Jul 11 200? 16:02 a@rf/ll/2ae7 15:56 8584146749 DEPR OGA PAGE 18/16 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION DIVISION OF HOTELS AND RESTAURANTS DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION Petitioner, vs. : . ; License No, 6214845 © PHILLY'S Respondent License Type 2010 espondent, Case No. 2007025837 i ADMINISTRATIVE COMPLAINT The DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION, DIVISION OF HOTELS AND RESTAURANTS, ("Petitioner"), files this Administrative Complaint against O FHILLY'S, ("Respondent’), and says: 1. Petitloner is the state agency charged with regulating the operation of public lodging establishments and public food service establishments, pursuant to Section 20.185 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’ 217 CORONADO AVE, CLEARWATER BEACH, FLORIDA 33767.The mailing address of record ig O PHILLY'S, at 217 CORONADO AVE, CLEARWATER BEACH, FLORIDA 33767. 3. Inspection of this establishment conducted pursuant to Sec. 509.037, Florida Statutes, revealed violations of the provisions of Chapter 509, Florida Statutes, and / or the rules promulgated therete 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 nat to exceed $1,000 per offense, mandatory attendance at Respondant'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 April 30, 2007 istfict Manager “By dlelegation of the Director, or designee Division of Hotels & Restaurants Department of Business & Professional Regulation COUNSEL FOR THE DEPARTMENT: Gharnes F. Tunniciiff, Lead Attorney Florida Bar No. 0153831 Department of Business & Professional Regulation 1940 North Monroe Street Tallahassee, Florida 32399-1007 GERTIFICATE OF SERVICE , ° BY CERTIFIED U.S. MAIL. ARTICLE NUMBER: SENDERS RECORD | HEREBY GERTIFY that a true and correct copy of the foregoing ADMINISTRATIVE COMPLAINT has been hand served by me on this___s day of , 2007, Certified Article Number Received by: Inspector's Signature Operator's Signature Title Title i! 203 Case Number: 2007025637 . District Number: 9: Licanse Number; 6214845 2010 Form revised 10.10.06 © PHILLY'S Jul 11 200? 16:02 a@rf/ll/2ae7 15:56 8584146749 DEPR OGA PAGE 11/16 Exhibit A License Number; 6214845 . License Type: 2010 PERMANENT FOOD SERVICE Case Number: 2007025837 “FC" as cited herein references specific provisions of the Food Code, Recommendations of the United States Public Health Service, Food and Drug Adininistration, 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 44-3, "Fire Prevention, General Provisions”, Florida Administrative Code, and 61C-1.004(5), Florida Administrative Code. “ denotes a critical violation. itis alleged that on March 16, 2007, April 18, 2007 the licensee was In violation of Florida Statuta 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 8. : 41,36-11-1 6404.11 FG: SURFACE CHARACTERISTICS. (4) EXCEPT AS SPECIFIED IN PARAGRAPH (8) OF THIS SECTION, MATERIALS FOR INDOOR FLOOR, WALL, AND CEILING SURFACES UNDER CONDITIONS OF NORMAL USE SHALL BE: (1) SMOOTH, DURABLE, AND. EASILY CLEANABLE FOR AREAS WHERE FOOD ESTABLISHMENT OPERATIONS ARE CONDUCTED; (2) CLOSELY WOVEN AND EASILY CLEANABLE CARPET FOR CARPETED AREAS; AND (3) NONABSORBENT FOR AREAS SUBJECT TO MOISTURE SUCH AS FOOD PREPARATION AREAS, WALK-IN REFRIGERATORS, WAREWASHING AREAS, TOILET ROOMS, MOBILE FOOD ESTABLISHMENT SERVICING AREAS, AND AREAS SUBJECT TO FLUSHING OR SPRAY CLEANING METHODS. (B) IN A TEMPORARY FOOD ESTABLISHMENT: (1) IF GRADED TO DRAIN, A FLOOR MAY BE CONCRETE, MACHINE-LAID ASPHALT, OR DIRT OR GRAVEL IF IT 18 COVERED WITH MATS, REMOVABLE PLATFORMS, DUCKBOARDS, OR OTHER SUITABLE APPROVED MATERIALS THAT ARE EFFECTIVELY TREATED TO CONTROL DUST AND MUD; AND (2) WALLS AND CEILINGS MAY BE CONSTRUCTED OF A MATERIAL THAT PROTECTS THE INTERIOR FROM THE WEATHER AND WINDBLOWN DUST AND DEBRIS. : FLOORS NOT MAINTAINED SMOOTH AND DURABLE. 2. 37-14-1 61C-1.004(6) FAC: (6) ALL BUILDING STRUCTURAL COMPONENTS, ATTAGHMENTS AND FIXTURES SHALL BE KEPT IN GOOD REPAIR, CLEAN AND FREE OF OBSTRUCTIONS. A. OBSERVED CEILING !N DISREPAIR. CEILING IS LEAKING IN SERVICE AREA. B. OBSERVED HOLE IN CEILING. * 3,4605-1 NEPA 104, 7.1.10.1, 61C-1.004(10)FAC:: MEANS OF EGRESS SHALL BE CONTINUOUSLY MAINTAINED FREE OF ALL OBSTRUCTIONS OR IMPEDIMENTS TO FULL INSTANT USE IN THE CASE OF FIRE OR OTHER EMERGENCY. MEANS OF ACCESS MUST PERMIT UNOBSTRUCTED TRAVEL AT ALL TIMES AND BE MAINTAINED FREE OF OBSTRUCTIONS AND FIRE HAZARDS. HALLS, ENTRANCES AND STAIRWAYS SHALL BE CLEAN, VENTILATED AND WELL- LIGHTED DAY AND NIGHT. HALL AND STAIR RUNNERS SHALL BE KEPT IN GOOD CONDITION. HAND RAILS SHALL BE INSTALLED ON ALL STAIRWAYS AND GUARD RAILS AROUND ALL PORCHES AND STEPS, ADEQUATE MEANS OF EXIT SHALL BE PROVIDED PURSUANT TO NFPA 104. OBSERVED OBSTRUCTED EXITS, STAIRS, HALLWAYS OR EGRESS. EXITS ARE NOT EASILY OPENED, DOOR STICKS-REQUIRES EXCESSIVE FORCE TO OPEN. Case Number 2007025637 . District Number @2 License Number. 6214845 2010 Form revised 10.10.06 O PHILLY'S Jul 11 200? 16:02 a@rf/ll/2ae7 15:56 8584146749 DEPR OGA PAGE 12/16 STATE GF FLORIDA | . "ene EXHI BI T B DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION DIVISION OF HOTELS AND-RESTAURANTS ween myfionida,onv/dbpr Foon Servier eEETN REFORT U NOTICE Fatlune to comply with this Notles may Intete an administrative complaint thet may rseutt in suspension oF revocation of your lleattee and fines, & 18/07 03:0 Complaint Fu 6214845 SEAT. Inspection Date ard Tine Inspection Reason License Number CREAMWORKS ING (THE) WARNING: Owner Name ‘ Violations: Inthe operation of your estabilsh LETAGP ATTA OPHILLY'S: Area Code/Talaphone Number Business Nama : ingpertion Resut 04/18/2007 08:00 AM . Oa/O1/08 Nember of Units Caliback Date/Time License, Expiration 217 CORONADO AVE . CLEARWATER BEACH, 39767 Address / Clty / State /Zip / ate. mm 45: Fire Extinguishers and Fire lencmam, roach hfmazor, 15 Dagreas F, . {Manager Neme; MatkNovek . | {nol sotup Ketraarn en fresh YD COBORT. Lo refication Date: 7/28/04 Cartified Hoth, reach in eooder, 47 Degrees F by; National Registry of Food Safety Cine ABC type Bho Exlingulher, Fomalatal Professionals elichon has 9 eenkicevon date af 12/06 afingulaher, ngs Selicioh detect NOTE: Items marked above with an asterisk (*) Indicate a Violation inspectore Commas . vidence of mals was not found. Rrstaurant hed been cleaned and any problam has bean taken care of. tructure has an excessive leak problam from the calling in the service area, Tha water had tn ba caught in @ bucket on the floor. There are hdles voughput Ihe ceiling in the establishment. 30 day warning is given to have the ceiling repaired. no employees Lagdmnewiadge racelpt of thle Inepection form and comments, Fook ene? 13-16-07 Signature of Reclptent Inspector Signature Dat Recipient; M ih Novak Pre For further information please contact: Title Carol Davis” Presigent Sonitaton 4 Safety Speciallet 3725 W Grace St, 520 Phone: 352-457-2793 . 850-487-1395 STATUS SOURCE i *Ots Appraved source “O3e Cold food at proper temperatures during storage, In in “07h Wholssoma, sound condition display, service, In ‘oz Griginal eontainar; properly labaled, date marking" 1N *02-13 Gansumer advisory on raw/undercopked animal Violations marked with en asterisk are crilcal violations, omg marked IN ara In compliance. Itame Marked OUT a afer ra violation, pects Wettids of volstion are fisted an OAPR Form HR 5022-015 Jul 11 2007 16:03 a@rf/ll/2ae7 15:56 8584146749 DEPR OGA PAGE 13/16 EXHIBIT B Pag Litehéa Number STATE OF FLORIDA - : DEP SEAT 6214845 “ART we or DRC Business Nama O PHILLY'S FooD SERVICE INS ETON REPORT nee eren? 03:09 PM LE — Fallure te comply with this Notice Mey Intiate af aciminietrstive ocrripieln her ay feputt in in Suepeneion or revorston af your Tontiea and thee. STATUS 3 433 Containers covered, adequate number, Insect and mdent "082 Food protection during storage, preparation, display, proc ernplld at proper intervals, cledn a ——— service, transportation ; 34 Quiside storage area clesn, erislosurs properly P08 Cross-contamination, aquipment, Personnel, storage D8 Potential for cross-contamination; storage practicas: : _ J = Se nee toes soaregston : : 35a Presence of Ingecte/roderits, 4 aris. nimi prohibited rash Outer op sad genie practions (observed), altarnetive | operating plan "12b Proper hygienic practicas, sating/drinking/smaking (evidence) 4 Food contact surfaces desiined, constructed, maintained, Installed, focatad 42 Prerhlsag malnainé 18 Non-foad contact surfaces designed, constructad, ' lashing ahd malnteriénce @4udipment properly stored. maintained, Installed, located ‘ rictad io'euthorizad pateerinil "16 Dishwashing facitilies designed, constructed, operated 1. Wash 2. Rings 3. Saritize 18 Pre-flushed, scraped, soaked 19’ Wash, fhge wets, ar Epan, brper temperature planes 35 - ~ properly inataed maintained "40 Planiniabla/ooinbustible materials - pioperly stored 23 Nore food conta surfaces élasn er [fea Stora i toma 1 | zy ni ryan safe operation EAR "52 Falde/mislsauiig statariants publlshad dt advertised relating to food/baverage h5da Food management corification vauiel ' Maki] Employee {reining validation 54 Florida Cleon indoor Air Act "30 cross conneetn back store backflow TOILET AND HANDWASHING FACILITIES 5? Hospliality Education Prog 7 Tollotand:handweshing fectitties;:num ber; convenient, designed, instaliad Total Numbar of COS Vialatlons: "32 Restrooms with sal-closing doors, fixtures operate properly, facility clean, supplied with handsvap, disnoxsbie Total Number of Repeat Vidlations: towels or hand drying devices, seus, coverad waste am Information provided Viptations marked with an aéterisk are eHiizal vietstlane, Rema marked IN ars in complaece, tema Marked OUT are violations. Specific details of vinlation ara fisted on Bubbaquent pages, Itt marked N/A, am Not Applicable. items Marked ag N/O are Net Obsurved, and were not being conducted at tha time of Inapaction DBPR Form HA S022.076 Jul 11 2007 16:03 7/11/2087 15:56 85adi4e749 DEPR OG PAGE 14/16 License Number ‘| X STATE OF FLORIDA, SEAT 621484 HIBIT B DEPARTMENT OF BUSINES: PROFESSIONAL REGULATION Busttans Neme DIVISION OF HG RESTAURANTS \ OPHILLYS . wows ber Inspection Dat i=] Foon SERVE, INSPECTION REPORT nape Taner 1 03:09 PM NG Fallure to comply with this Notice may Initiate an administrative combat that may raeult In evepension of revocation of your license and fies. Vitlatlon(a): 37-43 1:Obsetved hola itt calling. 37-14.4:Observed calling in disrepair. "87-44-12 peeved catng fn dlatepatt, Geving ls leaking in aatview eran. 42-03-71: Wol mop not hung to dry. 36-15-1 Observed debris accumulated on kitchen floor. 14.47-1:Observed cutting board groovedipitied and no tanger cleanable. 361 1-1:Floors not maintained smooth and durable, 22-18-1:Obsetved interior of microwave solled, 38-07. 1:Lights mizsing the propar nit, Bleave enetings ereavera, 46-05-1: Observes obstructed onits, stalrs, hallways or egrege. exits xra net enriky opened: DBPR Form HR 5022-015 Jul 11 2007 16:03 a@rf/ll/2ae7 15:56 8584146749 DEPR OGA PAGE 15/16 Page 1 EXHIBIT B STATE OF FLORIDA DEPARTMENT OF BUSINESS iD PROFESSIONAL REGULATION DIVISION OF Hi NB RESTAURANTS WA myficrtde, com/dbpr CALLBACK INSPECTION REPORT "LEGAL NOTIGE Fallurate comply with thle Notica may IniMate an administrative complaint thet may result In Euspension or revocation of your lleange ard fins. Da 8/07 11:34 AM Warning 6214845 SEAT Callback Inspecton Date and Time itspatton Reason Ucense Number GREAM DRKS ING (THE ADMINISTRATIVE COMPLAINT 227 AAPATTS er Name . fecommended, Area Code/Telephone Number OPHILLY'S. . “ ‘ Business Name ; Inspection Result rs oane/2007 San NSr "arene , Numbar of Unite . Requested Callback Date/Tima Initial Waming Date 217 CORGNADO AVE : _ CLEARWATER BEACH, 33767 Address / Clty / State/ Zio / etc, . Comments following Item(s) have been recommendad for Administrative Complaint: lotation: 46-05-1 bserved obstricted exits, stairs, always or agrece, axits are nct eosily oppnad joleton: 37-14-4 perved celling in disrepair. Nation: 37-149 bserved celling 3m distapalr. Celting t leaking in services aren, 4/18/07 : Data Signature of Reciplant _ Inspector Slansture ’ Rectpiant: Mark Novak sabia information Please contact: Title Owner Sanitation & Safety Specialist 3725 W Grace St, Phone: 352-457-1793 620 Temps, FL 33607 850-487-1295 DBPR Form HF S022-005 Jul 11 200? 16:04 a@rf/ll/2ae7 15:56 8584146749 DEPR OGA ETATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION DMSION OF HOTELS AND RESTAURANTS wan. nryflaiide.com/dbpr CALLBACK INSPECTION REPORT LEGAL NOTICE EXHIBIT Bace2 04/18/07 11:34 AM Failure ty comply with this Notes may Initiate on edininistrative complaint that may resutt In susperelon or revocation of your llcanse and fines. isation: 37-13-t bserved hota tn celling. relation: 36-17-1 thors not maintained smooth and durable, Jollowing Item(s) ara in complianes: folation: 42-03-41 fat mop riot hung ta dry, lolatlon: 38-07-71 {his missing the proper shield, sides eosiings or covers. lation: 3B 15+4 bserved debris accumufated on kitchen foor. lolatton: 22-19-7 bserved Interior of microwave eolled. lation: 1437-1 bserved cutting beard grooved/pitied and no longer clanaabic, DBPR Form HR 8022-005

Docket for Case No: 07-003130