#2910 P.002/007 District 4. Division of H&R NOV.15'200d 10:59 4073177839 - STATE OF FLORIDA ay or DEPARTMENT OF BUSINESS AND PROFESSIONAL REGUL AHON@ |2: 25 DIVISION OF HOTELS AND RESTAURANTS . EPARTMENT OF BUSINESS AND an PROFESSIONAL REGULATION Pe ; vad ; Petitioner, _ Se ee * AN “ | 15 PIZZA HUT #630001 License No. 5900282 License Type 2010 Permanent Food Service Respondent. / Case No. 2004048662 SD ADMINISTRATIVE COMPLAINT The DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION, DIVISION OF HOTELS AND 1. Petitioner is the state agency charged with regulating public food service establishments, Pursuant to Section 20,4 . 2. Respondent Is, and has been at all times material hereto, licensed by or subject to the jurisdiction of the Li t. The Violation(s) found nd applicable law ara described in Exhibit *a,* Porated herein by reference. Inspection documents are attached as Exhibit "B*, Signed October 06, 2004. Valerie Freeman, District Manager By delegation of the Director, or designes Division of Hotels @ Restaurants Department of Business & Professional Regulation COUNSEL AOR THE DEPARTMENT: Charles F. Tumnicliff, Lead Attorney Florida Bar No. 0153831 Department of Business & Professional Regulation 1940 North Monroe Street Tallahassee, Florida 32399-4007 CERTIFICATE OF SERVICE 8Y CERTIFIED U.S. MAIL, ARTICLE NUMBER; { HEREBY CERTIFY that a true and correct co hid served by me on this Gra. _ ) : EX nepec , oa a dE Rit LPEe. Case Number: 200404 8662 Form. revised 9/8/04 License Type: 2010 Pemanent Food Service District Number: 04 Ucanse Number: 5900252 PIZZA HUT #630001 License Number: 5900252 License; Type: 2010 PERMANENT FOOD SERVICE Case Number: 2004048662 | Exhibit A “FC” as cited herein references specific provisions of the 1999 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. [tis alle sed that on September 21, 2004 and September 22, 2004 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. “ * 1.35A-01 6-501.111FC CONTROLLING PESTS. THE PRESENCE OF INSECTS, RODENTS, AND OTHER PESTS SHALL BE CONTROLLED TO MINIMIZE THEIR PRESENCE ON THE PREMISES BY: (A) ROUTINELY INSPECTING INCOMING SHIPMENTS OF FOOD AND SUPPLIES; (B) ROUTINELY INSPECTING THE PREMISES FOR EVIDENCE OF PESTS; (C) USING METHODS, IF PESTS ARE FOUND, SUCH AS TRAPPING DEVICES OR OTHER MEANS OF PEST CONTROL AS SPECIFIED UNDER SECTIONS 7-202. 12, 7-206.12, AND 7-206.13; AND (D) ELIMINATING HARBORAGE CONDITIONS. THERE WERE TEN TO TWENTY LIVE ROACHES UNDER THE SEAT/BOOTH IN THE DINING ROOM, AND THREE LIVE ROACHES ON A CLIP BOARD ON THE WALL TO THE LEFT OF THE DISHMACHINE. fii * denotes critical violation Exhibit A Case Number: 2004048662 Page 1 License Type: 2010 PERMANENT FOOD SERVICE License Number: 5900252 Page 1 of 1 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION DIVISION OF HOTELS AND RESTAURANTS. EXHI BIT B CALLBACK INSPECTION REPORT LEGAL NOTICE Failure to comply with this Notice may initiate an administrative complaint that may result in suspension or revocation of your license and fines, 9/22/04 2:39:57 PM Warning 5900252 . SEAT Callback Inspection Date and Time Inspection Reason License Number PIZZA HUT OF TITUSVILLE INC ADMINISTRATIVE COMPLAINT recommended. (407)846-3702 Owner Name Area Code/Telephone Number PIZZA HUT #630001 Business Name Inspection Result Number of Units “ Requested Callback Date/Time Initial Warning Date 1000 W VINE ST KISSIMMEE FL 347414167 Address / City / State / Zip / etc. Comments istrict 4 officer Ann Johnson recommended an administrative complaint upon reviewing t - call back results per phone conversation {The following item(s) have been recommended for Administrative Complaint: 10 to 15 live roaches stil! observed under the seat/booths in the dinning and 3 live roaches in a clip board to the left of the dishmachine oom bondttllntt SED Date Signature of Recipient Inspector Signature Recipient: Robert Hector For further information please contact: Title Edwin G WEIMER , management State Inspector 400 W Robinson N 802 Orlando 32801 Phone: 407 846 3702 850-487-1295 DBPR FORM HR 5022-005 EXHIBIT B DBPR HR-7003 -~ Division of Hotels and Restaurants Consumer Complaint Form STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL 95-04915145120696 REGULATION 9/15/2004 2:51:20 PM 1940 North Monroe Street Tallahassee, FL 32399-0183 !f you have any questions or need assistance in completing this application, please contact the Department of Business and Professional Regulation or your local district office. A District Office Address and Contact information Sheet can be found on H&R's page of the DBPR web site at www.MyFlorida.com SECTION :1:- ESTABLISHMENT: INFORMATION License Type: @ Food Service e) Lodging Oédtevator O Registered Elevator Company O Elevator Inspector Name Pizza Hut Address 1000 W Vine St, Rte 192 City County State Zip Code , ei ¢ I Kissimmee | Osceola (59) FL Oda 54 7 ¥ / Business Phone: 407-846-1579 | License Number: SEA5900252 SECTION 2- COMPLAIN — Last Name First Middle Title Suffix Organization Name (if representing an organization, please provide the name of the organization) Street Address or P.O. Box a, City State Zip Code (+4 optional) FL County (if Florida address) | Country United States _—CONTACT INFORMATION. a Primary Home Phone Number Primary Business Phone Number L . Primarg-Mail Address . Does the Complainant want to be contacted? O Yes © © No_ SEE PAGE 2 EXHIBIT B 95-04915145120696 9/15/2004 2:31:20 PM = Reporter states that Pizza Hut General Manager "Robert" has been aware for more than a month that “bugs are living in booths where people sit," that "roaches" infest the kitchen and dishwasher area, that insects crawl all over the booth seating area and customers have refused to be seated when they observed insects crawling all over booth seating area. Reporter states staff have reported the infestation of insects and roaches “living” in restaurant, and that the “staff joke about it." Reporter requests anonymous report. 9/21/04 2:53:58 PM STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGUL: DIVISION OF HOTELS AND RESTAURANTS FOOD SERVICE INSPECTION REPORT LEGAL NOTICE Failure to comply with this Notice may initiate an administrative complaint that may result in suspension or revocation of your license and fines. Complaint Full 5900252 Page 1 of 8 wrote EXHIBIT B SEAT Inspection Date and Time PIZZA HUT OF TITUSVILLE INC Inspection Reason License Number WARNING: Owner Name PIZZA HUT #630001 tabi it mi Business Name Inspection Result Violations in the operation of your 3702 rr 09/22/2004 08:00 AM Area Code/Telephone Number Number of Units 1000 W_VINE ST Callback Date/Time License Expiration KISSIMMEE FL 347414167 Address / City / State / Zip / etc. \tem 03: Food Temperatures item 53a: Cert. Food Managers Item 20: Warewashing Sanitization Item 45: Fire Extinguishers and Fire Suppression Systems Dates | ‘Cheese, walk in cooler, 37 Degrees F. Chicken wings, walk in cooler, 39 Degrees F Pizza, cooking temperature, 198 Degrees F. Manager Name: Michael Darr Certification Date: 9/21/04 expires today Certlied by: National Registry of Food Safely Professionals Sanitizer Type: Chlorine found at concentration of 100 ppm PPM, A Class ABC type Fire Extinguisher, found invat k tchen has a ceriification date of 8/04 A Class ABC type Fire Extinguisher, founc in/at dining room has a certification date of 8/04 NOTE: Items marked above with an asterisk (*) indicate a violation Inspector's Comments lleged roaches in the seating areas Nonymous complaint ‘oches observed in the seating boths and at the dishmathine a 24 hour warning is being issued to get rid of the verman junicipal/Utility. Sewage: Municipal/Utility. Employees trained by Other Approved Corporate Training Water Source: | acknowledge receipt of this inspection form and comments. Prick LQ aS ce > 09/21/04 3:54 PM Inspector Signature Signature of Recipient For further information please contact: Date/Time Recipient: Michael Darr . Edwin G WEIMER Title management State Inspector 400W Robinson N 802 Oriando 32801 Phone: 407 846 3702 850-487-1395 stars | SOURCE STATUS PHF TEMPERATURE CONTROL Yes *O1a Approved source Yes *03b Hot food at proper temperature Yes *O1b Wholesome, sound condition Yes *03c Foods properly cooked/reheated Yes 02 Original container; properly labeled, date marking Yes *03d Foods properly cooled — STATUS PHF TEMPERATURE CONTROL Yes *04 Facilities to maintain product temperature Yes *03a Cold food at proper temperatures during storage, Yes 05 Thermometers provided and conspicuously placed display, service, transport, and cold holding Yes 06 Potentially hazardous foods properly thawed Violations marked with an asterisk are critical violations. Items marked YES are in compliance. tems Marked NO are violations. Specific details of violation are listed on subsequent pages. Items marked N/A are Not Applicable. Items Marked as N/O are Not Observed, and were not being conducted DBPR FORM HR 5022-014 STATE OF FLORIDA LEGAL NOTICE DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION DIVISION OF HOTELS AND RESTAURANTS FOOD SERVICE INSPECTION REPORT Page 2 of & Neear eo BLT B Inspection Date 9/21/04 2:53:58 PM Failure to comply with this Notice may initiate an administrative complaint that may result in suspension or revocation of your license and fines. STATUS PHF TEMPERATURE CONTROL STATUS GARBAGE AND REFUSE DISPOSAL Yes *07 Unwrapped or potentially hazardous food not re-served |Yes [33 Containers covered, adequate number, irisect and rodent Yes *08a Food protection during storage, preparation, display, proof, emptied at proper intervals, clean service, transportation Yes 134 Outside storage area clean, enclosure properly Yes *08b Cross-contamination, equipment, personnel, storage constructed Yes *O8c Potential for cross-contamination; storage practices; STATUS INSECT AND RODENT CONTROL \damaged food segregated No "35a Presence of insects/rodents. Animals prohibited Yes ]09 Foods handied with minimum contact Yes "35b Outer openings protected from insects, rodent proof No 10 In use food dispensing utensils properly stored STATUS FLOORS, WALLS, CEILINGS STATUS PERSONNEL Yes 36 Floors properly constructed, clean, drained, coved Yes 41 Personnel with infections restricted No. 37 Walls, ceilings, and attached equipment, constructed, No *12a Hands washed and clean, good hygienic practices clean |(observed), alternative operating plan Yes 38 Lighting provided as required. Fixtures shielded No *12b Proper hygienic practices, eating/drinking/smoking Yes 39 Rooms and equipment - vented as required (evidence) _ STATUS OTHER AREAS Yes 13 Clean clothes, hair restraints 40 Employee lockers provided and used, clean STATUS FOOD EQUIPMENT AND UTENSILS Nes pate Toxic items properly stored Yes 14 Food contact surfaces designed, constructed, — *41b Toxic items labeled and used properly __} maintained, installed, located 42 Premises maintained, free of litter, unnecessary articles. Yes 15 Non-food contact surfaces designed, constructed, a= and maintenance equipment properly stored. maintained, installed, located Kitchen restricted to authorized personnel Yes 16 Dishwashing facilities designed, constructed, operated Yes a3 Complete separation from from living/sleeping area, area, laundry _| 1. Wash 2. Rinse 3. Sanitize Yes ag Clean and soiled linen segregated and properly stored _| No 17 Thermometers, gauges, test kits provided SAFETY Yes 18 Pre-flushed, scraped, soaked Yes eas Fire extinguishers - proper and sufficient Yes 19 Wash, rinse water clean, proper temperature No_ Exiting system - adequate, good repair *20a Sanitizing concentration "47 Electrical wiring - adequate, good repair Yes STATUS Yes *20b Sanitizing temperature Yes "48 Gas appliances - properly installed, maintained hes 21 Wiping cloths clean, used properly, stored Yes "49 Flammable/combustlible materials - properly stored No 22 Food contact surfaces of equipment and utensils clean STATUS GENERAL No 23 Non-food contact surfaces clean *50 Current license properly displayed Yes 24 Storage/nandling of clean equipment, utensils 51 Other conditions sanitary and safe operation STATUS | SINGLE SERVICE ARTICLES *52 False/misleading statements published or advertised Yes 25 Service items properly stored, handled, dispensed relating to food/beverage Yes 26 Single service articles not re-used "53a Food management certification valid STATUS WATER AND SEWAGE/PLUMBING "53b Employee training validation Yes "27 Water source safe, hot and cold under pressure 54 Florida Clean Indoor Air Act Yes "28 Sewage and waste water disposed proper! 55 Automatic Gratuity Notice Yes 29 Plumbing installed and maintained 56 Copy of Chapter 509, Florida Statutes, available Yes STATUS GENERAL *30 Cross-connection, back siphonage, backflow TOILET AND HANDWASHING FACILITIES Yes 57 Hospitality Education Program Information provided "31 Toilet and handwashing facilities, number, convenient, designed, installed No 32 Restrooms with self-closing doors, fixtures operate properly, facility clean, supplied with handsoap, disposable towels or hand drying devices, tissue, covered waste 58 Smoke Free Total Number of COS Violations: 0 Total Number of Repeat Violations: 1 Violations marked with an asterisk are critical violations. Items marked YES are in compliance. {tems Marked NO are violations. Specific details of violation are listed on subsequent pages. Items marked N/A are Not Applicable. Items Marked as N/O are Not Observed, and were not being conducted Page 3 of 8 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION _ License Number DIVISION OF HOTELS AND RESTAURANTS SEAT 5900252 Inspection Date FOOD SERVICE INSPECTION REPORT 9/21/04 2:53:58 PM LEGAL NOTICE FXH | BIT B Failure to comply with this Notice may initiate an administrative complaint that may result in suspension or revocation of your license and fines. Waring(s): 35A-01 - Observed the presence of insects, rodents, or other pesis.many roaches are observed in the booths and a few at the dish machine This violation must be corrected by : 9/22/04. Violation(s): 10-02 - Observed ice scoop with handie in contact with ice. 10-05 - Observed in-use utensil not stored on a clean, protected location if used with a food that is nonpotentially hazardous.ice scoop on soda head 12A-12 - Observed food employee touching ready-to-eat food with their bare hands. No approves Alternative Operating Procedure ir place.lemons are touched by bare hand REFERENCE TEXT: 61C-4.010(1)(d) FAC : No bare hand contact of exposed ready-to-eat food. Food employees may contact ready-to-eat foods with their bare hands immediately prior to service if the operator of the public food service establishment maintains a written operational procedure. 12B-01 - Observed employee in a restricted area drinking from an open beverage container. REFERENCE TEXT: 2-401.11 FC : Eating, Drinking, or Using Tobacco. (A) Except as specified in Paragraph (B) of this section, an EMPLOYEE shall eat, drink, or use any form of tobacco only in designated areas where the contamination of exposed FOOD; clean EQUIPMENT, UTENSILS, and LINENS; unwrapped SINGLE-SERVICE and SINGLE- USE ARTICLES; or other items needing protection can not result. (B) A FOOD EMPLOYEE may drink from a closed BEVERAGE container if the container is handled to prevent contamination of: (1) The EMPLOYEE'S hands; (2) The container; and (3) Exposed FOOD; clean EQUIPMENT, UTENSILS, and LINENS; and unwrapped SINGLE-SERVICE and SINGLE-USE ARTICLES. 17-01 - Observed no chemical test kit provided when using chemical sanitizer at three compartment sink. 22-02 - Observed encrusted material on can opener. Repeat Violation. 23-02 - Observed gaskets with slimy/mold-like build-up.on the pizza make box 32-02 - Observed lack of handwashing sign at a handsink used by food employees.in the restrooms 35A-01 - Observed the presence of insects, rodents, or other pests.observed live roaches under the booths 10 to 15 and 2 live ones at the dish machine at the power control box. No evidence in the rest of the facilities of roaches 37-02 - Observed ceiling soiled with accumulated grease.at the a/c vents 37-02 - Observed wail in disrepair.in the mens restroom 46-11 - Observed exit fights not properly illuminated.at the west entry REFERENCE TEXT: 61C-1.004(10) FAC : Exits shall be clearly masked with approved illuminated exit signs. 513-04 - Observed no Heimlich maneuver sign posted 56-01 - Observed copy of Florida Statute 509 not available in the establishment. REFERENCE TEXT: 509.101(2) FS : Each operator shalt maintain at all times @ current copy of this chapter in the office of the licensed establishment which shal be made available to the public upon request.

Docket for Case No: 05-001765