#2403 P.C07/007 District 4. Division of H&R OCT.19'2004 10:02 4073177839 STATE OF FLORIDA ROS MAY 15 P B33 DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION: NAY |b DIVISION OF HOTELS AND RESTAURANTS DEPARTMENT OF BUSINESS AND Pie PROFESSIONAL REGULATION ' Petitioner, i” 7 OS -V1eT CICI'S PIZZA #202 License No, 1504734 Respondent. License Type 2010 Permanent Food Service / Case No. 2004046773 ADMINISTRATIVE COMPLAINT ND PROFESSIONAL REGULATION, DIVISION OF HOTELS AND The OEPARTMENT OF BUSINESS A is Administrative Complaint against CICI'S PIZZA #202, (‘Respondent’), RESTAURANTS, ("Potitioner’), files th and says: 1. Petitioner is the State agency charged with regulating Public food service establishments, 2. Respondent is, and has been at all times material hereto, li 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; mandatory attendance at Respondent'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 September 22, 2008 . x JOLAN ( } A. Ae Valerie Freeman, District Manager By delegation of the Director, or designee Division of Hotels & Restaurants Department of Business & Professional Regulation COUNSELOR THE DEPARTMENT: Charles F.: Tunnicliff, Lead Attorney Florida Ba No. 0153831 Department of Business & Professional Regulation 1940 North Monroe Street Tallahassee, Florida 32399-1007 CERTIFICATE OF Case Number: 2004048773 : Form revised 9/8/04 License Type: 2010 Permanent Food Service Distrlet Number: O04 License Number: 1504734 CICI'S PIZZA #207 License Number: 1504734 License Type: 2010 PERMANENT FOOD SERVICE Case Number: 2004046773 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. Itis alleged that on July 23, 2004, August 26, 2004 and August 27, 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. 36-09 6-201.11 FC FLOORS, WALLS, AND CEILINGS. EXCEPT AS SPECIFIED UNDER 6-201.14, THE FLOORS, FLOOR COVERINGS, WALLS, WALL COVERINGS, AND CEILINGS SHALL BE DESIGNED, CONSTRUCTED, AND INSTALLED SO THEY ARE SMOOTH AND EASILY CLEANABLE, EXCEPT THAT ANTISLIP FLOOR COVERINGS OR APPLICATIONS MAY BE USED FOR SAFETY REASONS. A TWELVE FOOT BY TWELVE FOOT AREA OF THE FLOOR IN THE KITCHEN PREP AREA WAS NOT EASILY CLEANABLE. WATER WAS POOLING ON THE UNFINISHED SURFACE. * 2.53B-06 61C-4.023(4)(A) FAC ALL PUBLIC FOOD SERVICE EMPLOYEES MUST RECEIVE TRAINING ON PROFESSIONAL HYGIENE AND FOOD BORNE DISEASE PREVENTION. PROFESSIONAL HYGIENE INCLUDES PERSONAL CLEANLINESS AND HYGIENIC PRACTICES IN ACCORDANCE WITH THE FOOD CODE AND TECHNIQUES TO PREVENT CROSS CONTAMINATION. FOOD BORNE DISEASE PREVENTION TRAINING MUST INCLUDE THE TYPES AND CAUSES OF FOOD BORNE ILLNESS, IDENTIFICATION OF POTENTIALLY HAZARDOUS FOOD, AND HOW TO CONTROL OR ELIMINATE HARMFUL BACTERIA IN A FOOD SERVICE ESTABLISHMENT. THERE WAS NO PROOF OF EMPLOYEE TRAINING AVAILABLE. * 3.53A-04 61C-4.023(1) FAC WHEN FOUR OR MORE EMPLOYEES, AT ONE TIME, ARE ENGAGED IN THE STORAGE, PREPARATION OR SERVING OF FOOD IN A LICENSED ESTABLISHMENT, THERE SHALL BE AT LEAST ONE CERTIFIED FOOD PROTECTION MANAGER PRESENT AT ALL TIMES WHEN SAID ACTIVITIES ARE TAKING PLACE. THE CERTIFIED FOOD PROTECTION MANAGER OR MANAGERS NEED NOT BE PRESENT IN THE ESTABLISHMENT DURING THOSE PERIODS OF OPERATION WHEN THERE ARE THREE FOR FEWER EMPLOYEES ENGAGED IN THE STORAGE, PREPARATION, OR SERVING OF FOODS. THERE WAS NO CERTIFIED FOOD MANAGER ON DUTY WHILE FOUR EMPLOYEES WERE ENGAGED IN FOOD PREPARATION. * 4.27-22 5-202.12FC HANDWASHING FACILITY, INSTALLATION. (A) AHANDWASHING LAVATORY SHALL BE EQUIPPED TO PROVIDE WATER AT A TEMPERATURE OF AT LEAST ...(110 DEGREES FAHRENHEIT) THROUGH A MIXING VALVE OR COMBINATION FAUCET. (B) ASTEAM MIXING VALVE MAY NOT BE USED AT A HANDWASHING LAVATORY. (C) A SELF-CLOSING, SLOW- CLOSING, OR METERING FAUCET SHALL PROVIDE A FLOW OF WATER FOR AT LEAST 15 SECONDS WITHOUT THE NEED TO REACTIVATE THE FAUCET. (D) AN AUTOMATIC HANDWASHING FACILITY SHALL BE INSTALLED IN ACCORDANCE WITH MANUFACTURER'S INSTRUCTIONS. THERE WAS NO HOT WATER PROVIDED TO THE HAND SINK IN THE KITCHEN/PREP ROOM ON JULY 22, 2004 AND NO HOT WATER TO ANY SINKS ON AUGUST 26, 2004 AND AUGUST 27, 2004. * denotes critical violation Exhibit A Case Number: 2004046773 Pace 1 License Type: 2010 PERMANENT FOOD SERVICE License Number: 1504734 Page 1 of 4 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION DIVISION OF HOTELS AND RESTAURANTS. CALLBACK INSPECTION REPORT EXH | B IT B 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. 8/27/04 4:08:50 PM Warning SEA15S04734 SEAT __ Callback inspection Date and Time Inspection Reason License Number SCHISCHI'S ENT INC ADMINISTRATIVE COMPLAINT 1299 Owner Name recommended. Area Code/Telephone Number CICHS PIZZA #202 Business Name inspection Result 150 08/26/2004 Number of Units Requested Callback Date/Time Initial Warning Date 01270 N WICKHAM RD MELBOURNE FL 32935 Address / City / State / Zip / etc Comments All empioyees should wash hands twice and use and sanitizer and wear gloves if injury occurs . There is no hot water at any hand sink and o ppm sanitizer at dishwash machine. All wares should be mannuaily senitize with a minimum of 50 ppm to maximum 100 ppm tested with chlorine test kit for chlorine sanitizer being used. , [The following item(s) have been recommended for Administrative Complaint: iolation: 27-22 iolation: 27-22 iolation: 27-22 bserved no hot or cold water provided at the only hand wash sink.in the kitchen prep area This violation must be corrected by : 08'27/04.repeat violation.2nd warning No ot water is provided to any sink. Hot water heater is in disrepair. lolation: 36-09 iolation: 36-09 iolation: 36-09 peeves floors not constructed easily cleanable. 12foot by 12 foot area in kitchen prep area is not easily cleanable And water is pooling on the unfunished floor surface. iolation was not corrected when inspected on 08/26/04 violation cited from 10/06/03 and 07/23/04 Pd~ APE Boor. Cobar 08/27/04 4:48 PM Date Signature of Recipient Inspector Signature Recipient: Edna Kilsby For further information please contact: Susan Cecilione sanitation and safety specialist 400 W. Robinson Phone: 321253 1289 Street Orlando, Fl. 32801 850-487-1395 Title manager DBPR FORM HR 5022-77? Page 2 of 5 STATE OF FLORIDA License Number DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION SEAT SEA1504734 DIVISION OF HOTELS AND RESTAURANTS Business Name CICI'S PIZZA #202 CALLBACK INSPECTION REPOREX, . HIBIT B Inspection Date LEGAL NOTICE 8/27/04 4:08:50 PM Failure to comply with this Notice may initiate an administrative complaint that may result in suspension or revocation of your license and fines. iolation: S3A-04 iolation: 53A-04 iolation: 534-04 Dbserved no currently certified food service manager noted on duty with four or more employees engaged in food preparation, This violation was not corrected when Inspected on 08/26/04 Joe Rosa manager on duty with no certified fod manager on premises on 08/26/04. IThe following item(s) are in compliance: iolation: 05-05 iolation: 05-05 iotation: 05-05, Dbserved no stem type thermometer provided to measure temperature of food product. food probe thermometer is broken. This violation must be corrected by : 07/23/04. iolation: 08A-21 iolation: O8A-21 iotation: OBA-21 Pbserved food not stored in a proper location.draining pasta stored next to chemical storage Corrected On Sile iolation: 29-05 iolation: 29-05 iotation: 29-05 Posered plumbing system in disrepair.Hot water faucet is stripped and does not provide hot waterbto the only hand sink in the front of the house handsink. This violation ust be corrected by : 07/23/04.corrected. iolation: 31-14 iolation: 31-11 iolation: 31-11 bbserved handwash sink not accessible for employee use al all times.handsink blocked bybvacuum cleaner in kitchen prep area. Repeat Violation. iolation: 42-02 iolation: 42-02 iolation: 42-02 Pbserved wet mop not hung to dry. iolation: 45-10 iolation: 45-10 iolation: 45-10 Dbserved partable extinguisher with tag partially torn away This violation must be corrected by : 07/23/04.corrected iolation: 45-10 iolation: 45-10 BPR FORM HR 5022 Page 1 of 2 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION DIVISION OF HOTELS AND RESTAURANTS CALLBACK INSPECTION REPORT FXH | B IT B 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. . SEA1504734 SEAT 8/26/04 3:45:35 PM Warning Fo homes Callback Inspection Date and Time Inspection Reason icense Numi SCHISCHT'S ENT INC ADMINISTRATIVE COMPLAINT recommended. (407)253-1299 Owner Name Area Code/Telephone Number CICI'S PIZZA #202 Business Name Inspection Result 150 08/27/2004 04:00 PM 07/23/2004 _ Number of Units Requested Callback Date/Time Initial Warning Date 01270 N WICKHAM RD MELBOURNE FL 32935 Address / City 7 State / Zip / etc. Comments ithe following item(s) have been recommended for Administrative Complaint: iolation: 36-09 fiolation: 36-09 bserved floors not constructed easily cleanable. 12foot by 12 foot area in kitchen prep area is not easily cleanable. Repeat Violation to be corrected by08/22/04 Niolation: 53A-04 Niolation: 53A-04 Observed no currently certified food service manager noted on duty with four or more employees engaged in food preparation. This violation must be corrected by : 08/22/04. Edna Kilsby 01/01 certified food manager. A certified food manager should be on site for every shift when four or more employees are preparing food lon site. No certified food manager on premises with four employees on site preparing potentially hazardous food. Kone (Cf Cb 08/26/04 4:21 PM Date Signature of Recipient _ Inspector Signature Recipient: Juan Rosa For further information please contact: TH Susan Cecilione te manager sanitation and safety specialist 400 W. Robinson Street Phone: 321 2531299 Orlando, FA. 32801 2 850-487-1395 DBPR FORM HR 5022-005 Page 2 of 2 STATE OF FLORIDA License Number DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION SEAT SEA1504734 DIVISION OF HOTELS AND RESTAURANTS Business Name CALLBACK INSPECTION REPORT Tri oe | CICI'S PIZZA #202 LEGAL NOTICE udis 2 jy Inspection Date 8/26/04 3:45:35 PM Failure to comply with this Notice may initiate an administrative complaint that may result in suspension or revocation of your license and fines. \jelation: 538-01 Niolation: 53B-01 Observed no proof of required employee training. This Violation must be corrected by : 08/22/04.No proof of employee training available. The following item(s) have been submitted for a Time Extension: Violation: 27-22 Niolation: 27-22 Observed no hot or cold water provided at the only hand wash sink.in the kitchen prep area This violation must be corrected by : 08/27/04.repeat violation.2nd waming [The following item(s) are in compliance: fiolation: 05-05 Violation: 05-05 bserved no stem type thermometer provided to measure temperature of food product. food probe thermometer is broken. This violation must be corrected by : 7/23/04. Miolation: 08A-21 Miolation: 084-21 Observed food not stored in a proper location.draining pasta stored next to chemical storage Corrected On Site. Miolation: 29-05 Violation: 29-05 poserved plumbing system in disrepair.Hot water faucet is stripped and does not provide hot waterbto the only hand sink in the front of the house handsink. This iolation must be corrected by : 07/23/04.corrected. Miolation: 31-11 Miolation: 31-11 observed handwash sink not accessible for employee use at all times.handsink blocked bybvacuum cleaner in kitchen prep area. Repeat Violation. Niolation: 42-02 Violation: 42-02 Observed wet mop not hung to dry. Niolation: 45-10 folation: 45-10 {Observed portable extinguisher with tag partially torn away This violation must be corrected by : 07/23/04.corrected Niolation: 45-10 iolation: 45-10 served portable extinguisher with tag out-of-date. portable fire extinguisher in dining room was last certified 05/03 This violation must be corrected by : 7/23/04.scheduled for monday 07/26/04 bREVARD FIRE SAFETY INC Miolation: 50-01 Page 1 of 4 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION DIVISION OF HOTELS AND RESTAURANTS CALLBACK INSPECTION REPORT FXH | B IT B 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. 7/23/04 1:11:12 PM Warming 1504734R SEAT Callback Inspection Date and Time Inspection Reason License Number SCHISCHI'S ENT INC Time Extended 1299 Owner Name Area Code/Telephone Number CICIS PIZZA #202 Business Name Inspection Result 150 08/22/2004 08:00 AM 07/22/2004 Number of Units Requested Callback Date/Time Initial Warning Date 01270 N WICKHAM RD MELBOURNE FL 32935 Address / City / State / Zip / etc. Comments CONTACT HOSPITALITY EDUCATION AT 800 704 1076 for ceryified food manager testing schedule .Or you may access the website ;www. hospitalityeducation.org for above mentioned testing. he following item(s) have been submitted for a Time Extension: iolation: 36-09 bserved floors not constructed easily cleanable. 12foot by 12 foot area in kitchen prep area is not easily cleanable. Repeat Violation to be corrected byO8/22/04 iolation: 45-10 tyserved portable extinguisher with tag out-of-date. portable fire extinguisher in dining room was last certified 05/03 This violation must be corrected by : 1723/04 scheduled for monday 07/26/04 BREVARD FIRE SAFETY INC lolation: 53A-04 AL Hon, haw Cn 07/23/04 1:42 PM Date Signature of Recipient Inspector Signature Recipient: Edna Kilsby For further information please contact: i Susan Cecilione Title cert. food mngr. sanitation and séfety specialist 400 W. Robinson Phone: 321 253 1299 Street Orlando, Fl. 32801 850-487-1395 DOBPR FORM HR 5022-77? Page 2 of 5 STATE OF FLORIDA License Number DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION SEAT 1504734R DIVISION OF HOTELS AND RESTAURANTS | Business Name CICI'S PIZZA #202 EXHIBIT B Inspection Date 7/23/04 1:11:12 PM Failure to comply with this Notice may initiate an administrative complaint that may result in suspension or revocation of your license and fines. CALLBACK INSPECTION REPORT LEGAL NOTICE served no currently certified food service manager noted on duty with four or more employees engaged in food preparation. This violation must be corrected by : 08/22/04 ‘dna Kilsby 01/01 certified food manager. A certified food manager should be on site for every shift when four or more employees are preparing food on site iolation: S3B-01 bserved no proof of required employee training. This violation must be corrected by : 08/22/04. he following item(s) are in compliance: jolation: 05-05 boserved no stem type thermometer provided to measure temperature of food product. food probe thermometer is broken. This violation must be corrected by : 07/23/04, iolation: OBA-21 bbserved food not stored in a proper location.draining pasta stored next to chemical storage Corrected On Site. iolation: 27-22 bserved no hot or cold water provided at the only hand wash sink.in the kitchen prep area This violation must be corrected by : 07/23/04, Violation: 29-05 Pposened plumbing system in disrepair.Hot water faucet is stripped and does not provide hot waterbto the only hand sink in the front of the house handsink. This violation just be corrected by : 07/23/04. iolation: 31-11 i handwash sink not accessible for employee use at all umes.handsink blocked bybvacuum cleaner in kitchen prep area. Repeat Violation. iglation: 42-02 Dbserved wet mop not hung to dry. jiolation: 45-10 bserved portable extinguisher with tag partially torn away This violation must be corrected by : 07/23/04. iolation: 50-01 bserved establishment operating without a current Hotel and Restaurant license. license displayed is expired and should be paid within the next five days in the district fice at 400 west Robinson Street,North Tower-802, Orlando Florida 32801. DBPR FORM HR 5022 Page 1 of 8 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION DIVISION OF HOTELS AND RESTAURANTS FOOD SERVICE INSPECTION REPORT EXH | B IT B LEGAL NOTICE M Failure to comply with this Notice may Initiate an adminlstrative complaint that may result in suspension or revocation of your license and fines. 7/22/04 11:38:22 AM Routine 1504734R SEAT Inspection Date and Time Inspection Reason License Number SCHISCHI'S ENT INC WARNING. Owner Name Violations in the operation of your 1299 Area Cade/Telephone Number CICI'S PIZZA #202 lishment must be corrected by: Business Name Inspection Result 150 07/23/2004 08:00 AM 01-APR-04 Number of Units Callback Date/Time License Expiration 01270 N WICKHAM RD MELBOURNE FL 32935 Address / City / State / Zip / etc. Item 03: Food Temperatures = Item 53a: Cert. Food Managers Item 20: Warewashing Sanitization item 45: Fire Extinguishers and Eire Suppression Systems Date beef topping, walk in cooler, 42 Degrees F. Ham, pizza prep table. 41 Degrees F. Sanitizer Type: Chlorine found al concentration of 50 PPM *A Class ABC type Fire Extinguisher, found in/at dining room has a certification date of 05/03 beef topping, pizza prep table. 43 Degrees F NOTE: Items marked above with an asterisk (*) indicate a violation .Inspector's Comments HE LICENSE FEE FOR THE DELINQUENT LICENSE IS 394.00 dollars. eb Site: www.hospitalityeducation.org. Water Source: Municipal/Utility. Sewage: Municipal/Utility: Provided { acknowledge receipt of this inspection form and comments. Je 2 Cor bower Cohn 07/22/04 12:58 PM Signature of Recipient Inspector Signature Date/Time ‘ - ate Recipient: Jose Rosa For further inforrnation please contact: . Susan Cecilione Title manager sanitation and safety specialist 400 W. Robinson Street Orlando, Ft Phone: 321 253 1299 350-487-1395 STATUS _| SOURCE PHF TEMPERATURE CONTROL [ves roved source *03b Hot food al proper temperature Yes *01b Wholesome, sound condition *03c Foods properly cooked/reheated Yes STATUS 02 Original container; properly labeled, date marking PHF TEMPERATURE CONTROL *03a Cold food at proper temperatures during storage, display, service, transport, and cold holding Violations marked with an asterisk are critical violations. Items marked YES are in compliance. Items 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 concucted DBPR FORM HR 5022-014 Page 2 of 8 License Number SEAT 1504734R STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION DIVISION OF HOTELS AND RESTAURANTS EXH | BIT 'BBpection Date FOOD SERVICE INSPECTION REPORT 7/22/04 11:38:22 AM 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. 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, insect and rodent No 08a Food protection during storage, preparation, display, proof, emptied at proper intervals, clean service, transportation Yes 34 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 Yes "35a Presence of insects/rodents. Animals prohibited Yes 109 Foods handled with minimum contact Yes *35b Outer openings protected from insects, rodent proof Yes 10 In use food dispensing utensils properly stored STATUS FLOORS, WALLS, CEILINGS | STATUS PERSONNEL No 6 Floors properly constructed, clean, drained, coved Yes +411 Personnel with infections restricted Yes 37 Walls, ceilings, and attached equipment, constructed, Yes "42a Hands washed and clean, good hygienic practices clean J (observed), alternative operating plan Yes 38 Lighting provided as required. Fixtures shielded Yes *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 Yes 40 Employee lockers provided and used, clean STATUS FOOD EQUIPMENT AND UTENSILS Yes "41a Toxic items properly stored Yes 14 Food contact surfaces designed, constructed, Yes *41b Toxic items labeled and used properly maintained, installed, located No 42 Premises maintained, free of litter, unnecessary articles. Yes Cleaning and maintenance equipment properly stored. maintained, installed, located Kitchen restricted to authorized personnel — Yes 16 Dishwashing facilities designed, constructed, operated |Yes 43 Complete separatios from living/sleeping area, laundry 1. Wash 2. Rinse 3. Sanitize Yes 44 Clean and soiled linen segregated and properly stored Yes 17 Thermometers, gauges, test kits provided STATUS SAFETY Yes No *45 Fire extinguishers - proper and sufficient Yes Yes *46 Exiting system - adequate, good repair Yes Yes *47 Electrical wiring - adequate, good repair Yes *20b Sanitizing temperature Yes *48 Gas appliances - properly installed, maintained [Yes 21 Wiping cloths clean, used properly, stored Yes *49 Flammable/combustible materials - properly stored Yes 22 Food contact surfaces of equipment and utensils clean STATUS GENERAL Yes 23 Non-food contact surfaces clean No "50 Current license properly displayed Yes 24 Storage/handling of clean equipment, utensils Yes 51 Other conditions sanitary and safe operation STATUS SINGLE SERVICE ARTICLES Yes *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 No *53a Food management certification valid STATUS WATER AND SEWAGE/PLUMBING No *53b Employee training validation No *27 Water source safe, hot and cold under pressure Yes 54 Florida Clean indoor Air Act Yes *28 Sewage and waste water disposed proper! Yes 55 Automatic Gratuity Notice No 29 Plumbing installed and maintained Yes 56 Copy of Chapter 509, Florida Statutes, available Yes *30 Cross-connection, back siphonage, backflow STATUS GENERAL STATUS TOILET AND HANDWASHING FACILITIES Yes 57 Hospitality Education Program Information provided No *31 Toilet and handwashing facilities, number, convenient, |Yes 58 Smoke Free designed, installed rooms with self-closi fixtures operat i oroperty, fetty clean, scppled with handsoap, digposable Total Number of COS Violations: 1 towels or hand drying devices, tissue, covered waste Total Number of Repeat Violations: 2 Violations marked with an asterisk are critical violations. Items marked YES are in compliance. Items 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 1504734R Inspection Date FOOD SERVICE INSPECTION REPORT 7/22/04 11:38:22 AM LEGAL NOTICE EXHIBIT B Failure to comply with this Notice may initiate an administrative complaint that may result in suspension or revocation of your license and fines. Warning(s): 05-05 - Observed no stem type thermometer provided to measure temperature of food product. food probe thermometer is broken. This violation must be corrected by : 07/23/04. 08A-21 - Observed food not stored in a proper location.draining pasta stored next to chemical storage Corrected On Site. 27-22 - Observed no hot or cold water provided at the only hand wash sink.in the kitchen prep area This violation must be corrected by : 07/23/04. REFERENCE TEXT: 5-202.12 FC : Handwashing Facility, Installation. (A) A handwashing lavatory shall be equipped to provide water at a temperature of al least ...(410 degrees Fahrenheit) through @ mixing valve or combination faucet. (B) A steam mixing valve may not be used at a handwashing lavatory. (C) A self-ciosing, slow-closing, or metering faucet shall provide a flow of water for at least 15 seconds without the need to reactivate the faucet. (D) An automatic handwashing facility shal! be installed in accordance with manufacturer's instructions, 29-05 - Observed plumbing system in disrepair.Hot water faucet is stripped and does not provide hot waterbto the only hand sink in che front of the house handsink. This violation must be corrected by : 07/23/04. 31-11 - Observed handwash sink not accessible for employee use at all times.handsink blocked bybvacuum cleaner in kitchen prep area. Repeat Violation. 36-09 - Observed floors not constructed easily cleanable. 12foot by 12 foot area in kitchen prep area is not easily cleanable. Repeat Violation. 42-02 - Observed wet mop not hung to dry. REFERENCE TEXT: 6-501.16 FC : Drying Mops. After use, mops shall be placed in a position that allows them to air-dry without soiling walls, EQUIPMENT, or supples. 45-10 - Observed portable extinguisher with tag partially torn away This violation must be corrected by : 07/23/04. REFERENCE TEXT: NFPA 10, 4-4.1 : Extinguishers shalt be subjected to maintenance, not more than one year apart. 45-10 - Observed portable extinguisher with tag out-of-date. portable fire extinguisher in dining room was last certified 05/03 This violation must be corrected by : 07/23/04, 50-01 - Observed establishment operating without a current Hotel and Restaurant license. license displayed is expired and should be paid within the next five days in the district office at 400 west Robinson Street,North Tower-802, Ortando Florida 32801. 53A-04 - Observed no currently certified food service manager noted on duty with four or more employees engaged in food preparation. This violation must be corrected by : 08/22/04. 53B-01 - Observed no proof of required employee training. This violation must be corrected by : 08/22/04.

Docket for Case No: 05-001767