. . State of Florida . Department of Business and Professional.Regulation Division of Hotels and Restaurants DEPARTMENT OF.BUSINESS AND PROFESSIONAL REGULATION , "Petitioner, vs, : ‘ License Number 1504734 CICI'S PIZZA Respond License Type 2010 espon: nt Case Number 2013016321 Administrative Complaint The DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION, DIVISION OF HOTELS AND RESTAURANTS, (‘Petitioner’), files this Administrative Complaint against CICI'S PIZZA, (‘Respondent’), and says: . . . : 1. Petitioner is the state agency charged with regulating the operation of public lodging éstablishments 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 1270 N WICKHAM RD STE 46-47C, MELBOURNE, FLORIDA 32935.The mailing address of record is CiCI'S PIZZA, at PO BOX 3790, DELAND, FLORIDA 32721. . 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 is described in Exhibit “A,” attached hereto and incorporated herein by reference. Inspection documents are attached as Exhibit “B’, incorporated herein by reference. . oan 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, 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 12, 2013 Valerie Freeman, District Manager By delegation of the Director, or designee Division of Hotels & Restaurants Department of Business & Professional Regulation COUNSEL FOR THE DEPARTMENT: Marc Drexler, Lead Attorney Florida Bar No. 0487058 N Department of Business & Professional Regulation 1940 North Monroe Street Tallahassee, Florida 32399-2202 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 , 2013. ; Received by: Inspector's Signature Operator's Signature Title : Title Case Number: 2013016321 | File Number: 203803 District Number: 04 License Number: 1504734 2010 Form revised 01.01.13 CICI'S PIZZA Exhibit A . License Number: 1504734 : License Type: 2010 PERMANENT FOOD SERVICE Case Number: 2013016321 , aan It is alleged that on May 9, 2012, September 20, 2012, March 19, 2013 Respondent was in violation of Florida Statute 509 (FS); the Rules of the Division of Hotels and Restaurants, Florida Administrative Code (FAC); and/or specific provisions of the Food Code, Recommendations of the United States Public Health Service, Food and Drug Administration, as incorporated by Chapter 61C, 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. : . ™ denotes a high priority violation. . * denotes an intermediate priority violation. ° ™ 1,03A-02-4 3-501.16(A)(2) FC High Priority: (A) Except during preparation, cooking, or cooling, or when time is used as the public health control.as specified under Section 3-501.19, and except as specified under Paragraph (B) and in Paragraph (C) of this section, potentially hazardous food (time/temperature control for safety food) shall be maintained: (2) At 44 degrees Fahrenheit or less. . On 05/09/12, Italian sausage, ham, diced chicken, shredded cheese and Alfredo sauce in the pizza make cooler were 44-53 degrees F. On 09/20/12, sausage, hamburger, ham, barbeque pork and: . chicken were 45-51 degrees F inthe pizza make cooler. On 03/19/13, italian sausage, shredded ‘cheese, ham and chicken were 49-52 degrees F in the pizza cooler. Case Number: 2013016321 — File Number: 203903 District Number: 04 License Number: 1504734 2010 Form revised 01.01,13 CICI'S PIZZA .

Docket for Case No: 13-002365