STATE OF FLORIDA DEPARTMENT OF BUSINESS-AND PROFESSIONAL REGULATIO} DIVISION OF HOTELS AND RESTAURANTS oy Soy 4, 2p DEPARTMENT OF BUSINESS AND “4 i) fa A PROFESSIONAL REGULATION We! Were Petitioner, v vs. , \ License No. 1617089 O | - O \. | MICHELLE'S cnr E dent License Type 2010 espon a . Case No. 2006062341 ADMINISTRATIVE COMPLAINT The DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION, DIVISION OF HOTELS AND RESTAURANTS, (‘Petitioner’), files this Administrative Complaint against MICHELLE’ 'S CAFE, (“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 to the jurisdiction of the Division of Hotels and Restaurants. The respondent's business address of record Is 299 E BROWARD BLVD, FORT LAUDERDALE, FLORIDA 33301.The mailing address of record is MICHELLE'S CAFE, at 13161 NW 11 CT, SUNRISE, FLORIDA 33323. 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 appilcable 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 follawing 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 November 14, 200: _ athy Driscoll, Deputy District Manager By delegation of the Director, or designee Division of Hotels & Restaurants . Department of Business & Professional Regulation COUNSEL FOR THE DEPARTMENT: Charles F. Tunnicllff, Lead Attorney Florida Bar No. 0153831 ; Department of Business & Professional Regulation 1940 North Monroe Street ; Tallahassee, Florida 32399-1007 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 : , 2006. Received by: ___: inspector's Signature Operator's Signature Title Title Case Number: 2006062341 District Number: 02 Ucense Number: 1647088 2010 : Form revised 10.10.06 MICHELLE'S CAFE : Exhibit A License Number: 1617089 . License Type: 2010 PERMANENT FOOD SERVICE Case Number: 2006062344 “FC" as clted herein references specific provisions of the 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 pravisions of the National Fire Protection Association Life Safety Code, incorporated by reference at Chapter 44-3, “Fire Prevention, General Provisions", Florida Administrative Code, and 61C-1.004(5), Florida Administrative Code. “*" denotes a critical violation, Itis alleged that on July 31, 2006, September 18, 2006, November 2, 2006 the Jicensee 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. * 4,02-22-1 3-601.17(A) FG:; (A) EXCEPT AS SPECIFIED IN PARAGRAPH (D) OF THIS SECTION, REFRIGERATED, READY-TO-EAT, POTENTIALLY HAZARDOUS FOOD PREPARED AND HELD INA FOOD ESTABLISHMENT FOR MORE THAN 24 HOURS SHALL BE CLEARLY MARKED TO INDICATE THE DATE OR DAY BY WHICH THE FOOD SHALL BE CONSUMED ON THE PREMISES, SOLD, OR DISCARDED, BASED ON THE TEMPERATURE AND TIME COMBINATIONS SPECIFIED BELOW: (1) 41° DEGREES FAHRENHEIT OR LESS FOR.A MAXIMUM OF 7 DAYS; THE DAY OF PREPARATION SHALL BE COUNTED AS DAY 1. ; OBSERVED READY-TO-EAT, POTENTIALLY HAZARDOUS FOOD PREPARED ON SITE AND HELD MORE THAN TWENTY-FOUR (24) HOURS NOT DATE MARKED. * 2,05-08-1 4-302.12 FC: FOOD TEMPERATURE MEASURING DEVICES SHALL BE PROVIDED _ AND READILY ACCESSIBLE FOR USE IN ENSURING ATTAINMENT AND MAINTENANCE OF FOOD TEMPERATURES AS SPECIFIED UNDER CHAPTER 3. (B) A TEMPERATURE MEASURING DEVICE WITH A SUITABLE SMALL-DIAMETER PROBE THAT |S DESIGNED TO MEASURE THE TEMPERATURE OF THIN MASSES SHALL BE PROVIDED AND READILY ACCESSIBLE TO ACCURATELY MEASURE THE TEMPERATURE IN. THIN FOODS SUCH AS MEAT PATTIES AND FISH FILETS, OBSERVED NO THERMOMETER PROVIDED TO MEASURE TEMPERATURE OF FOOD PRODUCT. 3. 14-35-1 4201.11 FC: EQUIPMENT AND UTENSILS SHALL BE DESIGNED AND CONSTRUCTED TO BE DURABLE AND TO RETAIN THEIR CHARACTERISTIC QUALITIES UNDER NORMAL USE CONDITIONS. OBSERVED RIPPED/ WORN TIN FOIL USED AS SHELF COVER....DISH-WASHING AREA. * 4,47-09-1 2-103.41(1) FC: PERSON IN CHARGE. THE PERSON IN CHARGE SHALL ENSURE THAT: (!) EMPLOYEES' ARE PROPERLY SANITIZING CLEANED MULTIUSE EQUIPMENT AND UTENSILS BEFORE THEY ARE REUSED, THROUGH ROUTINE MONITORING OF SOLUTION . TEMPERATURE AND EXPOSURE TIME FOR HOT WATER SANITIZING, AND CHEMICAL CONCENTRATION, PH, TEMPERATURE, AND EXPOSURE TIME FOR CHEMICAL SANITIZING; OBSERVED LACK OF USE OF CHEMICAL TEST KIT WHEN USING CHEMICAL SANITIZER AT THREE~ COMPARTMENT... SINK/ WARE-WASHING MACHINE. * 5, 22-28-1 4-601.11(A) FG:: (A) EQUIPMENT FOOD-CONTACT SURFACES ‘AND UTENSILS SHALL BE CLEANED: (1) EXCEPT AS SPECIFIED IN PARAGRAPH (8) OF THIS SECTION, BEFORE EACH USE WITH A DIFFERENT TYPE OF RAW ANIMAL FOOD SUCH AS BEEF, FISH, LAMB, PORK, OR POULTRY; (2) EACH TIME THERE 1S A CHANGE FROM WORKING WITH RAW FOODS TO WORKING WITH READY- TO-EAT FOODS; (3) BETWEEN USES WITH RAW FRUITS AND VEGETABLES AND WITH POTENTIALLY HAZARDOUS FOOD; (4) BEFORE USING OR STORING A FOOD TEMPERATURE MEASURING DEVICE; AND (5) AT ANY TIME DURING THE OPERATION WHEN CONTAMINATION MAY HAVE OCCURRED. Case Number: 2008062341 District Number; 02 License Number: 1617088 2010 Form revised 10.10.06 MICHELLE'S CAFE feasiarpiainicihaghenend DEPARTMEN. = SUSINESS AND PROFESSIONAL REGULATION . Otviston of Hotets and Restaurants DBPR,, EXHIBITB “ican vores £2010 Permanent Food Service ae, Food Service Inspection Report (2012 Theme Park Food Cart Seleras ‘Qwner Name: (7 2013 Catering ( Unscheduled (ROUT) Ld (0 2014 Mobile Food Dispansing Vehicle [5 Ucensing (LIC) Titers [DSA)Neme: 21 2046 Vending Machine = GonrpentFul (con [1 2051 Unticeisad Food Complaint Partial (CPAR} . Li DiswsterRespanse (STR) | seen Aldress: en (2 Epktamiotogical (EPI) City, Stale, Zi: 1-108 O Service Request (SERV) REMINDER: Your licanse expires ff 1 Quality Assurance (QA) 1 Training (TRNG) D1 Orginal Visit -f,q'callback ‘The cireled fetters to the leff of each item indicate that Item's status at the time of Inspection Mark "X" In appropriate box for COS and/or R IN ={n compliance OUT =notin complianca_NIO=not observed NIA = not applicable GOS = corrected on-site during Inspaction_R = repeat violation COMPLIANCE STATUS : cos| R | tN { OUT : O1a_| Food obtained from approved source : Approved Source IN | OUT _|.N/O O1b _| Wholesome, sound condition [| iN | ouT | NO | N/A | 02 | Orginal container; property labeled, date marking, shell stock tags, {| IN |-OUT | NIA | 02-11 | Consumer advisory on raw/undercooked oysters ‘| ‘ Consumer Advisory IN N/A | 02-13 | Consumer advisory on raw/undercooked animal products : : Cold food at proper tamperatures during storage, display, service, transport, } Potentially N | OUT | NA | 038 | and cold holding” Hazardous Food IN | OUT | N/O_| NA 03b__{ Hot food at proper temperature Time/Temperature IN | OUT | N/O | NIA 03c__| Foods properly cooked/reheated IN {| OUT | N/O | N/A | 03d | Foods properly cooled IN_ {OUT Q7 _| Unwrapped or potentially hazardous food nat re-served Protection from IN| OUT O08a_| Food protection during storage, preparation, display, service, transportation Contamination IN_|_OUT 0Bb__{ Cross-contamination, equipment, personnel, storage IN_ |_OUT 22 _| Food contact surfaces clean and sanitized IN| OUT |_N/O 09 | Foods handled with minimum contact IN| OUT 11__| Personnel with infections restricted in | out | wo 42a Hands washed and clean, good hygienic practices (observed), allemative ; Personnel iN ouT [No 7b _| Proper hygienic practices, eatingldrinking/smoking (avidencel Restrooms with self-closing doors, fixtures operate properly, facility clean, IN | QUT | ° 32 | supplled with hand soap, disposable towels or hand drying devices, tissue, covered waste receptacles . Chemical A Ot | 44a _| Toxic substances properly stored : 41b__| Toxic substances properly labeled, used ' Demonstration of Food management cartification valid : Knowledge Complaint Re [C1 Inspection Completed —No Further Acton (ISAT) | [] Callback — Complied (CBCM) nw Pa fe Complaint Recommend Oy Emergency Onder Recommended 0CL) faint = > 1 Waming Given (WARN) Cl Catack — Extension Given (CBEX} O tac ry Emermensy Order Callback Callback - Admin. Complaint Recommended Administrative Complaint Callback —Tima r-) Emergency Order Callback ~ Tine [11 Seasonal (SEAS) Oceano} Extension (ACE o Administrative Determination Recommended SOC Lasse Tie Tnapectors Nar (Peasy Prin) BSH -~4o2 2201 Sige Ze C858) 47 +139S "Talaphona [ 5 nipectors Telephone wyew, MyFloric pr , . 2008 May 2 1 Closed ~ Outof Business (COFB) oO Administrative Complaint Callback — Not oO Energency ra ‘Calfoack ~ Not pr rene repens necro Pag 20 DBPR,, " EXHIBIT B LEGAL NOTICE ont ate Food Service Inspection Report COMPLIANCE STATUS (7°04 Facilities to maintain product temperature 05 Thermomelers provided end conspicuously placed E108 Potentially hazardous foods properly thawed [2] *08c Potenttal for cross-contamination, storage practices; damaged food segregated 10 In use food dispensing utensils properly stored [1.13 Clean clothes, halr restraints 44 Food conlact surfaces designed, constructed, maintained, “35a Prasence on Insects/rodents, Animals prohibited *35b Outer openings protected from Insects, rodent proof 0 36 Physical facilitles-floors properly constructed, clean, drained, 137 Paeal aamles-wall, ceilings and attached equipment, constructed, clean ('7'38 Lighting provided as required. Fixtures shielded Installed, located: 39_Rooms and equipment - vented as required (2 15 Non-food contact surfaces designed, constructed, maintained, [] 40 Employes lockers provided and used, clean Installed, located £1 42 Premises maintained, no unnecessary arlicles, Cleaning & maintenance equipment properly stored, Kitchen restricted, ) 43 Complete separation from living/sleeping area, laund 44 Clean and soled lInen segregated and properly stored °45_ Fire extinguishers — proper and sufficient : __FIRE EXTINGUISHERS: Data(s) SUPPRESSION SYSTEMS: Datals) LJ 48 Dishwashing facies designed, contracted, operated 1, Wash 2, Rinse 3, Sanllize (117 Thermometers, qaugas, test kits provided L118 Pre-iushed, scraped, soaked [1.19 Wash, rinse water clean temperature “20a Sanitizing concentration m 1"20b Sanitizing temperature *Fahrenhet, | | | ] 21 Wiping cloths clean, used properly, stored . 23 Non-food contact surfaces clean “48 Exiting system — adequate, good repair _ cm 24 Storage/handling of clean equipment, utensils {_] "47 Electrical wiring - adequate, good repalr 25 Service items properly storad, handled, dispensed | [1 *48 Gas appliances — properly installed, maintained (C1 26 Single service arliclas not re-used [| (149 Flammable/combustibte materials — proparly stored [) 27 Water sowce sale, holandcold under pressure ||| J *60. Current Iicense, properly displayed | 28 Sewage and waste water disposed proper [ [Et 5t_Other conditions sanitary and safe operation 29 Plumbing Installed and maintained [ ft | Oe Falseimteadng stalements published or advertised relating : ("7 30 _Cross-connection, back siphonage, backflow [| to food/be (_}*31 Tollet and hand washing facilllies, number, convenient, designed, __installed Notice [CT 33 Garbage containers covered, adequate number, Insect and rodent ts [J 86 Copy of Chapter 509, Florida Statutes available proof, emplied at proper intervals, clean {J 57 Hospitality Education Program Information pravided Violations cl Cerny Tek Ge Sinden * SaB. Item No. [J Additional Comments on Attached Sheot Person in Charge (Signature) Inspector (Signature) : DBPR Form HR 8022-015 Date 1/3./ol, www. MyFlorida.com/dbpr 2006 May 2 Page 1 EXHIBIT B. STATE OF FLORIDA PARTMENT OF BUSINESS AND PROFESSIONAL REGULATION DIVISION OF HOTELS AND RESTAURANTS www. myflorida,comdbpr CALLBACK INSPECTION REPORT LEGAL NOTICE Fallure to comply with this Notics may Iniiate an administrative complaint thal may reault In suspension or revocation of your license and fines, Q9/1B/06 01:05 PM. Callback Inspection Date and Time MICHELLE'S CAFE INC Inspection Reason Warnin 1617089 SEAT. License Number Time Extended 954.462.2301 Owner Name . + Area Code/Telephone Number MICHELLE'S CAFE Business Nama Inspection Result 28 10/31/2006 08:00 AM Number of Units Requested Callback Date/Time 299 E BROWARD BLVD Address / Clty / State / Zip / etc. Comments » Inital Waming Date FORT LAUDERDALE, 33301 = ‘ha following item(s) have been racommended for Administrative Complaint: ation; 29-05-1 . No mop/servica sink Installed/avaltable al astablishment, Fhiraletion mest bs corrected ay OY Oer— Notation: 22-28-41 A 4 lbserved intertor of reach-In freezer solled with accumutation of food residue, lolation: 22-24-1 BA bserved bulldup of silme on sods dispensing nozzles. 9/18/06 Data Signature of Recipient Recipient: Jessica sanchez Title pic Phone: 954 462 2301 DBPR Farm HR 5022-005 Inspector Signature For further Infarmation please contact: LARRY TORRES 5080 coconut creek parway suite A margate, fl «33063 . . 850 487 1395 Page 2 STATE OF FLORIDA License Number DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION SEAT 1617089 DIVISION OF HOTELS AND RESTAURANTS Business Name EXH | B IT B wew.myfiorida,com/dbpr MICHELLE'S CAFE inspection Date CALLBACK INSPECTION REPORT: LEGAL NOTICE 09/18/06 01:06 PM Fallura to comply with this Notice may Initlate an administrative complaint that may result in suspension or revocation of your license and fines, latation; 17-09-1 ack of use of chemical test kt when using chemical sanitizer al three-compartment sinkwarewashing machine, nobewatebie-— iolation: 14351 bserved HppedAvom tin foll used as shai cover dishwashing ares » jotatlon; 05-08-4 jo Ihermometer provided to measure temperature of food product, Miolation: 02-22-1 jeady-to-aat, potentially hazardous food prapared on site and hald more than 24 hours wih ot properly date markedy a following item(s) have heen recommendad for Time Extension; flotation: S3B-08-1 he proof of required employee training provided, All public [ood service establishments must provide the division with proof of employee training upon request, Including, byt at limited Lo, at the time of any division inspection of the establishment, This violation must be corrected by + 10/21/06, he following item(s) are In compliance: jolation: 838-011 , priager lacking proof of Food Manager Certification, This violation must be corrected by ; 10/31/06. tation; 42-03-1 Wat mop no! hing to dry. folation: 41A-09-1 : re toxic Item storad In food preparation Brea.glua stick lotation: 40-04-1 Dbserved personal care Kem stored with single service lems, straws lolatlon: 35A-03-1 bserved dead roaches on premises, dead by dishwashing orea Nation: 32-15-1 DBPR Fonn HR 5022-005 ‘ Page 3 STATE OF FLORIDA License Number DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ; SEAT 1617089 EXH | B IT B DIVISION OF HOTELS AND RESTAURANTS Business Name . worw.myflorida.com/dbpr MICHELLE'S CARE Inspection Date CALLBACK INSPECTION REPORT ; LEGAL NOTICE 09/18/06 01:06 PM Fallura to comply with this Notica may Initiate an administrative complalnt that may result in suspension or revocation of your license and fines, jo handwashing sign provided at a handsink used by food employees.front counter area tolation: 31-12-14 served hendwash sink used far purposes othar than handwashing.hose Inside ft iotation; 31-09-1 landwash sink nat accessible for employes use at all times,obstructed by hose lolation: 22-28-1 bserved Interlor of reach-n cooler solled with sccumulation of food residue. jolation: 10-07-1 , bserved in-use ulensil stored in standing water lass than 135 dagreas Fahranhelt, iotation: O8A-28-1 oserved raw animal food stored over ready-lo-eat food, beef over ham al freezer, egns over bagels at true refrigerator lation: DBA-16-1 ‘ bserved food stored tn a prohibltad area, mashed potatogs storad In olginal open motal container DBPR Farm HR 5022-005 EXH IBIT Berartment oF BUS ATE OF FLORIDA reset SINESS AND PROFESSIONAL REGULATION DIVISION OF HOTELS AND RESTAURANTS wew.myfiorida.com/dbpr FOOD SERVICE INSPECTION REPORT LEGAL NOTICE Failure to comply with this Notics may Initiate an admintstrative complaint that may result In suspension or revocation of your license and fines, 07/31/06 01:58 PM Routine 1617089 . SEAT - (nspection Date and Time Inspection Reason License Number MICHELLE'S CAFE INC WARNING: . Owner Nama Violations in the operation of your establish 954,482,230 MICHELLE'S CAFE : g ate Area Code/Telephone Number Business Nama Inspactlon Resul 28 08/31/2006 08:00 AM . O1-DEC-06 Number of Units . Callback Date/Time Ltcanse Expiration 299 E BROWARD BLVD : FORT LAUDERDALE, 33301 Address / City /State/Zip/ete, © ltem 03; Food Temperatures tem 53a; Cert, Food Managers Item 20; Warewashing Sanitization | ftam 45: Fire Extinguishers and Fire o Bel, roach in conler, 41 Dagruas F, Sanitizer Type: Not Sat Up found at |A Class ABC ype Firs Extinguisher, found inst Eogs, reach In cooler, 41 Dagtdas F, 5 kitchen has a Gerilfication datd of 3/06 Poultry, reach In cooler, 41 Oagraos F, . concentration of 0 PPM. : Seatoad, ranch In cooler, 41 Degas: F. Bauces/pravy, ranch in cooler, 135 Degrans F, Aiody ta uo+PHF, cook linn, 155 Dograns F, NOTE: Items marked above with an astatisk (*) Indicate a violation Inspector's Comments mplaint 2006-041091, bserved no handwash sink avallabie in dishwashing area. any future handwashing violations inthis area will result in a request for a new handwash Ink to ba Installed in the dishwashing area, noone currently washing dishes at this time. roof of certified food manager and employee training can ba faxad to 954 956 5699. atin. larry torres Provided Web Site: www.myflorida.com/dbpr backnowledga receipt of this inspection form and comments. 07-31-06 5 Date Signature of Reclplont For tart Ingpactor Signature ‘ Rociplent Jessica nchez : ‘or further information please contact: Title pic LARRY TORRES . INSPECTOR Plione: 954 462 2901 ‘ STATUS SOURCE PHF TEMPERATURE CONTROL In “01a Approved source lin *O1b Wholesome, sound condition | *02 Original container; property labeled, date marking [mn *03a Cold food at proper temperatures during storage, display, service, 02-11 Consumer advisory on raw/undercooked oysters *02-13 Consumer advisory on raw/undercooked animal S03c Foods properly cooksd/reheated *03d Foods properly cooled . *04 Facilities to maintain product temperature *05 Thermometers provided and conspicuously placed Out Violations marked with an asterisk ara critical violatlons. llams marked IN are in compliance. Items Marked OUT are violations. Specific detalls of violation are listed on DBPR Form HR 5022-015 EXHIBIT B STATE OF FLORIDA wew.myfiorda.com/dbpr DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION DIVISION OF HOTELS AND RESTAURANTS FOOD SERVICE INSPECTION REPORT Page 2 License Number SEAT 1617088 Business Name MICHELLE'S CAFE Inspection Date 07/31/06 01:58 PM LEGAL NOTICE Fallure to comply with this Notice may Initiate an administrative complalnt that may resutt In suspansian or revocation of your licanse and fines, STATUS PHF TEMPERATURE CONTROL STATUS lin fear Unwrapped or potentially hazardous food not re-served Out "08a Food protection during storage, preparation, display, GARBAGE AND REFUSE DISPOSAL 33 Containers covered, adaquale number, Inséct and rodent} proof, emptied al proper Intervals, clean service, transportation 34 Outside storage area clean, enclosure proparly constructed ___INSECT AND RODENT CONTROL "33a Presence of insects/rodents. Animats prohibited "35b Outer openings protected from Insects, rodent proof FLOORS, WALLS, CEILINGS in *08b Cross-contamination, equipment, personnel, storaga "08 Potential for cross-contamination; storage practicas; damaged food sagragatad., + fOut In "09 Foods handled with minimum contact Out 10 In usa foad dispensing utensils properly stored STATUS STATUS PERSONNEL In "11 Personnel with infections restricted In "42a Hands washed and clean, good hygtentic practices (observed), alternative operating plan "1 2b Proper hygienic practices, ealing/drinking/smaking (evidence) 36 Floors properly constructed, clean, drained, coved 37 Walls, ceilings, and attached equipment, constructed, 138 Lighting provided as required. Fixtures shielded 38 Rooms and equipment - vanted as required OTHER AREAS | sd 13 Clean clothas, halr restraints 40 Employes lockers provided and used, clean FOOD EQUIPMENT AND UTENSILS. 14 Food contact surfaces designed, constructed, maintalned, Installed, located 15 Non-food contact surfaces designed, constricted, maintained, Installed, located . "16 Dishwashing facilities designed, canstructed, operated Out Out | 1. Wash 2. Rinse 3. Sanitize (sd "17 Thermometers, gauges, test kits provided : STATUS 18 Pre-flushed, scraped, soaked | 19 Wash, rinse water claan, proper temperature "41a Toxic items properly stored. "41b Toxic Items labeled and used proper '2 Premises maintained, free of litter, unnecessary ariicies, Cleaning and maintenance equipment properly stored, Kitchen restricted to authorized personnel 43 Complete separation from Iiving/steeping area, faund 44 Clean and solled fInen segregated and proparly storad SAFETY “45 Fira extinguishers - proper and sufficient "46 Exiting system - adequate, good repair *20a Sanitizing concentration STATUS @ : BS "47 Electrical wiring - adequate, good repair "48 Ges appliances - properly Installed, maintained 49 Flammable/combustibie materials - properly stored GENERAL "50 Current ticense properly displayed 54 Other conditions sanitary and sala operation "52 False/misleading statements published or advertised - relating to food/baveraga STATUS SINGLE SERVICE ARTICLES 25 Service items properly stored, handled, dispansed 26 Single service anticlas not re-used Out STATUS: WATER AND SEWAGE/PLUMBING Out "27 Water source safe, hot and cold under pragsure "26 Sewage and waste water disposed proper! "63a Food management certification valld "3b Employee training validation 54 Florida Clean indoor Alr Act 55 Automatic Gratuity Notice 29 Plumbing installed and maintained "30 Cross-connection, back siphonage, backflow STATUS STATUS TOILET AND HANDWASHING FACILITIES : Out *31 Tollat and handwashing facilities, number, convenient, designed, installed Out *32 Restrooms with self-closing doors, fixtures opsrate properly, facility clean, suppiled with handsoap, disposable towels or hand drying devices, tissue, covared waste 56 Copy of Chapter 509, Florida Statules, avallable GENERAL 57 Hospitality Education Program Information provided Total Number of COS Violations: Total Number of Repeat Violations; Violalions marked wilh an asterisk aro critical violations. lems marked IN ara In compliance. Items Marked OUT are violalions. Specific delails of violation are listed on subsequent pages, llams marked N/A ara Not Applicable, tems Marked as N/O are Nol Observed, and wt OBPR Form HA 5022-015 ere not being conducted at the lime of inspection. Page 3 License Number STATE OF FLORIDA SEAT 1617089 EXHIB TMENT OF BUSINESS AND PROFESSIONAL REGULATION — gusinoss Name DIVISION OF HOTELS AND RESTAURANTS MICHELLE'S CAFE wow.myflorida,com/dbpr Inspection Date FOOD SERVICE INSPECTION REPORT 07/31/06 01:58 PM . LEGAL NOTICE Fallure to comply with this Notice may Inillate an administrative complaint that may result In suspension or ravocation of your license and fines. Waming(s): 29-05-1:No mop/service sink inslalled/avaitable at establishment, This violation must be correctad by : 9/1/06, 53A-01-1:Manager lacking proof of Food Manager Certification. This victation must ba corrected by : 10/31/06. REFERENCE TEXT: 809,038 FS and 610-4.023(1) FAC: All managers employed by a food service establishment must have passed [the food service manager] test end recelved a certificate attesting Iheroto, Managers have a period of 20 days after employment to pass the required test. All managers who are responsible for the storaga, preparation, display, and serving of foods to the publle shall have passed a certification test approved by the division demonstrating a basic knowledge of food protection practicas as adopted in thts chapter, Those managers who successtully pass an approved cerilficallon examinauon shall be Issued 6 ceriificate by the cenifying organization, which Is valld for a period of five years from the date of Issuance, 538-08-1;No proof of required employee training provided, All public food sarvice establishments must provide the division with proot of employee tralning upon request, Including, but no! iImited to, at the time of any division inspection of the establishment. This violatlon must be corrected by ; 10/31/06, REFERENCE TEXT: 509.048 FS: Food service employee training, The division shell adopt, by rule, minimum food safety protection standards for the training of all food service employees who are responsible for the slorage, preparation, display, or serving of foods to the public In establishments ragulated under this chapter, These Standards shall nol include an examination, but shall provide for a food safety traning certificate program for food service employees lo be administered by a private nonprofit provider chosen by the division, Any food safety training pragram established and administered to food handlar 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 Hcensee of the public food service establishment to pravide tralning in accordance with the described rule to all employees under the llcensee’s supervision or coniro!, The licansee may designale a cartified food service manager io perform this function 88 an agent of the licensee, Food service amploysas must recalva certification pursuant to this sactlon by danuary 1, 2001, Food service employees hired afer November 1, 2000, must recalve cartificatlon within 60 days after employment, Certification purausnt to this section shall remain valid for 3 years, Violatlon(s): 14-35-1:Observed rlpped/worn tin fall used as shell coverdishwashing erea 42-03-1:Wat mop not hung to dry. 35A-03-1:Observed dead roaches on premises. 1 dead by dishwashing area 08A-26-1:Observed raw animal food stored aver ready-to-eal food, beef over ham al freezer, eggs aver bagels at true reftigarator 22-28-1:Observed interior of reach-In cooler solfed with accumulation of food residue. 22-28-1:Observed Intertar of reachsin freezer solled with accumulation of food residue. O8A-16-1:;Observed fond stored Ins prohibiied area, mashed potatoes stored In original open metal container 31-12-1;Observad handwash sink used for purposes other than handwashing.hose Inside tt - 31-09-1:Handwash sink not accessible for employee use at al! imes.obstructed by hose 32-18-1;No handwashing sign provided ta handsink used by fond employess,front counter area. 414-09-1:0bserved toxic iiem stored In food preparation orea.giue stick 10-07-1;Obgerved In-tuise utensil stored In standing water less than 135 degrees Fahrenheit. 22-24.4:Observed buildup of slime on soda dispensing hozzieg, 02-22-1:Ready-to-val, potentially hazardous food preparad on site and held more than 24 hours with nol property date marked. 05-08-1:No thermometer provided lo measure temperature of food product, DBPR Form HR 5022-016 EXHIBIT B Page 4 License Number , STATE OF FLORIDA SEAT 1617089 « . DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION Business Name DIVISION OF HOTELS AND RESTAURANTS www. mnyliorida.comvdbpr MICHELLE'S CAFE FOOD SERVICE INSPECTION REPORT Inspection Data LEGALNOTICE 07/31/08 01:58 PM Failure to comply with this Notice may Initlate sn administrative complaint that may result In suspension or ravocation of your licanse and fines, 17-09-1:Lack of use of chemical test kit when using chamical sanilizer at threa-compariment sink‘warewashing machina.not available: 40-04-1:Obsarved personal care Item siored with single service Items, straws OBPR Form HR 5022-015

Docket for Case No: 07-000181