Jul 24 2006 13:31 arf2d/20686 13:27 8584146749 DEPR OGA PAGE 3/12 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION DIVISION OF HOTELS AND RESTAURANTS DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION Petitioner, WS. NEW YORK BRICK OVEN PIZZARIA Nene OI Respondent, Case No. 2006035920 ADMINISTRATIVE COMPLAINT The DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION, DIVISION OF HOTELS AND RESTAURANTS, (*Petitioner’), files this Administrative Complaint against NEW YORK BRICK OVEN - PIZZARIA, (‘Respondent"), and says: 1. Petitioner is the state agency charged with regulating the operation of public lodging establishmants and public food service establishments, pursuant to Section 20.185 and Chapter 509, Florida Statutes, 2, Respondantis, and has been at all times material hereto, licansed by or subject to the jurisdiction of the Division of Hotels and Restaurants, The respondent's business address of record is 2225 CR 220 SUITE B, MIDDLEBURG, FLORIDA 32068.The mailing address of record is NEW YORK BRICK OVEN PIZZARIA, at 2225 CR 220 SUITE 8, MIDDLEBURG, FLORIDA 32068. 3, Inspection of this establishment conducted pursuant to Sec, 509.032, Flaride Statutes, ravealed violations of the provisions of Chapter 509, Florida Statutes, and / or the rufes promulgated thereto governing operation of the establishment. The violatlon(s) found and applicable law are described in Exhibit “A,” attached hereto and incorporated hereln by reference. Inspection documents are attached as Exhibit °“B”, incorporated herein by reference. WHEREFORE, Patitioner 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 pragram sponsored by the Department's Hospitality Education Program: suspension, revocation, or refusal of a licanse Issued pursuant to this Chapter, and/or any other relief authorized by Chapter 609, Florida Statutes, or the rules promulgated thereto, Signed June 29, 2008 Steve VonBodungen, Dat Manager By delegation of the Director, or designee Division of Hotels & Restaurants Department of Business & Professional Regutation GOUNSEL FOR THE DEPARTMENT: Gnaries F. Tunnicliff, Lead Attomey Florida Bar No. 0153831 Department of Susiness & Professional Regulation 1940 North Monroe Street Tallahassee, Florida 32399-1007 CERTIFICATE OF SERVICE BY CERTIFIED U.S. MAIL, ARTICLE NUMBER: 7. 9 3577 ‘0 ) HEREBY CERTIFY that a true and correct copy of the foregoing ADMINISTRATIVE COMPLAINT has been hand served by me on this. day of , 20086. Received by: Inspector's Signature Operator's Signature nr Title Title Case Number 200603820 District Number: 05 Form revised 03,08.0€ License Number, 2001056 2010 NEW YORK BRICK OVEN PIZZARIA Jul 24 2006 13:31 arf2d/20686 13:27 8584146749 DEPR OGA PAGE @4/12 Exhibit A License Number: 2001056 License Type: 2010 PERMANENT FOOD SERVICE Case Number: 2006035920 "FC" as cited herein references specific provisions of tha Food Code, Recommendations of the United States Public Health Service, Food and Drug Administration, incorporated by Chapter €1C, Florida Administrative Code, "NEPA" a6 cited herein referances specific provisions of the National Fire Pratection Association Life Safety Code, Incorporated by referance at Chapter 44.4, “Fire Pravention, General Provisions”, Florida Administrative Code, and 61G-1.004(5), Florida Administrative Code. “ denotes 2 critical violation. Itis alleged that on September 23, 2005 and April 27, 2006 the licensee was In violation of Florida Statute 509(F8) 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 referanced inspection(s) are attached hereto and incorporated by reference as Exhibit B. ? 4,4531-1 NFPAQG, 10.1.2: COOKING EQUIPMENT THAT PRODUCES GREASE-LADEN VAPORS AND THAT MIGHT BE A SOURCE OF IGNITION OF GREASE IN THE HOOD, GREASE REMOVAL DEVICE, OR DUCT SHALL BE PROTECTED BY FIRE-EXTINGUISHING EQUIPMENT. OBSERVED THE USE OF COOKING EQUIPMENT PRODUGING GREASE LADEN VAPORS WITH NQ HOOD SUPPRESSION SYSTEM INSTALLED SMALL TABLE TOP ELECTRIC FRYER IN USE. * 247-051 610-1,004(11) FAC: ELECTRICAL WIRING, TO PREVENT FIRE OR INJURY, DEFECTIVE ELECTRICAL WIRING SHALL BE REPLACED AND WIRING SHALL BE KEPT IN GOOD - REPAIR. NO EXTENSION CORDS SHALL BE USED EXCEPT DURING CLEANING, MAINTENANCE AND OTHER TEMPORARY ACTIVITIES. ONLY A WALL SWITGH OR APPROVED PULL CORD SHALL BE PERMITTED IN BATHROOMS. IN AGCORDANCE WITH THE PROVISIONS OF NFPA 70, THE NATIONAL ELECTRICAL CODE, AS ADOPTED BY THE DIVISION OF STATE FIRE MARSHAL IN CHAPTER 44-3, ee UNM FIRE SAFETY RULES AND STANDARDS, SUFFICIENT ELECTRICAL OUTLETS SHALL BE PR . ‘ OBSERVED EXTENSION CORD IN USE FOR NON-TEMPORARY FERIOD - MULTHPLUG ADAPTER IN USE NEAR AQUARIUM AREA. Gage Number: 2006035920 Oistict Numbar; 0S Lieenee Number: 2001056 2010 Form cavited 03.06.08 NEW YORK BRIGK OVEN PIZZARIA Jul 24 2006 13:31 arf2d/20686 13:27 8584146749 DEPR OGA PAGE 5/12 : STATE OF FLORIDA Page t Fh ch neo 40 Depo cheema, reach in cooler, 44 Kegenes F. Dan Fulton, The MANAGER Sentation arxl Safety Speciafict 7960 Ariingtnt Phone: 904 278 x70 Expressway Sube 610 octane, AL 3224), 850-407-L9R} 904 727-5558 a Font preety PS se OT aa onraeD oF oGuely placed pir of Molton are Rated on subeenient pages, Woletions snared datecak ae Gitical winlations. Tarr stacked YES TS are ii camplance. Hear Murtid HG ore viotationr, Specie deta alto murd vl 0 Oa Sa evil 8 AYO are Nok bere, Berea, a eed state rm of Feet DOPR Form HR 9022-095 Jul 24 2006 13:32 arf2d/20686 13:27 8584146749 DEPR OGA PAGE §6/12 a. EXHIBIT. STATE OF FLORIDA DEPARTMENT DF BUSINESS AND PROFESSTONAL REGULATION Uoerse Number DIVISION OF HOTELS ANG RESTAURANTS SEAT 201056 www.eryflorids com) dpe Inspection Date FOO SERVICE Tr ‘ PEC TION REPORT 4/27/06 1:08:57 PM FaRore tn comply with this Notion muy iafiete an adminetretivs complaint that may result in suepeneton of revocation of your Nownsa STATUS PHF TEMPERATURE CONTROI. THs ANG REFUGE Yea 7 Unverspped oF potentially hazardous find nok re-seved = Vee Containers covered, adequatn number, Insect and recent | vex Oda Food protection citing piorage, praparstion, displty, . r emptied at proper Intarvalr, clean truneportation Yeu sinrage area deen, enddsure property consucted | ‘Yes Gmet-contamination, equipment, pankonnel, storage : co] eee for cross-contarnination; storage practices; STATUS JNSECT AND RODENT CONTROL maged food sagragatad Ya "35a Presence of Insecta Animals profited Yeu Pie Foods handed wih rintraim exrtact You hb Quien openings protected from insects, proof Yes hd tn usa food dizpensing utanails propery shored STATUS FLOORS, WALLS, CEILINGS | status PERSONNEL No Floora properly constructed, aan, drained, coved Yea 71 Pernonnal With infections rextricted Yes 7 Wells, colings, and ettiched equipment, constructed, ean Yes ize Hands wathed end clean, goad hygiene practices Cobserved), nRaraiva eparating plan fea Lighting provided as required. Fires shielded 126 Proper prachose, emting/ er) Yes aor and equipment « veniad as required evidences) STAN OTHER Yor 13 Gean othes, hair restraints Yas Jockers provided and used, clea STATUS FOOD EQUIPMENT AND WTENSELS Na iia Toxks Remit property Yaa 14 Food contact surfaces designed, constructed, maintained, | Yee 4ib Tonde arte labeled and used property Inctatec, locatad Ye Preis nian, eo i, Mecay eS, © Yes 15 Nene conic mrfces cad coewie, enna riedifrinaerbinhaeetil Property Yes 715 Dateeshing feciides designed, condructad, opersted 1. Wach 2. Rina 3, Sanktize Yar "17 Thermometers, gauged, feet kits provided Yes 18 pereapad, eooked Yes 29 , Hines Water clean, proper tampanstune Yea 20a Sanitizing concentration Yea Senaing temperatura NO 1 Wiping clothe clean, used properly, stoned Ne 2a Food contact fF equipment and utensils cleat No aa Nerfood contac: surtscnn clean Yoo Yer [24 Srage/handiing of clean equipment, ufenede No 51 Other conditions sankary and eave operation STATUS SINGLE ARTICLES Yes Fz Faloe/misiending suieoments published or advertioed relating res SE Service Raine property stored, handled, cieperted ; to feed beverage Yes 2S Sings Service articles not fi-tibed Ye6 Peaa Food managurnent certification valid aA WATER AND SEWAGE/PLUMEING = [Ys “Figo Employee training veldation Yea 7 Water source safe, hot and cold under preveure vi Fierida Clean Indoor Air Act [Yes ——«( 2S Sewage arel waete water disposed property Yee EE Aumeetic Grebilty Notes Yer Fo) Inecenied and maintainest iy 5h Copy of Chapter 509, Florida Statubes, available Yes ___ [P30 Croco-conneetion, back elphonege, backTiow STATUS oe STATUS TornkT AND HARCWAGHHING FACULTTIEN [Yes Id? Hospitality Education Program anformation provided No #3] Tole and handwashing feciies, number, conveckant, Yes ry w= cecigned, Inctalled SE ee cay, decemae towels oF Rae Total Nunber of COS Violationst = arya devices, Uesve, covered weste receptacles Total Number of Repeit Vielaione: = olstions martaad wath with an asteHek are critice violations. Tiiminoa. Rares arkca YES ara complinnee,Hitea Maried NO are pittonm, Speciic details of violation ara brted on subsequent pages. theme earked N/A are Net Applicaba, lems Marked ae: N/D are Not Obcerwad, ated were Nok boing pandiooted at thee tne of inspection, OPA Form HR 5042-024 Jul 24 2006 13:32 arf2d/20686 13:27 8584146749 DEPR OGA PAGE @7/12 — EXHIBIT B STATE OF FLORIDA Page 3 DEPARTMENT OF RUSINESS AND PROFESSIONAL REGULATION License Number DIVISTON OF HOTELS AND RESTAURANTS SEAT 2001056 ween com / dbp Inspection Date FOOD SERVICE INSFECIION REPORT rn LEGAL NOTICE 4727/06 1:08:57 PM Femive to comply With tha Notice may initiate an edainietrative eowotaint thet may result in eamanalon or revocation of your Bcsnee Administrative Complairt(s): 23-03-1, - Observed bulid-up off granse on nonfded-contact surface. FRYERS ' 431-1- ca ot cman rae tet th en en ten ie Noted Fire ATH, SMALL TABLE TOP ELECTRIC FRYER 47-051, « Cherved & splitter/mult+plug adapter in use-AQUARTUM AREA. Violation): U3A-07P-1 = Obmerved pobentielly harrerious food cold hal st gresbar than 42 degreet Pabrenhelt W-L1-1 - Wiping doth chlorine eaniiizing sokution not it proper minim strength, 22-23+1 - Qheerved encrusted reteria! on can opener. 72-10-1 - Observed interior of microwave soled. 2-03-1 - Observed bukt-up of gramsa on nonfoee.contact curtuce. TABLTE To? FRYER. 31-06-41» Handwash unk not accesible for employea use at al times. BLOCKED BY FLOOR FAN AND PIZZA PAN IN BOE OF SINE. 26-001 - Observed Floor and well junctures nok coved SOME AREAS, , 3-3-1 - Observed grease accumulited umder cooking aquipmert anid hard to get placer. 4Ui-O9+1 « Obeatved tridc tem etoned ir food preparation area.VER TRIPLE ,PREP SINK. 1-141 « Carbon dlaside/hallem tanks not acleustely securad. DAPA Ferm HA 3022-015 Jul 24 2006 13:32 arf2d/20686 13:27 8584146749 DEPR OGA PAGE 8/12 Tome Se ™ rs DEPARTMENT UF BUSINESS AND PROFESSIONAL XEGULATION EXHIBIT gare Division of Hotels and Restaurants y fi ' CALL BACK/RE-INSPECTION REPORT"! SRP | OSNOVIG PH 03 VOD | OLopeinG [fi Food SERVICE a [a0 1108 A | WARNING OF NOTICE TO DIRECT NOTICE: SHOW CAUSE Failure to be ln compliance You will hw issued a Notice ta with thia notica at any Show Cause why sanctions AY Complied Citearing raquested a Pre-conterence Not comatied ©) Out of iusinass (16n Stipulation (Clon Hesring Order Dither: future Inapaction may should not he asneased againet resaltin a direct Roties to your lirense, & hearing will be held at a time and plees to be dealgnated by tho director, (Tima axtanded a, eS ane RTE i DBPR Fom HR SE , Revieed 2000 August 40 Jul 24 2006 13:32 arf2d/20686 13:27 8584146749 DEPR OGA PAGE 9/12 STATE OF FLORIDA Page 1 DEPARTMENT OF BUSINESS AND FROFESSIONAL REGULATION PMSION OF HOTELS AND RESTAURANTS BX BIT B we nyfierida,convdbpr . FOGO SERVICE INSPECTION REPORT LEGAL NOTICE Falfure to comply with this Nolics rosy Inttlate an admminicirative cotiptatit thet may resutt In suspension oF Terocaton of your (eange and fines, bg PM Complaint ul 20005 SEAT Inspection Date and Time License Nunibar DEHART ENTERPRISES, ING. . Qumer Name 174 W YORK OVEN Pazzi Arga Code‘Telephone Number Business Name 45 jor24/2005 08:00 AM Sita Number of Unite " Callbgok Date/Time Licanza Expiration 2225 OR 220 MIDOLEBURG FL 32068 Addross / City / State / Zip / ec. ‘Suthedt meats, *ofen le aober, 47 Degrees F, Beat, react In coger 41 Dogreaa F. faeen , epoh in coiter, 42 Dogrene F Deky prietucht cheese, reach in comier, 42: Degrees F, Pork pappmitril, rich in costar, A Desgeee F, NOTE: ems marked shove with an eetetok (4) indicate a vielation Inepactor’s Commerc Hl : complaint of rddelving raw Chicken wings on 9/19/05," nat completely Tried”, Staind wings were returned to estabfishment where they refused retui his money or re-codk them. Wings ara received raw, frazan, thewed, cooked portally and. retridgerted, than refried when ordered. Peron in ange not aware of complaint, ta amployers, 2 cartified mgrs. only ‘ . Lagneviedge receipt of frla Ingpection torm and "Signature of Reciplent inspector Signature Dats * mocipient: 5 babinnt a For further infarmation planes contact tenet D'Antoni Tite mgr. Sano Sty Spin 560 Agen mem SB . 1 Jackoniie, abl Phone: 278 1770 0 47-1905 Ok FBS Fx : . [SOURCE STATUS. PHF TEMPERATURE CONTROL vos __—PtaAppmvedsowce | Y88 |G Hot soc et proper temperature [Yee oth eon Yas *03¢ Foods property coaked/rahestad jal container property tabe ' ves “13d Foods properly cooled F TEMPERATURE CONTROL Yes "04 Facditien to maintain product tepereiure Yes hOSa Cold food at proper temperatures during storage, Yes ‘ display, sardes, transport, and cold holding Yet Vietotions marked with An esterisk arm crtieal violations, Items: marked ‘YES arz in compliance, ttams Raarkad NO are ‘olettana, Specific deteva of violation ara listed on subsequent paged. tenn marked NYA ane Not Applicable, Hams Marked ag NM pre Not Obsarans, and ware nck being conducted at fhe tee of Inspection. OBPR Form HR 5022-015 * Jul 24 2006 13:33 DIVISION OF HOTELS AND RESTAURANTS: SEAT 28 RW nny florida. comsaape int Date FOOD SERVICE INSPECTION REFORT BrRANS 4:05:58 PM . LEGAL NOTICE Falkire to comply with this Nodes may Inkiate en acrrintetrative complaint that may roeutt in auapension or ravocetion of your Ticanes and fines, ‘TUS PHF TEMPERATURE CONTROL | status _| GARCAGE AND REFUSE DISPORAL fo? Uowpedorpommioy Pemestogcermssned [re [ETS covered, adequate number, Insect ad tadent ox hofa Food protection during storage, praparation, diepisy, proof, emptied at proper Infarvals, clean service, transportation 34 Outside storage area clean, enclosure proparty Yas OBb Cross-contamination, equipment, personnal, storage | a : E] ‘Yat ho8¢ Potential for eross-contamination: aterage practicas; STATUS NSECT AND RODENT CONTROL damaged food cagregated yea 359 Proconce of Insacts/rodents. Animals prohibited [yes (| *09 Fouts handiad with minimum contact, ves 25h Outer epanings protected trom Insects, rodent proat [Yas ttn use fond dispensing utensil properly storod, | STATUS _| FLOORS, WALLB, CEILINGS PERSONNEL yes ___28 Floors: property eonetrusted, clean, drainte, coved "vee “12a Handa washed and clean, qood hygienic practices clean observed), alternative operating plan ]yes [a Lighting provided as required. Fixtures shielted (evidence) Yet 113. Clean etathes, halrrestraints (Yes _ {40 Employee lockers provided and used, clean STATUS FOOD EQUIPMENT AND UTENSILS ives 41a Toxic hema properly stored ee 14 Food contact surfaces designed, constructed, Wee *44b Toxic tems Iibaled and used pro 4? Bramises malnutined, free of litter, urineoagsary erticles. as Cisaning and malnitanonce equipinent property stored, maintained, Instalted, located : Yas "76 Dishwashing faciities designed, coneiusted, operated 1. Wash 2, Rinse 3, Sanities " Kitchen restricted to authored personrial No Yea ast yes a was proper tempera. [ves a ing ever [res Pope Sanitizing concentration [No __—(*47 Electrical wiring - aclequall, ¢ ai [Yes 20h Sanitizing tampsrature yes [48 Gas appllances - properly Inetalléd, maintainet! Yes 21 Wining jean, used property, stored arma aq mista I22 Food contact surfaces of equipment ard utenwite clean 123 Notfood contact surfaces gaan [Yes (24 Storagamandling of clean equipment, utensilt 51 Other coruditio ta a yas 52 Falsermisieading statements published or advertised 5 Sarvion itents property storad, handled, dispanzed frlating to foodeenarage : frat [a6 single service artistas not reused [Yea Food management cartitention valld Sab Employes taining validation, STATUS "Yes per 68 Copy of Chapter 609, Florida Statutes, avaliable 4 nection. back siphoned STATUS GENERAL 0 Croge-oc a backflow | STATUS _| "TOH,ET AND HANDWASHING FACLITIES spit are 4 Tolet and handwashing facilities, number, convenient, Yas deelgnad, inetalted Ro Rearoome with eetf-claping door, fixtures operate property, - faciity dean, aupplied win hardecgp, disposable twas or hand drying devicds, esi, covered wHete Mmooptacles Total Number of COS Vielations: q Total Number of Rapeet Violations; = 0 Violations marked with in asneritk ore crftical violtions, Kart marked YES are In Compllencas. [terns Marken! NO ave violations. Specific cetalta of vixetion are sted on AvbSequert pags. Homa marked N/A ore Not Applicable, Items Marked pa N/C are Hot Qhoerved, end yar not boing conducted At the time of Ingppetion. DaPR Ferm Me S215 arf2d/20686 13:27 8564146749 DEPR OGA PAGE 18/12 ~ STATE OF FLORIDA a Page 2 DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION —Liconse Narnber XH BIT B Jul 24 2006 13:33 arf2d/20686 13:27 8584146749 DEPR OGA PAGE 11/12 _ a - wes EXHIBIT B STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION — License Number DIMSION OF HOTELS AND RESTAURANTS Sear 25001068 www. ntyflorda.comidbpr Ingpaction Date 9723/06 4:05:59 PM FOOD SERVICE INSPECTION REPORT LEGAL NOTICE Fallure to comply with this Notiae may initiate an administrative coriplnint that mary raqult In superior ef revocation ef your license and fines. Vigiatlan(a): . 1708-1 - Observed reorect chemical leat kit provided wher Halng Chemica! sanitizer at ihhee-comparimont sinkAwereweahiog machine; Guats Mt, using chioring, 22-27-41 « Qosarvad food-contuct surfaces encrumed with preese and/or soil dopoalts; Interior of table top fryer/bankat used to cock wings. cheese sticks, ote. Ze 18-1 ~ Obeerved Inverter of microwave coiled. ZAK - Qpaerved bulk-up of binek thick gresse on aontood-contact gurtivoe! table top fryer witertor, 2203-1 - Observed Dullé-up of grease of nanfoex-onntact aurfoes. inp of chee froazer nner fryer. 20-021 » VacHUM Drea her misiig aU thraadad hoe bibb on water feater, 22-151 - No handivsahing sign provided at # handsink stad try food employee. ° AE-G11-1 - Observed sha use of cooking eqlprient producing grasa Isdan vapornisioke {lable top iryat) with no hood suppression eystern InstaRed, Nobifted Fire AR, Chip Eset, Glay County Fire Martha by talephone ol, DARDOMKiNUE ime of thie equipment Irmmciatly. 47.06-1 ~ Qoaenied multiple phi ectapier (extension cord) In use for norelempormy period by aquarium. Ste11-2 - Garton dioxide/hallum tanks nor adequately secured. 54-(11-1 » Copy of Florida Statute 600 nol avanania in the establishment, REPBRENCE TEXT; 500.101(2} FS: (2) Gach opermtor shan matieln at all times m cuitent copy oF this chapter In the omic of he Hcensed establishment which shall be: med avalinble-to lhe PUIG Lipa mequet, DBPR Form HR 622-015

Docket for Case No: 06-002662