Jul 20 200? 12:50 arf2e/28ea7 12:46 8584146749 DEPR OGA PAGE @d4/14 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION DIVISION OF HOTELS AND RESTAURANTS DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION Petitioner, vs. CURTIN NANCY License Number 1907225 JERNAN'S CAFE & ICE CREAM License Type 2010 Respondent. Casé Number 2006061505 i ADMINISTRATIVE COMPLAINT The DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION, DIVISION OF HOTELS AND RESTAURANTS, ("Petitioner’), files this Administrative Complaint against JERNAN'S CAFE & ICE CREAM, (“‘Respondant"), and says: 1. Petitioner is the state agency charged with regulating the operation of public lodging establishments and pubiic food service establishments, pursuant to Section 20.185 and Chapter 509, Florida Statutes. 2. Respondent is an establishment subject to the jurisdiction of the Divisian of Hotels and Restaurants. The respondent's business address of record is 202 US HWY 41, INVERNESS, FLORIDA 34450.The mailing address of record is JERNAN'S CAFE & IGE CREAM at 8050 E PEACOCK LN, FLORAL CITY, FLORIDA 34450. 3. Based on observation of Respondent's establishment activities and a thorough search of the Division's licensure records, Respondent was determinad to ba operating without statutorily required licensure, in violation of the provisions of Chapter 509, Florida Statutes, as described in Exhibit “A’ of this Complaint. Respondent was therefore Issued an Administrative Determination of Non-icensure on September 06, 2008, attached hereto as Exhibit "B’, documenting the activities requiring licensure and directing Respondent to apply for or renew the required license. Respondent thereafter falled to obtain licensure and was issued an Order of Closure on September 06, 2006, pursuant to Section 509.264(3), Florida Statutes, and attached hereto as Exhibit “C". WHEREFORE, Petitioner respectiully 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 axpense at an educational program sponsored by tha Department's Hospitality Education Programm, suspension, revocation, or refusal of a license issued pursuant to this Chapter, and/or any other reliat authorized by Chapter 509, Florida Statutes, or the rules promulgated thereto. Signed Novernber 08, 2006 . Te! Erdman, Deputy District Manager By delegation of the Director, or designee Division of Hotels & Restaurants Department of Business & Professional Regulation Case Number: 2006081505 , . District Number: 03 License Numbet; 1901225 2010 Form revised 10.10.06 JERNAN'S CAFE & ICE CREAM arf2e/28ea7 12:46 8584146749 Jul 20 200? 12:51 DEPR OGA PAGE 45/14 Deco BP 2006 4:41PHh DBF. HER PLAN REVIEW BlagSB6..12 p.d . — COUNSEL FOR THE DEPARTMENT: Charias F. Tunniciiff, Lead Attorney. Florida ‘Bar No. 0153834 . Oepartment of Business & Professional Regulation . 1949 North Monrse Street ’ Tallahasses, Florida 32389-1007 ¢ CATE OF §: BY CERTIFIED U.S. MAIL, ARTICLE NUMBER: : LHEREBY CERTIFY that a true and comect copy Gener yee A ADMINISTRATIVE COMPLAINT has bean hand served by me on this: day of _, 2008, ‘ - Wo ac@S 5 Ipspector's Signature 7 j or Seth tye el wy _ Title : oc} Article Number " Corti District Number 03 ‘Dasa Number, 2006061505 ' Fotm revised 10.10.05 ‘Lleanes Number: 1901225 2010 JERNAN'S CAFE & IGE GREAM Jul 20 200? 12:51 arf2e/28ea7 12:46 8584146749 DEPR OGA PAGE 46/14 Exhibit & License Number: 1901225 License Type: 2010 PERMANENT FOOD SERVICE Case Number: 2006061505 41. Based on the foregging, itis alleged that on August 3, 2005, September 6, 2008 Respondent violated the following provisions of Chapter 509, Florida Statutes, or the rules promulgated thereto: $09.247(1) FS LICENSES; ANNUAL RENEWALS. « Each public lodging establishment and public food service establishment shall obtain a license from the division, Such license may not be transferred from one place or individual to another . . . Licenses shall be renewed annually, . .. §09.241(2) FS APPLICATION FOR LICENSE. — Each person who plans to open a public ladging establishment or a public food service establishment shall apply for and receive a license from the division prior to the commencement of operation. ESTABLISHMENT OPERATING WITHOUT A HOTEL AND RESTAURANT LICENSE. * denotes critical violation Licenea shad ° 0 preheat File Number: 205658 License Number: 1901225 JERNAN'S CAFE & ICE CREAM Jul 20 200? 12:51 arf2e/28ea7 12:46 8584146749 DEPR OGA PAGE @7/ld Sep O8 2006 10:11AM DBPR TAMPA HER Si3356 1613 EXHIBIT B STATE OF FLORIDA ‘ . DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION DIVISION OF HOTELS AND RESTAURANTS InRe : CURTAIN NANCY ' : 202 5 US HWY 44 JERNAN'S CAFE INVERNESS, FL 34460 Gase Number, 2008048167 ; License Number: 0 : ‘Licanse Fype: 2057 ADMINISTRATIVE DETERMINATION ‘ANDO R Pursuant to Section 505.244, Fierlda Statutes, each public lodging establishment and publicfeod = sarvica establiahmant shall cotain a lieanee from the Division, Section 609.101, Florida Statutes, pravidar that the division shall prin a Benedie of foes te be paid by bach public food sanviee or public ledging establishment a : : sure. Based on the foregoing, an establishment is not licensed url such | fee ara paid in full. A thorough search of the licensure records maintained oy the ‘Givision reveals that the subject establishment ia not currently licensed, A: Certification of Non-licansure prepared bythe ¢ Custodian of Records is attachad a5 Exhibit “a, On bn day ot September. 2006, the undersigned authorized representative of the Division . personally observed this eatablishment to. be performing the following activiies necessitating tcenaure without Section 508.264 (3) provides: The division shail pest & prominent closed-for-cperation sign on any public Jodging establishment or public food service establishment judicially or administratively determined to be operating without 4 lcense. [ts # misdemennsor of the second degres, punishable as provided in 5.775.082 oF 2,775,083 for any person to deface or remove such closed-for-operation sign or for sny ‘public Iedging establishment or public food service establishment to open for operation without a fieonse or to open for operation while ifs Hcenee ls suepended o7 revoked. The division may Impote administrative sanctions for viotstions of this section. YOU ARE HEREBY NOTICED THAT THIS ESTABLISHMENT IS CLOSED FOR OPERATION UNTIL CONDITIONS FOR LICENSURE ARE MET AND LIGENSURE IS OBTAINED FROM THE DIVISION. ‘LICENSURE APPLICATION MAY BE MADE IN PERSON AT THE DISTRICT OFFICE. Please direct any questions to tha District office at the telephone, numbar div played below. artify that a correct copy of the foregoing was provided! ie by, atthe 38 _ o'clock (an fp.m. on the day of September 2008, as Tepreseniative of the aboy rained establishment. Sanitation and Batety pes Wiliam Pippin : ; Divisfon of Hotels and Restayrants Suite 620, Bromley Building : 3725 West Grace Street Tampa, Florida 35807-4822 813-380-1607 850-487-1995 NOTICE OF APPELLATE RIGHTS , ‘This Order conatitutes final agency action. Any party who is adversely affected by thie ordar has the right to seek judicial review of the anlar pursuant to Chapter 120.68, Florida Statutes, by filing a notice of: appeal purauant to Rule 9.170, Florida Rules of Appatiate Progecure, with the ape cropriate district court-of appeal and with the Agency Clerk, Notices of appeal must be filed within 30 days of the date this final order |s filed with the agency clert. arf2e/28ea7 12:46 8584146749 Jul 20 200? 12:51 DEPR OGA PAGE 8/14 EXHIBIT B Firsts futere .. DBPR, STATE OF FLORIDA . aetiet. DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION AP ade a! Jeb Bush, Govemor “f Simone Marstillar, Secretary STATE OF FLORIDA } } COUNTY OF HILLSBOROUGH } |, doe Perez, Custodian of Records, Tampa District Office, Division of Hotels & Restaurants, Department of Business and Professional Regulation, State of Florida, after a diligent search of all records, do hereby certify on September 6, 2006, that Nancy Curtain, d/b/a Jernan's Cafe at 202 US Hwy 41 §, Inverness, Florida 34450 is not licensed nor has been licensed by this agency as a public food service establishment in the State of Florida, Custodian of Records Tampa District Office The foregoing instrument was acknowledged before me this September 6, 2006, by Joe Perez, who is personally known to me. - ey, GAIL FRAZIER a. MY. COMMISSION & DD 431170 EXPIRES: May 19, 2009 Bane Thu Bue Hetary Servicer * wt an ag. . ’ 4 ; Ks heels hee Notary Public, State of Florida Conn dy oy feb tds berousl, 850_487,1395 3728 W. Grace Street intevnet! www, MyFlorida.com/dbpr . Bromley Bldg., Suita 520 ' Tampa, Florida 33607-4822 ar! 28/2087 eanging (LIC) (71 Conpiint Fur (COMP) [71 Compleint Partial (CPAR) (7) Olsaster Response (DSTR} CI Epitambtogicat (EPI) (7) Service Request (SERV) (1 Quality Assurance (QA) (1 Training (TRNG) 12:46 85841 Jul 20 200? 12:51 46749 DEPR OGA PAGE @g/1d4 DEPARTMENT OF BUSINESS AND PROFESSIONAL REG * Divieion of Hotels and Rostrurante EPs eee] owner Name: The ciced ktiers 0 fhe leaf each fem indtcate that iwn’s statue at the tre of ina lance NID = notobserved N/A = notapplinabla IN = in complianca OUT = not In comm a COMPLIANCE STATUS Nancy Curfain LEGAL NOTICE ft Food Service Inspection Report 2012 Theme Park Food Cart . (CO 201d Catarng (2014 Mobtle Fond Dispensing vebicie [J 2015 Vending Mastine 0 2051 Unicensed Food ie tt 2 Th appro COS = coreciad on-site 4 cos] Rk I OUT Ota _| Food obtainad from (1 SOUrSe _~ : Approved Source IND] OUT [WO 1b__| Wholesome, sound condition ; | OUT {| NiO |N, 62 | Orginal container, propaity labeled, date marking, shed! stack tags, 7 ‘ OUT NA 62-11 | Consumer advigory on rawundarcooked oysters Ce Le ween 0! —_ consumer Advisory IN OUT NA _| 02-13 | Consumer advigory on rawiundercooked animal products Cold food at propar temperatures during storage, display, service, transporl, Potentially CD) out NIA | 933 | and cold holdin — Hazardous Food OUT | NYO | NA 03b._ | Hot food at proper temperature Timme/Temperature OUT [WO [NA [_0ac._| Foods properly cookedtrehested es eee ee _ OUT | N/O | N/A 03d _| Foods properly cooled OUT O7_ | Un dor polantially hazardous {god not re-served Protection from OUT 08a | Food protection during storage, preparation, display, service, transportation _. Contamination IN) | OUT. 08b _ | Cross-contamingtion, equipment, personnel, storage _ "| our 72 | Food contact surfaces clean and sanitized.” out | NiO 09 _| Foods handled with minimum contact ILA OUT 11__| Personnel with Infactions restricted __. Hands washed and clean, good hygianic practices (observed), altemative { QUT | NfO 12a Personnel - ~ soe operating pian __ oe el oo INA] OUT | NID 12b__| Proper hygienic practices, eatingldrinking/amaking (evidence Restrooms with sell-closing dots, fixtures operate properly, facility ciean, (> OUT 32 | supolled with hand soap, disposable towels or hand drying devicas, tissue, coverad waste es Chemical out #ja_| Toxic substances properly stored em OUT 71h _| Toxic eubstences properly fabeled, used Demonstration of OUT b3a_| Food management certification valld Knowledge I Out §3b | Employee Training verification IervLocation Ta IervLocstion Temp: Nama. Date orepenttn Complain = No Further Acton (SA) | [] Catbeck - Conpfed (CBCM) [ Métiate ComplietRecanmendes | py yn Ons reo ned Wiig OMEN WARN) Ge 2 - [1 Cafbaok - Extansion Given (CBEX) OG ce tala Callback — Emergency Ore catback ~ Caiaok— Admin. Compieint Recommended |p) Admintstratve Cemnpisint Calbeck—Tine [Ty Emergency Order Calbeck = Time 1 Saaganal (SEAS) (GENO) : Extonsion (AC Extension Ta Giosed Ovtef Basness (CORB) Ey Aaa Daterminaton Recemmendad |] p Administ ve Comptaltt Galback Nk oO Emergency Order Calack = Not ney G ATW Way. If want! Nara ene 4 it a “ [ try , Bardon in Charoe Stat & Ue Inapector’s Signer Inepoctors Telephone wow. MyFlorida,com/dbpr 2008 May 2 DBPR Form HR, Jul 20 2007 12:52 arf2e/28ea7 12:46 8584146749 DEPR OGA PAGE 1@/1d4 Prtlevilend Felean.., DEPARTMENT OF BUSINESS AND) PROFESSIONAL REGULATION EXHIBIFB Paye 2 of a DBP Divialon of Hotels and Restaurants , LEGAL NOTICE Food Service Inspection Report COMPLIANCE STATUS 30 _Rooms and aquipmant —yanied a5 required EI] "04 Facliles to maintain product temperature ge C&S Thermometers provided and conspicuously laced [35a Fresance on Insects/odents, Animals prohibtied. . TE_ 06 Potentiatly hazardous foods properly thawed _ "35b Cuter openings protacted from Insects, rodent proof | *08c Polenfial for crdss-contamination, storage practices; damaged (1 36 Physica facilties-floors praperly constructed, clean, drained, [ fooda ted t coved : 37 Physical facilites-walls, celllngs and attached equipment, 40_Eny fockers provided and used, clean, Installed, located . {1 42 Premises maintained, no unnecessary arficles. Cleaning & “45 Fire extinguishers — proper and sufficient 18 Pre-fiushed, scraped, soaked 19 Wash, rinse water clean, proper temperatura *20e Sanitizing concentration : temperature * Fahrenheit FIRE EXTINGUIBHERS: Date(s) 4 Sloreefhanding ofclean equipment, uensis | “47 _Eleciricat witing — agaquate, repair 26 Single service articles not re-used “49 Flammablatcombustible materials — properly sk 7 8 Dishwashing facies designed, constructad, operated ’ maintenance equipment properly stored. Kitchen restricted, _| 1.Wash 2. Rinse 3, Sanitize 43 Complete separation tom fiving/sleaping area, laund Ll i? Thannomaters, gauges, test kits provided 44 Clean and soiled linen segregated and proparly stored a en gregated and property + 25 Seryica tems properly stored, handled, dispensed "48 Gas appliances — properly installed, malntained __ _. ‘ orad BUPERESSION SYSTEMS, Date) 23 Non-ood contact surfaces clean *46 Exiting system ~ adequate, good repair a : a _ “27 _Water source safe, hot and cold under pressuna : CO Currant llcanse, properly displayed 28 Sewage and waste walbt diaposed properly 51_Other conditions sanitary and safe operailon Ll 29 Fhimbing instafled and maintained __ 62 Falseimisieading sislements published or advertised retating E210 Gross-connection, back siphonage, backliaw a a OS rs a 37 Toilet and hand washing facilities, number, convenient, designed, 54 Florde Clean Indoor Air Act Compliance ee installed . \ 55 Automatic Gratuity Noticg “TT 35 Garbage containers covered, adequate number, insect and rodent 56 of Chapter 508, Florida Statutes available root, emptied at proper Inlervats, clean 57_Hospltality Education Program Information provided eT ett et OOS eae ailon! flon prov TAR a must bg corrected within the lime: Irames below, or,as stated on page 1. . . a Bond secice oe — Te ba sobre ee: +3-0 ‘Additional Gowmments on Attach: Person in Charge (Signatura) _inspector (Signature, DBPR Form HR 5022-015 www, MyFlorkfa.comvdbpr 2006 May 2 arf2e/28ea7 12:46 ‘DBPR FR Jul 20 2007 12:53 8584146749 DEPR OGA GEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION Hivision of Hotels and Restaurants Py LEGAL NOTICE . Birwis al Ee PAGE 11/14 orgunal Vig 83-0 mre fi pection Repo 2012 Thema Park Food Cart (772013 Catering (2 2014 Mobile Food Dispensing veticte J Licensing (Lic) SaaaE . ain 0 2015 Venetiig Machine DEA) Name: nating 7 Comptsin Fun (com) ¢ C at e (73 2051 Unitcensad Food (C3 Complaint Parital (CPAR) (77 Disaster Response (DSTR) Epjdemiciegicat (EP!) I] Sarvica Requast (SERV) (Oy Guatity Assurance (QA) 1 Training (RNG e Sees LOL & US ftWY 4] Fy REMINDER: Your icensa exp ! 0 Originar visit == : IN _ |_Food obtained from aroed source . Approved Source =| IN | OUT | NiO ‘Dib _[ Wholesome, sound condition , IN| OUT | NiO Original container properly labeled, date marking, shell stock . IN | OUT | Consumer advisory on rawiundartooked oysters Consumer Advisory Ht Consumer advisory on raw/undarcooked animal products Cold food at proper lamperaiuras during storage, display, service, transpori, Potentially IN | ouT NA | 932 | and cold holding Hazardous Food IN [| OUT | N/O | N/A | 03b_ | Hot food at proper tamperature Time/Temperature |IN | OUT [NIG |N/A | 080 | Foods properly cnoked/reheated _ al iw [OUT : Foods properly cooled ; iN | OUT |._07__|_ Unwrapped or potentially hazardous food not re-servad : O82 | Food protection during storage, preparation, display, service, transportation | Crose-contamination, equipmant, personnel, storage Food contact surfaces clean arid sanitized Foods handled with minimum contact Personnel with infections restricted Hands washed and claan, good hyglenic practices (observed), altemative Protection fram IN Contamination IN U | 12a | a operating plan Persannel [OUT [WO 1[Wa ””|Proper hypianis practices, eatingldrinking/amnok Restrooms with self-closing doors, fixtures operate properly, facility clan, IN. | OUT 52 | supplied with hand soap, disposable towels or hand drying devices, tissue, | coverad wasta receptacies ‘ . IN { OUT 41a | Toxic substances properly stored Ghewvical IN| OUT | 4b _| Toxie substances property labeled, used 53a | Food management certification valid Demonstration of = LIN GUT | Knowedge in | our [| 586 | Employee Training verfication | PSE CJ) Calback - Compiied pre Inspection Completed — No Further Action (IBAT) EOCL) Emergency Grder Cattiack = Gompltad (EGGh) Emergency Order Callback — Time Exton (FOEX) (1 Callback - Extension Given (GBEX) ‘Waming Given {WARN} Emergency Order Galback = Nat pled [EDNG) Closed — Out of Business (COFB) is 1 is Wr - = Gag bs = TT) pacorg Nae [Plena Fi] ay Z ? Maan hav AE Cwsiyyg 7-15 PIP II2 BF? J = Llhas f £0) 2006 May 2 DSFR Fon HR 5022-015 www.MyF lorida, com/dbpr Jul 20 2007 12:53 DEPR OGA PAGE 12/14 ar/2e/28e7 12:46 8584146749 Folie, fetus. DEPARTMI INESS OPERSION, DBP ENT OF Busi NE a8 AND PROPS S108 AL REGULATION _ Page 2 2 . F; LEGAL NOTICE ; re Food Service Inspection Report COMPLIANCE STATUS x ____..COMPUANCE STATUS ns “04 _Faciities to maintain product temperatura [7H Culside storane area clean, enclosure properly constructed || LZ 05 Themometers arevided and conspiauously placed wad. [| SbaPrasence.on Insante/mdents, Animals prohibited | 08, Polentially hazardous foods properly thawed ~ L *35b Cuter openings profaciad from Insects, rodent proof Ll "08c Potential for crdse-contemination, storage practices; damaged t “ET 38 Physical faalilties-floors Properly constructed, clean, draine, || coved . — foodseyregated 37 Physical faciiities-walls,-cellings and attached equipmant, ___constructed, clean i 38 Lighting provided ae required. Fixtures shielded nnn MNstalled, located nee 39_Roame and equipment — vented as required ___ (1 16 Nonood contest surfaces designed, constructed, malitained, 40 Employes lockers provided and weed, clagin C 42 Premises majntained, no unnecessary articles, Cleaning & installed, located CJ 76 Dishwashing factifies designed, constructad, operated Maintenance equipment properly slored. Kitchen reatricted, 43 Compldte seperation from living/aléeping grea, laundry +— 1.Wash 2, Rinse 3, Sanitize 17 _Thethometers, gauges, test kits provided we. a! 44 Clean and solled linen seqréqated and properly stored | 45 Fire extinguishers — proper anc sufficient Lt SUPPRESSION SYSTEMS: Date(s 38_Pre-fushed, sctapad, soaked 19. Wash, rinse water dean, proper temperature FIRE EXTINGUISHERS: Date(s) "20a Sanifzing concentration ppin *20b Sanilzing temperature wow Eahrenhelt_ 21 Wiping cloths clean, used propatiy, stored Lj 22 Nowdocd contact surfaces clean peers a "46 Exiting eystem - adequate, goqd repair a TI) #4 3 lent, utensils "47 Electrical wirng~ adequate, good repair _ 25_ Service tems propery stored, handled, dispensed . "48 Gas appliances ~ ry Installed, maintained L 26 Single service articles not re-used “49 Flammable/combustibla materials - properly stored _ “2/ Water source safe, hot and cold under pressure : 50 Current license, properly displayed . “28 Sewage and waste water disposed properly tL ___| 51 _Other conditions sanitary and safe oparation 52 Falsafmisiaading statements published ar advartised ralating 20 Plumbing installed and maintained 30. Gross-connestion, beck siphonage, backflow = tofoodbeverage “1 Toilet and hand washing facilities, number, convenient, designed, L. | $4 Florida Glean Indoor Air Act Camnfianca . installed _ | ORY SS Autonatia Gratulty Notice CY SS Garbage containers cavarad, adequate number, insect and rodent 56_Copy of Chapter 509, Florida Statutes avaiable i —_ 7 _Hospltlly Education Program information provided ______ proof, emptied al proper intervals, clean Matiyrt 5, Ty ot Par 5 acct Dye 7 arrected within the time fram below, or a6 stated on rage 1. od service. cense issued 1, 104lp , mers plere | o v 5 — i ( Aucitional Commants on Attached Sheet Person in Charge (Signature) fa ot? : inspector (Signature) Li 2006 May 2 waw, MyFlorida, com/dbpr DBPR form HR 5022-015 Jul 20 200? 12:54 f/f 28/2087 12:46 8584146749 DEPR OGA PAGE 13/14 Nev O7 GG O5: 8p William Pippin (352)837-6781 pid DEPR DEPARTMENT GF GUAINESS AND PROFOSSIONAL REGULATION R Sivicton of Hotels and Roctauranis Py mm LEGAL NOTICE 2010 Patrtmnend Food Sarvioe : Food Service Inspection Rep 2072 Their Park Food Gar Ba fe ~ EF 2043 Catering (=) Unsaie RU ON AWS a U ct iA 12) 2014 Mobile Food Dispensing Vaticia poe Hy on Tuslpans TOGA) anes D2 2015 Vending Machine Elcareisi rea (ora ernan's CA f t (012044 Uneensed Food CibieasterResponae sms; | MIE OTS. US HWY SI a i Say Clepitembegiea 0 (2) Service Request (SERV) 2 Osattty Aseurance (GA) Ei * In appropriate box far GOS and/or A fs bo the afl of aan vat ‘nda ate ie state al ha Ime 1 Inepection IN = In compfance OUT 9 nef incompllence MO = notobserved_ N/A = nol applicable GOS = corrected ct-aie durin apection R= tepent violation : GOMPLIANCE STATUS ° coe | LIN | Out Approved Soune = [IN {| OUT — A) OUT FO | Wa | jebaled, date — Ne Nik” | O2-11_| Consumer advisory on rawiundercooked oysters i Consumer kdvisory ig ar TA 68 13 Gene gra aie Cort pra 1 ‘| Cold food al proper temperatures during storage, display, service, tran ort, Potentaly NOT | MA | 038 | and cold holding ° Hazardous Food Lin | OUT | NO {WA | Ogb ‘Tol food of proper temperature 7 t TitefTemperature = [IN [_OUT | WO | NVA | 3c | Foods properly cnokedirehealed | OUT CNG | WA_|_03¢_“{ Foods properly coiled W our tT or | Unwrapped or potentially hazardous ood nol ra-served | Protection ftom iW [ OUT O8a__| Food prolection during storage, preparation, display, nervice, transportation Contamination IN] OUT Cross-contamination, equiptrent, personnal, clorage __| Wt OUT 22 __| Food contael surfaces clean ond sanitized IN [ OUT | NiO 09 | Foods handied with minimum eantact iN | our 17] Personnel with infections restricted _L w! our | wo 42a Rands washed and glean, good hygienic practices (obse/ved), alternative Porcontial sve {_ online -Speratia Hat erect a on IN| OUT | N/O {2b | Proper hygienic practices, eatingidrinkin gismoking (evidenca), a T Restrooms with sall-closing doors, fixtures operate propertly, facility cleen, IN | OUT 32 | supplied with hand soap, disposable towels or hand drying devices, fssue, covered waste rapaptacies Chamical IN -[ OUT. 41q__} Toxic substances properly stored We) OUT 41b | Toxic substancas labeled, used Demonstration ct "IN? OUT Saa_| Food management certification valid ___ Kaowledge In [ OUT 83b | Employae Training vertication | ItenyLocation, ES Nerv/Lagaton, Tam Agi ‘amplaint Aenommencdad oO Erneta tney Cider Ricornmentt Le prtedon Competed — No Furfer Acton (SAT) { ] Catbark - Carwpied (CBCM) D nor o Airset Carpal = Ene RF = (C1 Warming Glen (WARR) CO Calthuck — Extension Glan (CBEX) te élpack — Admin, Complant Recommended o Aemwsimave Cornpiaint Gralfbeck = Time oO wegen rt aE Tite FS Sensonal (SEAS) im] (CANO) Extension {At Extara orinstrat commended alive Complant calback — Nel Enoge TS GaGa ha TE] Gansed — Out of xttnass (COPB). o * ove Determination Recommended | () rues Comp pa ees nd Thad plate. k, Phebe} i FEIN Ne heweuy tenia ava carat Ae LL DY87- 1A tT F " Tay none petore Sate Taxpecire TAEDA i www MyFlorida.comidbpr 2008 May 2 DaBPR Form HR 5022-015 Jul 20 200? 12:54 arf2e/28ea7 12:46 8584146749 DEPR OGA PAGE 14/14 Mov 07 06 O5:0ap William Pippin (352)637-6781 p.4 DEPARTMENT OF USNS AND PROFESSIONAL REGULATION DBPR, Diviainn af Hotel: and Rastaurante. LEGAL NOTICE Food Servite Inspection Raport —— OMPLIANCE STATUS S| 34 Oulalde slerags area clean, éncicsure properly 25a Pragence on Insatisiodanls. Animals protiiled | | "350 Cuter aperings profected trom insects, rodend vl Ste eel oad __ oT ON ree ert ne a pdied 45 Non food contact surfaces designed, constructed, malniai [ r 40 Employee lockers provided and ured cleat | inetalled, localed C3 42 Promises maintained, no unnecessary aficles. Cleaning 8 maintenance equipment properly storect, Kitchen restricted, __ 16 Dishwashing fscifies designed, consinucied, operaied + i i.Wash 2 Rime 3, Soniize (37 Thamenmeters, gauges, test kits provided 43_Complate sanaration from living/simaping area, laundry 44_Claan and soiled linen segraqaled and property stored ‘45 Fire exdinguishere — proper and sufficient i ARE EXTINGUISHERS: Datefs] GUPPRESGION BYSTEMS; Labist _ 46 Exiling systam - adequate, good repair ae — "47 Electical whing — fc. go oh "48 Gas abphances - fy inslalied, mamiainad “49, Flammableyeombustibie malerials — properly alored *30_Current flemnse, proparty displayed 1 Other condivions sankary and gato ope CT 52 Falsemisteading statements published or advertised relating to sas Con Gar seus eermarassussinmanaautsfenssisssl — Copy of Chaplar 505, Florida Stalties avaitable 57 _Hosptally Education Proyram information cee on ______Prool ampiled at proper intarvalé, clean Installed rn [P33 Garbage comamers covered, adequate number, Insent and rodent _ a See i date (7 7-0 & nn > e 2006 May 2 ww. MyFlonta.comdnpr DBR Form HR 8022-015

Docket for Case No: 07-003375