Other conditions sanitary and sale operation 7 52 False/misteading statements published or advertised relating a sieiss oD seg age gigle Bee ele sla B18 Ta ie a igs i ri | i | if 1 oa Tollel and hand Tee faciities, “number, See a designed, r Een da Clean Indoor Air Act Cor . : ___ 55_ Automatic Gratuity Notice _ installed of Chapter 509, Florida Statutes available H Hospitality Education Program Information provided LD 33 Garbage containers aovered, adequate number, insect and rodent ___ proof, emptied at proper intervals, clean Violations cited In this Ve prea —e ot ple ‘4 Ling Warring tue “iololog mak Le sete hed Ol ~@ —_~ bo fo impact af om — z ote Bish mes? washing vtensife ih 7 £ el Pan Aeaening thig” vill be kecce. =o . ae tee hea Suter Hpleemttet. ota biseu ts “eit @ bof e Latte $ j Shee ze var. Warning thie “Veo be torched by poy-og “ic _| Be An ty eet Like dan tra tesy ty geess behind - LAX ee ee [J Additional Comments on Attached Sheet Og : Date Person in Charge (Signature: he Ke oS {inspector (Signature) fake Z. A-Loc, Date /6 -OY ~oF 2006 May 2 www. MyFlorida.com/dbpr DBPR Form HR 5022-015 DEPARTMENT OF BUSINESS AND eroressioue Addo B TI. ark | (e~ey<6 . Division of Hotels and Restaurants LEGAL NOTICE Food Service Inspection Re §4 2010 Permanent Food Service 7 2012 Theme Park Food Cart (2013 Catering 1 2014 Mobile Food Dispensing Vehicle (7 2015 Vending Machine ort Unscheduled (ROUT) Licenshg (LIC) , C2) Complaint Full (COMP) (71 Complaint Partial (CPAR} [] Disester Response (OTR) 25 Gavchins. Blof 7 Epidemiological (EPI) - { 33%, Sone Request (SERV) Visit Date : Quality Assurance {QA) {Month Oey Year sia Ci eahing (RNG) Lu) tye toe | pias [aur | Clrcied letters to the left of each item indicate that Item's status at the time of Inspection Mark *X" in appropriate box for COS andfor R iN = In compliance OUT = nat In compliance W/O = not observed NIA = not applicable COS = correcied on-site during inspection _R = repeat violation . COMPLIANCE STATUS 7 : cosT Rk IN [OUT | O1a__| Food obtained from approved source = Approved Source IN | OUT | NiO O1b _{ Wholesome, sound condition ee | IN| OUT | NiO Original container; properly labeled, date marking, shell stock ta [| j IN | OUT Consumer advisory on rawfundercooked oysters | Consumer Advisory in OUT y” [Consumer advisory on rawiundercooked animal products _ iw | our Cold food at proper temperatures during storage, display, sarvice, transport, Potentially and cold holdin : i Hazardous Food IN| OUT [NAO | er tempera ; | TimeMTemperature [IN| “OUT Foods properly cookedireheated dC : (Nj OUT Foods properly coofed IN a Protection from IN’ [CoUT? ing storage, preparation, display, service, transportation Contamination {IN equipment, personnel, storage . IN . CIN-|_OUT_|_NO | — — Cin Personnel with infections restricted : ~ IN Fangs ruplen and. clean, good hygienic practices (observed), alternative : : operating plan Personnel in| OUT WS Proper hygienic practices, eatingidrinkingismoking (evidence) Restrooms with self-closing doots, fixtures operate properly, facility clean, IN supplied with hand soap, disposable towels or hand drying devices, tissue, tacles covered waste re : Chemical IN [ 4ta_| Toxic substances properly stored I - IN | “4b | Toxic substances properly labeled, used co Demonstration of | |_IN_|_OUT | ; cone wou] om es Dl neomirihtentnfin| El cat-cometien Lat agente [cy ear ren | [oinsameam (Otte commons | Mame eee a ~ Adi i ck — Time Emergency Order Calback — Ti , ’ ce fe iy rte spon 7. = nk VVO-49 7-139 Telephone . inspectors Signatwe P ‘inspactors Telephone 2006 May 2 oO Emergency Order Catback — Not Complied (EONO Licks Mim se tt Tie 7 Tapects Ware Pe b. Wrack noe Parebn in Charp DBPR Form HR.§022-015 . www.MyFiorida.com/dbpr * ) EXHIBIT B Floris faturtre ” DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION Page 2 of DBPR Division of Hotels and Restaurants ~~ . . LEGAL NOTICE a Food Service Inspection Report ethos Paaarantncid *35a Presence on Insects/rodents. Animals prohibited [-1*35b Outer openings protected from insects, rodent 36 Physical feclifes oes properly constructed, clean, drained, | coved 37 Physical iedliteswall, Cellings and attached equipment, “08c Potential for sross-confemition storage practices; damaged | food ated LJ 10” Inuse food dispensing utensils properly stored. stored -_" 13 Clean clothes, hair restraints ee ee constructed, clean Pie “Food contact surfaces designed, construcled. maintained. en sng nied a Sue Fes led installed tocated Lol L_]_39 Rooms and equipment — vented as required | "LA 15 Non-food contact surfaces designed, constructed, maintained, 40 Employee lockers provided and used, clean installed, located imag 2 Premises maintained, no unnecessary articles. Cleaning & De 16 Dishwashing facies designed, constructed, operated maintenance equipment properly stored, Kitchen restricted. 1, Wash 2.Rinse 3, Sanitize _ [| 43 Complete separation from fivin 17_Thermometers, gauges, test kits provided LJ 44 Clean and soiled linen 18_Pre-flushad, sora soaked” J *45 . _CJ 19 Wash, rinse water clean proper temperature. t+ FIRE EXTINGUISHERS: Date(s) SUPPRESSION SYSTEMS: Date(s) oD “20a Sanit convention ° ~~ _---Eatirenheit rly, stored .23...Non-food contact surfaces clean Hes “46 Exiting system - adequate, goodrepalr —— Soraoeranding (Coan eaipmer ens L_1*47 Electrical wiring ~ adequate, good repai¢_ 25 Service items red, handled, di: | [£148 Gas appliances — properly installed, maintained 3 le service a a re-used _ {| (}*49_ Flammable/combustible materials - properly stored fl *27_Watet source safe, hot and cold under pressure : {1°50 Current license, properly displayed __ [) *28 Sewage and waste water disposed properly _ inl 51. Other conditions sanitary and safe operation _ “Ey 29 Plumbing installed and maintained a ("J 52 False/misleading statements published or advertised relating (J 30 Cross-connection, back siphonage, backflow 1 _..... 10 food/beverage eter a (9 *31 Toilet and hand washing facilities, number, convenient, designed, §4 Florida Clean indoor AirActCompliance = . Installed _ 55_ Automatic Gratuity Notice _ + vee CT 33 Garbage containers covered, adequate number, insect and rodent |" LJ 56 Copy of Chapter 509, Florida Statutes available r= fi Smo a peper Intervals, clean. . ] 57 Hospitality Educ {sn ea eran eed item No. Miatone eed ia his epo st be cote ne fe Kanes bei of as stated on pag ge 1. 414 (2 yee acd protuette n: tien for C455 Bs bufleh, _ @ 3 comp ee tuseat Sink. at. thane ke . — _. _ Date W~/6-0¢ DBPR Form HR 8022-015 www. MyFlorida.com/dbpr : ; 2006 May 2 Z0U-S4G REQUEST FOR ADMINISTRATIVE COMPLAINT ¢06666/ | Business Name: License Number: temp ton Ian Con Prrce ¥ Bok bass _ 63 O07K% ; ; License Type (such as 2010): Ty im Pos i, / UP £7 | Owner: | ROO. Inspector Area Number: I$ LE File Number: ig yi Ownership (& Mailing Addr. if Possibie) Verified by: £, ky Corhite Peete: ii laeloe _| GE | [pate lag/ag | inspection Data Entry Verified by: Inspection Chronology ~ include inspection dates on Exhibit A only when violation(s) was observed Inspection Type ~ ; Inspection Result — Routine, Complaint, CB, On-Stip : Warning, TE, AC Request, Complied . Researched by: > & lsalog | “Case History Worksheet ¥ 1@) | “Offender Status: Number of violations: —~ | Critica: | Non-Critica: “~~ | Fine (Optional): (7D Violations Combined: -Y 7 N Viol. Nos. Combined for H&R Stats Notes Box: ; Exhibit A Dates (include adequate inspection dates to show compliance with division warning policy for violations cited): | Supervisor : Approval —™S Deputy Distict Manager fev: J Oates IV J — dae: Violations - attaching PDA inspection for editing is an alternative to writing violation codes and observations Violation Observations Violation Code . Dey WAS 06 a yan parti We uidha 15aHH. ~*This case plus number of ACs, withiolations other than license paymer, clerked within 2 years for this operator at t location : ; ; **Attach Case History Worksheet if Offender Status > 1 OR if other AC or EOS was issued for this licensee & location.

Docket for Case No: 07-000860