Oct & 2009 16:33 lafar/2aeg 11:14 8584146749 DEPR OGA PAGE 83/85 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION DIVISION OF HOTELS AND RESTAURANTS DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION Petitioner, VS HAKUSAN JAPANESE RESTAURANT rieense Type a Respondent Case No 2009017030 / ADMINISTRATIVE COMPLAINT The DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION, DIVISION OF HOTELS AND RESTAURANTS, (“Petitioner”), fles this Administrative Complaint against HAKUSAN JAPANESE RESTAURANT, ("Respandent’}, and says 1 Petitioner ts the state agency charged with regulating the operation of public lodging establishments and public food service establishments, pursuant to Section 20 165 and Chapter 505, Flonda Statuies 2 Respondents, and has been at alll 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 4413 W HILLSBORO BLVD, COCONUT GREEK, FLORIDA 33073 The mailing address of record is HAKUSAN JAPANESE RESTAURANT, at 4413 W HILLSBORO BLVD, COCONUT CREEK, FLORIDA 33073 3. Inspection of this establishment conducted pursuant to Sec 509 032, Flonda 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 descnbed in Exhibit “AY attached hereto and incorporated herein by reference Inspection documents are attached as Exhibit "B", incorporated herein by reference WHEREFORE, Petitioner raspectfully requests entry of an Order imposing ohé 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 Programm, suspension, revocation, or refusal of a license issued pursuant to this Chapter, and/or any other relief authorized by Chapter $09, Florida Statutes, or the rules proknplgated thereto Signed April 01, 2009 Ken Buck, District Manager By delegation of the Director, or designee Division of Hotels & Restaurants Department of Business & Professional Regulation COUNSEL FOR THE DEPARTMENT Charles F Tunniciiff, 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 foregomng ADMINISTRATIVE COMPLAINT has been E] hand served by me on this. day of 209 Received by Inspector's Signature Operator's Signature Title Title Case Number 2009017030 9 File Number 210878 Oistrict Number 02 License Number 1620394 2010 Farm revised Of O7 07 HAKUSAN JAPANESE RESTAURANT Oct & 2009 16:33 lafar/2aeg 11:14 8584146749 DEPR OGA PAGE @4/@5 Exhibit A License Number 1620391 License Type 2010 PERMANENT FOOD SERVICE Case Number 2009017030 “BC” as cited herein references specific provisions of the Food Code, Recommendations of the United States Puble Health Service, Food and Drug Administration, incorporated by Chapter 61C, Florida Administrative Code “NFPA” as cited herein references specific provistons of the National Fire Protection Association Life Safety Code, incorporated by reference at Chapter 4A-3, “Fire Prevention, General Provisions", Florida Admumatrative Code, and 61C-1.004(5), Florida Admunstrative Code “ denotes a critical violation Itig alleged that on March 16, 2009 the licensee was In violation of Florida Statute 509(FS) and/or the Rules of the Onision of Hotels and Restaurants, Florida Administrative Cade (FAC), in the following particulars Copy(s) of the report(s) for the abave referenced inspaction(s) are attached hereto and incorporated by reference as Exhibit B * 4 52-04-71 509 292(1})FS (1) AN OPERATOR MAY NOT KNOWINGLY AND WILLFULLY MISREPRESENT THE IDENTITY OF ANY FOOD OR FOOD PRODUCT TO ANY OF THE PATRONS OF SUCH ESTABLISHMENT THE IDENTITY OF FOOD OR A FOOD PRODUCT IS MISREPRESENTED IF (A) THE DESCRIPTION OF THE FOOD OR FOOD PRODUCT IS FALSE OR MISLEADING IN ANY PARTICULAR, (B) THE FOOD OR FOOD PRODUCT 15 SERVED, SOLD, OR DISTRIBUTED UNDER THE NAME OF ANOTHER FOOD OR FOOD PRODLCT, OR (C) THE FOOD OR FOOD PRODUCT PURPORTS TO BE OR IS REPRESENTED AS A FOOD OR FOOD PRODUCT THAT DOES NOT CONFORM TO A DEFINITION OF IDENTITY AND STANDARD OF QUALITY IF SUCH DEFINITION OF IDENTITY AND STANDARD OF QUALITY HAS BEEN ESTABLISHED BY CUSTOM AND USAGE OBSERVED THE IDENTITY OF FOOD OR FOOD PRODUCT MISREPRESENTEL...IMITATION CRAB MEAT MISREPRESENTED ON THE MENU AS CRAB MEAT. Case Number 2009017030 Fila Number 210878 Oistnet Number 02 License Number 1620391 2010 Form revised 07 07 07 HAKUSAN JAPANESE RESTAURANT

Docket for Case No: 09-005527