D5 423+4 & ce py STATE OF FLORIDA Gy DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION).@;, , co DIVISION OF HOTELS AND RESTAURANTS Mf, DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION Petitioner, Vs. LA CAFETERIA AT COMCAST License No. 2612608 R dent. License Type 2010 Permanent Food Service espon / : Case No. 2004061113 ADMINISTRATIVE COMPLAINT The DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION, DIVISION OF HOTELS AND RESTAURANTS, (“Petitioner’), files this Administrative Complaint against LA CAFETERIA AT COMCAST, (‘Respondent'), and says: 1. Petitioner is the state agency charged with regulating the operation of public lodging establishments 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 fo the jurisdiction of the Division of Hotels and Restaurants. The respondent's business address of record is 6805 S. SOUTHPOINT PKWY, JACKSONVILLE, FLORIDA 32216.The mailing address of record is LA CAFETERIA AT COMCAST, at 6805 S. SOUTHPOINT PKWY, JACKSONVILLE, FLORIDA 32216. 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 are described in Exhibit “A,” attached.hereto and incorporated herein by reference. Inspection documents are attached as Exhibit “B", incorporated herein by reference. 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 December 23, 2004 Steve Moe fe District Manager By delegation of the Director, or designee Division of Hotels & Restaurants Department of Business & Professional Regulation COUNSEL FOR THE DEPARTMENT: Charles F. Tunnicliff, Lead Attorney Florida Bar No. 0153831 Department of Business & Professional Regulation 4940 North Monroe Street Tallahassee, Florida 32399-1007 CERTIFICATE OF SERVICE BY CERTIFIED U.S. MAIL, ARTICLE NUMBER: 7160 3901 9848 5780 8525 THEREBY CERTIFY that a true and correct copy of the foregoing ADMINISTRATIVE COMPLAINT has been hand served by me on this. day of , 2004, Received by: Inspector's Signature Operator's Signature Title Title Case Number: 2004061113 Form revised 10/25/04 License Type: 2010 Permanent Food Service District Number: 05 License Number: 2612608 LA CAFETERIA AT COMCAST License Number. 2612608 License Type: 2010 PERMANENT FOOD SERVICE Case Number: 2004061113 Exhibit A "EC" 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 Cade, 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 September 23, 2004, October 25, 2004 and November 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. * 4.53B-01 509.049FS FOOD SERVICE EMPLOYEE TRAINING. THE DIVISION SHALL ADOPT, BY RULE, MINIMUM FOOD SAFETY PROTECTION STANDARDS FOR THE TRAINING OF ALL FOOD SERVICE EMPLOYEES WHO ARE RESPONSIBLE FOR THE STORAGE, PREPARATION, DISPLAY, OR SERVING OF FOODS TO THE PUBLIC IN ESTABLISHMENTS REGULATED UNDER THIS CHAPTER. THESE STANDARDS SHALL NOT INCLUDE AN EXAMINATION, BUT SHALL PROVIDE FOR A FOOD SAFETY TRAINING CERTIFICATE PROGRAM FOR FOOD SERVICE EMPLOYEES TO BE ADMINISTERED BY A PRIVATE NONPROFIT PROVIDER CHOSEN BY THE DIVISION. ANY FOOD SAFETY TRAINING PROGRAM ESTABLISHED AND ADMINISTERED TO FOOD HANDLER EMPLOYEES PRIOR TO THE EFFECTIVE DATE OF THIS ACT SHALL BE SUBMITTED BY THE OPERATOR TO THE DIVISION FOR ITS REVIEW AND APPROVAL. IT SHALL BE THE DUTY OF THE LICENSEE OF THE PUBLIC FOOD SERVICE ESTABLISHMENT TO PROVIDE TRAINING IN ACCORDANCE WITH THE DESCRIBED RULE TO ALL EMPLOYEES UNDER THE LICENSEE'S SUPERVISION OR CONTROL. THE LICENSEE MAY DESIGNATE ACERTIFIED FOOD SERVICE MANAGER TO PERFORM THIS FUNCTION AS AN AGENT OF THE LICENSEE. FOOD SERVICE EMPLOYEES MUST RECEIVE CERTIFICATION PURSUANT TO THIS SECTION BY JANUARY 1, 2001. FOOD SERVICE EMPLOYEES HIRED AFTER NOVEMBER 1, 2000, MUST RECEIVE CERTIFICATION WITHIN 60 DAYS AFTER EMPLOYMENT. CERTIFICATION PURSUANT TO THIS SECTION SHALL REMAIN VALID FOR 3 YEARS. : OBSERVED NO PROOF OF REQUIRED EMPLOYEE TRAINING AVAILABLE FOR TERRY CLEMENTS. * denotes critical violation Exhibit A Case Number: 2004061113 Page 1 License Type: 2010 PERMANENT FOOD SERVICE License Number: 2612608 DEPARTMENT OF BUSINESS AND PROFESSIONAJ. REGULATION EXHIBIT B. Division of Hotels § Restaurants ‘ CALL BACK/RE-INSPECTION REPORT page__J:of_|_ f| (LODGING {1 FOOD SERVICE aA TAG WARNING DATES ESSN SHERTIONDATERS FEL EENSRCONTROLUNUMBERE: Month | Year" Month County FleNumber | _Sulfix Ab WARNING OF NOTICE TO DIRECT NOTICE: SHOW CAUSE Failure to be in compliance You will he issued a Notice to with this notice at any Show Cause why sanctions future inspection may should not be assessed against result in a direct Notice ta your license. A hearing will be Show Cause. held at a time and place to be designated by the director. - complied EJHearing requested LJPre-conference ‘CINot complied CJ Out of business (ClPre-hearing (Jon Stipulation (On Hearing Order (Time-extended date: ot Cooter: time: Owner Name: Lh feol Services cule. Cities tone LA Feud Cale AL Caw Business Address: ce ¥ 05 .. Sot ny 2 K VAN} Business City: Tac Aol ‘Sey ECU See Co ee fe aed EW dine mu 2 23, $58, 465, 5}, 938 — Not Cow) pled 2M, rain | ay Clb rainenea pa) INSPECTOR'S NAME zs PRINT) Davis Or INSPECTOR'S Loses ESTABLISHMENT TELERHO! q OFFICE TELEPHONE L710 t (2) DSPA Form HA 5022-005 Revised 03 February 199) Page 1 of 4 EXHIBIT STATE OF FLORIDA E DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION DIVISION OF HOTELS AND RESTAURANTS CALLBACK INSPECTION REPORT LEGAL NOTICE Fallure to comply with this Notice may initiate an administrative complaint that may result in suspension or revocation of your license and fines. 40/25/04 12:52:42 PM Warning 2612608 SEAT Callback Inspection Date and Time Inspection Reason License Number L AFOOD SERVICES CERTO GROUP LLG 7786 Time Extended Owner Name . ‘Area Code/Telephone Number LA CAFETERIA AT COMCAST. LACAFETER|A AT eer Business Name Inspection Result 41/22/2004 08:00 AM 09/21/2004 Number of Units ; Requested Callback Date/Time Initial Warning Date 6805 S, SOUTHPOINT PKWY. JACKSONVILLE FL 32216 Address / Clty / State / Zip fete. Comments Extension given due to several Hurricane .. 2 following lkem{s) have been submitted for a Time Extension: . Dbserved no proof of required amployee training. This must be corrected 11/22/04 lye fatlowing Item(s) are In compliance: bpserved no chemical test provided when sanitizer at three compartment sink. poserved wat wiping cloth not stored in sanitizing solution between uses. bbserved residue bulld-up on non-contact surface - 70/25/04 Date Signature of Recipient inspector Signature . Recipient: Brian Yeary For further information please contact Title Manager Moses Davis Ir. Sanitation and Safety Specialist 7960 Arlington Phone: 904/374/77B6 Exp. Ste 610 Jacksonville, FL 32211 850-487-1395 DBPR FORM HR 5022-777 Page 2 of ATL | Di | License Number STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION SEAT 2612608 DIVISION OF HOTELS AND RESTAURANTS Business Name LA CAFETERIA AT COMCAST CALLBACK INSPECTION REPORT . inspection Date LEGAL NOTICE 10/25/04 12:52:42 PM ly with this Notice may Initiate an administrative complaint that may result In suspension or revocation of your license and fines. Fallure to comp! observed live files in kitchen « | biserved the use of cooking equipment producting grease li jaden vapors. bybserved carbon dioxide tank no adequately secured . | DBPR FORM HR 5022 Fallure to comply with this Notice may Initiate a 9/23/04 8:08:56 AM Inspection Date and Time LACAFETERIA. CERTO GROUP LLC Owner Name LA CAFETERIA AT COMCAST. Business Name Number of Units 6805 S. SOUTHPOINT PKWY. STATE OF FLORIDA DEPARTMENT OF 8 DIVISION OF HOTELS AND RESTAURANTS FOOD SERVICE INSPECTION REPORT LEGAL NOTICE Complaint Full USINESS AND PROFESSIONAL REGULATION administrative complaint that may result in suspension or Page 10f8 revocation of your license and fines. 2612608 SEAT Inspection Reason WARNING: Violations in the operation of your bi ed by: Inspection Result 10/23/2004 08:00 AM. Callback Date/Time License Number Area Code/Telephone Number 6/1/05 License Expiration JACKSONVILLE FL 32216 Address / Clty / State / Zip etc. Item 03: Food Temperatures Nem 53a: Cert. Food Managers Item 20; Warewashing Sanitization ‘ Item 45: Fire Extinguishers and NOTE! Items marked above with an asterisk Inspectors Comments jomplaint #280/ 95-049228510218 : Repo Ithy. in the dumpster.Manager state he has been rovided Industry Bulletin 2004-02/05 loves in use anager are not to use fryers to cook foods between esuits | Observed 2 Small deep fat fryers in the establishment on the In this establishment since ried menu Items from meal, as per District Manager , Steve. (‘) indicate a violation rier states that a DBPR HAndR Inspecter has warned Comeast staff and Manager couple times that staff! the next time they would be fined, The floors are 41 A.M., even after receiving the warning that | acknowledge receipt of this Inspection form and camments. La Gas counter behind the serving line.Observed New Manager discarded the fat fryers 9/20/04 and was unaware of fryers waming . Informed Manager to remove all AVWree Deel. EXHIBIT B 9/23/04 Signature of Recipient Inspector Signature Date/Time Recipient: Brain Yeary For further information please contact Moses Davis Jr. Title cM , Sanitation and Safety Specialist 7960 Artinglon Exp. Ste 610 . Jacksonville, FL32211 Phone: 904/374/7786 350-487-1355 STATUS SOURCE ‘ STATUS PHF TEMPERATURE CONTROL Yes *03b Hot food at proper temperature sound condition Yes ["03c Foods proper cooked/reheated 02 Original container; properly labeled, date markin, PHF TEMPERATURE CONTROL “03d Foods properly cooled *04 Facllities to maintain product tem erature “03a Cold food at proper temperatures during storage, display, service, transport, and cold holding Ye Yes 05 Thermometers provided and conspicuously placed __}06 Potentially hazardous foods properly thawed Ss Violations marked with an asterisk are critical violations. tems marked YES are in compliance. Items Marked NO are violations. Specific detalls of violation are listed on subsequent pages. Items marked N/A are Not Applicable. DBPR FORM HR 5022-014 tems Marked as N/O are Not Observed, and were not being conducted Lise ee STATE OF FLORIDA Page 2 of B DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION License Number DIVISION OF HOTELS AND RESTAURANTS - SEAT 2612608 Inspection Date FOOD SERVICE INSPECTION REPORT 9/23/04 8:08:56 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. ——$<—J STATUS Loe Yes GARBAGE AND REFUSE DISPOSAL Yes 33 Containers covered, adequate number, insect and todent proof, emptied at proper Intervals, clean PHF TEMPERATURE CONTROL 07 Unwrapped or potentially hazardous food not re-served Yes "08a Food protection during storage, preparation, display, _ jservice, transportation Yes 34 Outside storage area clean, enclosure properly Yes POBb Cross-contamination, equipment, personnel, storage constructed Yes bose Potential for cross-contamination; storage practices, INSECT AND RODENT CONTROL damaged food segregated No "35a Presence of insects/rodents. Animals prohibited Yes bo Foods handled with minimum contact Yes "35h Outer openings protected from insects, rodent proof Yes 10 In use food dispensing utensils properly stored STATUS + FLOORS, WALLS, CEILINGS STATUS PERSONNEL, _|Yes 36 Floors properly constructed, clean. drained, coved "44 Personne! with infections restricted Yes 137 Walls, ceilings, and attached equipment, constructed, 38 Lighting provided as. required. Fixtures shielded 's and equipment - vented as re wired Yes *42b Proper hygienic practices, (evidence) OTHER AREAS yes 43 Clean clothes, hair restraints [Yes 40 Employee lockers provided and used, clean STATUS FOOD EQUIPMENT AND. UTENSILS Yes 41a Toxic Items proper! stored Yes 44 Food contact surfaces designed, constructed, Yes 4b Toxic items labeled and use maintained, Installed, located Yes 42 Premises maintained, free of litter, unnecessary articles. Yes 15 Non-food contact surfaces designed, constructed, Cleaning and maintenance equipment properly stored. maintained, installed, located Kitchen restricted to authorized personnel Yes 16 Dishwashing facilities designed, constructed, operated Yes 43 Complete separation from living/steeping area, laund 1. Wash 2. Rinse 3. Sanitize [Yes - (44 Clean and solled linen segregated and properly stored. No 47 Thermometers, gauges, test kits provided [_srarus_| . SAFETY ves | 18 Pre-flushed, scraped, soaked Ro Fas Ee exngusbers properandsuident —_| Fire extinguishers - proper and sufficient Nee Tie Wash, nso ser oan, poperiemperatue —_| 9 Wash, rinse water clean, proper” temperature Yes +45 Exiting system - adequate, good repalr Yes *20a Sanitizing concentration Yes "47 Electrical wiring - adequate, ood repalr es *20b Sanitizing temperature Yes "48 Gas appliances - proper! installed, maintained No 21 Wiping claths clean, used properly, stored Yes 49 Flammable/combustible materials - propert siored Yes 22 Food contact surfaces of equipment and utensils clean [_status_| GENERAL No 93 Non-food contact surfaces clean Yes 50 Current license properly displayed Fed |ot Siragehanding of den eupmeniuensis __| 24 Storage/handling of clean eq ulpment, utensils No 51 Other conditions sanita and safe operation STATUS PSBwsr SINGLE SERVICE ARTICLES —___| SERVICE ARTICLES Yes "52 False/misieading statements published or advertised yes Fetating to food/hever ee Yes 56 Single service articles not re-used Yes "53a Food management certification valid STATUS WATER AND SEWAGE/PLUMBING No, ___[*53b Employes training validation Yes "27 Water source safe, hot and cold under pressure Yes __|54 Florida Clean Indoor Alr Act Yes [28 Sewage and waste water disposed properly Yes 55 Automatic Gratulty Notice Yes 29 Plumbing Installed and maintalned yes 56 Copy of Chapter 509, Florida Statutes, available *30 Cross-connection, back slphonage, backflow TOILET AND HANDWASHING FACILITIES *31 Tollet and handwashing facilities, number, convenient, designed, installed STATUS. | GENERAL Yes 7 Hospitality Education Program Information provided 5 [ves _—_—iisa Smoke Free Total Number of COS Violations: 0 32 Restrooms with self-closing doors, fixtures operate properly, facility clean, supplied with handsoap, disposable towels or hand drying devices, tissue, covered waste Total Number of Repeat Violations: 1 Violations marked with an asterisk are critical violations. Items marked YES are in compliance. flems Marked NO are violations. Specific details of violation are listed on subsequent pages. ltems marked N/A are Not Applicable. Items Marked as N/O are Not Observed, and were not being canducted EXHIBIT B STATE OF FLORIDA Page 3 of 8 DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION License Number DIVISION OF HOTELS AND RESTAURANTS SEAT 2612608 Inspection Date FOOD SERVICE INSPECTION REPORT 9/23/04 8:08:56 AM LEGALNOTICE , 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}: 47-01 - Observed no chemical test kit provided when using chemical sanitizer at three compartment sink. 21-02 - Observed wet wiping cloth not stored In sanitizing solution between uses, 23-02 - Observed residue bulld-up on nonfood-contact surface. Inside beverage cabinel . 95A-01 - Observed live files In kitchen, 45-23 - Observed the use of cooking equipment producing grease taden vapars/smoke with no hood suppression system installed. Repeat Violations Observed evidence of fryers operating producing grease laden vapor . §1-02 - Observed carbon dloxide/hellum tanks not adequately secured, 538-01 - Observed no proof of required employee training. This violation must be corrected by : 10/23/05.

Docket for Case No: 05-004329