O7-063¢ , STATE OF FLORIDA ; DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION:2, DIVISION OF HOTELS AND RESTAURANTS ae DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION Petitioner, vs. MELONIE'S RESTAURANT License Tyee 2010 Respondent. Case No, 2006046682 / ADMINISTRATIVE COMPLAINT The DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION, DIVISION OF HOTELS AND RESTAURANTS, (‘Petitioner’), files this Administrative Complaint against MELONIE'S RESTAURANT, - (‘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 20.168 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 209 E MAIN ST, DUNDEE, FLORIDA 338384218.The mailing address of record is MELONIE'S RESTAURANT, at PO BOX 1431, DUNDEE, FLORIDA 338381431. : 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 ated thereto Signed August 28, 2006 erez, District Manager By delegation of the Director, or desi 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 1940 North Monroe Street ~ Certified Article Number Tallahassee, Florida 32399-1007 es . 7160 3801 9849 3032 £373 CERTIFICATE OF SERVICE BY CERTIFIED U.S. MAIL, ARTICLE NUMBER: SENDERS RECORD | HEREBY CERTIFY that a true and correct copy of the foregoing ADMINISTRATIVE AINT has been hand served by me on this. day of 2006, Received by: Inspector’s Signature Operator's Signature Title Title Case Number: 2006046682 District Number: 03 License Number; 6302026 2010 , ___ Form revised 07.17.06 MELONIE’S RESTAURANT Exhibit A License Number: 6302026 : License Type: 2010 PERMANENT FOOD SERVICE Case Number: 2006046682 “FC" as cited 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 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. “*" denotes a critical violation. It is alleged that on June 8, 2006, July 18, 2006 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. 08A-28-1 3-305.11 FC:: FOOD STORAGE. (A) EXCEPT AS SPECIFIED IN PARAGRAPHS (B) AND (C) OF THIS SECTION, FOOD SHALL BE PROTECTED FROM CONTAMINATION BY STORING THE FOOD: (1) INA CLEAN, DRY LOCATION; (2) WHERE IT |S NOT EXPOSED TO SPLASH, DUST, OR OTHER CONTAMINATION; AND (3) AT LEAST 6 INCHES ABOVE THE FLOOR. (B) FOOD IN PACKAGES AND WORKING CONTAINERS MAY BE STORED LESS THAN 6 INCHES ABOVE THE FLOOR ON CASE LOT HANDLING EQUIPMENT AS SPECIFIED UNDER SECTION 4-204.122. (C) PRESSURIZED BEVERAGE CONTAINERS, CASED FOOD IN WATERPROOF CONTAINERS SUCH AS BOTTLES OR CANS, AND MILK CONTAINERS IN PLASTIC CRATES MAY BE STORED ON A FLOOR THAT IS CLEAN AND NOT EXPOSED TO FLOOR MOISTURE. OBSERVED FOOD STORED ON FLOOR, BOX OF FRENCH FRIES ON FLOOR IN WALKIN FREEZER, * 2.32-04-1 6-202.14 FC, 61C-1.004(2)(B) FAC:: PUBLIC BATHROOMS SHALL BE COMPLETELY ENCLOSED AND SHALL HAVE TIGHT- FITTING, SELF CLOSING DOORS OR, IN BATHROOMS LOCATED OUTSIDE A PUBLIC FOOD SERVICE ESTABLISHMENT, HAVE ENTRANCES AND EXITS CONSTRUCTED IN SUCH A MANNER AS TO ENSURE PRIVACY OF OCCUPANTS. SUCH DOORS SHALL NOT BE LEFT OPEN EXCEPT DURING CLEANING OR MAINTENANCE EXCEPT THAT THIS [ENCLOSURE] REQUIREMENT DOES NOT APPLY TO A TOILET ROOM THAT IS LOCATED OUTSIDE A FOOD ESTABLISHMENT AND DOES NOT OPEN DIRECTLY INTO THE FOOD ESTABLISHMENT SUCH AS A TOILET ROOM THAT IS PROVIDED BY THE MANAGEMENT OF A SHOPPING MALL. BATHROOM DOORS ARE NOT SELF CLOSING, 3. 37-01-1 61C-1.004(6) FAC:; (6) ALL BUILDING STRUCTURAL COMPONENTS, ATTACHMENTS AND FIXTURES SHALL BE KEPT IN GOOD REPAIR; CLEAN AND FREE OF OBSTRUCTIONS. OBSERVED CEILING TILE IN DISREPAIR IN THE KITCHEN. 4. 38-07-1 6-202.11 FC:: LIGHT BULBS, PROTECTIVE SHIELDING. (A) EXCEPT AS SPECIFIED IN PARAGRAPH (B) OF THIS SECTION, LIGHT BULBS SHALL BE SHIELDED, COATED, OR OTHERWISE SHATTER-RESISTANT IN AREAS WHERE THERE IS EXPOSED FOOD; CLEAN EQUIPMENT, UTENSILS, AND LINENS; OR UNWRAPPED SINGLE-SERVICE AND SINGLE-USE ARTICLES. (B) SHIELDED, COATED, OR OTHERWISE SHATTER-RESISTANT BULBS NEED NOT BE USED IN AREAS USED ONLY FOR STORING FOOD IN UNOPENED PACKAGES, IF: (1) THE INTEGRITY OF THE PACKAGES CAN NOT BE AFFECTED BY BROKEN GLASS FALLING ONTO THEM; AND (2) THE PACKAGES ARE CAPABLE OF BEING CLEANED OF DEBRIS FROM BROKEN BULBS BEFORE THE PACKAGES ARE OPENED. (C) AN INFRARED OR OTHER HEAT LAMP SHALL BE PROTECTED AGAINST BREAKAGE BY A SHIELD SURROUNDING AND EXTENDING BEYOND THE BULB SO THAT ONLY THE FACE OF THE BULB IS EXPOSED. KITCHEN LIGHT MISSING THE PROPER SHIELD, SLEEVE COATINGS OR COVERS. Case Number: 2006046682 District Number: 03 License Number: 6302026 2010 Form revised 07.17.06 MELONIE'S RESTAURANT . * 5. 45-36-1 NPFA 96, 11.2.4: AN INSPECTION AND SERVICING OF THE FIRE-EXTINGUISHING SYSTEM AND LISTED EXHAUST HOODS CONTAINING A CONSTANT OR FIRE-ACTUATED WATER pensews tt BE MADE AT LEAST EVERY 6 MONTHS BY PROPERLY TRAINED AND QUALIFIED HOOD SUPPRESSION SYSTEM TAG OUT-OF-DATE. TAGGED 7/05. Case Number: 2006046682 . District Number: 03 License Number: 6302025 2010 Form revised 07.17.06 MELONIE'S RESTAURANT ) ne ' _ DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION LEGAL NOTICE Division of Hotels and Restaurants CONTROL NUMBER INSPECTOR FOOD SERVICE INSPECTION REPORT © Catering ICENSI ‘bericr © BODOND p.2 10 a oy BUSINESS NAM PFriGso { «cs fe as Ki eriny ADDRESS — ‘. : oof FO ff] 5 eae cry ZIP (Optional) /},<~ A et vA , 8 : bsp © General ‘J Seating Ye | INSPECTION REASON Failure ta comply with this Notice may initiate an administrative compiaint that may result in suspension or revocation of your license and fines. 1 @. Routine 3 © Complaint 4 © information & © Epidemiological DISPOSITION 6 © Pending oO HACCP INSPECTION INSPECTION RESULTS 1 © ANY VIOLATIONS noted hersin must be corracted by the NEXT ROUTINE INSPECTION, 28868 2 @® WaRrNina: Violations In the operation of your establiahment must be corrected by: pate OL-I9-OG sine FED 3 (3 ADMINISTRATIVE COMPLAINT recommended. 6 EMERGENCY ORDER recommended based upon a severe and Immediate threat to the public. BESGSRS@aaBaB ITEM *03; FOOD TEMPERATURES Circled temperatures are in violation ‘Type of Food Temperature —teye NOTE: ITEMS IN RED AND MARKED WITH AN ASTERISK ARE OF CRITICAL CONCERN ANO MUST BE CORRECTED IMMEDIATELY, See reverse side for explanation of citations. oO 970 wo a Bnd ‘com ‘or “08 6 20 “Os s@ eo 6O sO eae 2» atc 17 wo 35h Ose 0b 9 180 270 320 Osc me 03 £3 1003 19f9 *2009 s7@ 450 56 eS *11C 3200 29 soe 009 5 : *ea( "12a °206C 300) 99 “4709 56 COMMENTS : SHIDO 2 3 OO ww 879 : ADDITIONAL GOMMENTS ON ATTACHED COMMENT SHEET f acknowledge receipt of this Inspection form and comments. REMINDER: Your ticense expires 2 7 1G, iY Recipient's Nome (PLEASE PRU Inspector's Marne x. EASHBPRINT) i? ay ty J pee: = AV} MV) , , A / Office Te Cre mts 7 12a AP wee ar ITEM ‘53a: CERTIFIED FOOD MANAGER Tite Tnspeciar Pe Signy 7. Esiablishment Tetephone Date and Tine OS Wm — te fen EXHIBIT B Alaris ics State of F lorida Control Number DBPR Department of Business and Professional Regulation 02g 2 Pie Division of Hotels and Restaurants 63 -POROQE pl www. hospitalityeducation.org : : : — Page_~ of 2—~ COMMENTS SHEET e002 Addendum to DBPR Forms HR 5022-005, 5022-014, 5022-015, 5022-082, or 022-083. For comments to the Lodging, Food Service, or HACCP Inspection; Call Back/Reinspection Report, or HACCP Plan Verification. Crcens Fy (Oa. Can 1 net secured 4 bserva he of fanch o on £loer ‘w welk,s, Ceeze- or by wate arf aed sie nok vere + O fhe nk veenr _sto-ed iy apres te wert be vii. 2 3 mat b arrecte b O7-BG a2 OBPR Form HR 5022-042 www. MyFlorida.com 2004 December 06 } Division of Hotels and Restaurants Ry Mg LEGAL NOTICE DBPR DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION EH B iT B [212010 Permanent Food Service Food Service Inspe 17) 2012 Theme Park Food Cart J - C1 2013 Catering ul 4 ' Btomt bemaleelemies Kuterert The | piithfotmmennva (2 Complaint Full (COMP) / . [ Complaint Partial (CPAR) AFic 10 Mies Kees van aupemumesas 1 Disaster Response (STR) Ss [1 Epidemiological (EPI) Ci, Stat, Zin: “On Cau anes ceo onunee . prem | TY er] fe Leet | come Home The circled fetters fo | al n Mark *X” in appropriate box for COS andlor R IN = in compiianca_ OUT = notin compliance NO = not observed NIA = not applicable COS = corrected on-site during inspection R= repeat violafon COMPLIANCE STATUS ° [cos | R LIN [ out Ota a Approved Source IN NiO Food obtained from approved source = Wholesome, Sound condition C fi LIN onsumer Advisory Ww . Cold food at proper temperatures during storage, display, service, transport, Potentially and cold holding tazardous Food Hot food at pi temperature _ lime/Temperature Foods properly cookedireheated __ Foods properly cooled Unwrapped or potentially hazardous food not re-served rotection from Food protection during Storage, preparation, display, service, transportation oe a Dontamination Cross-contamination, equipment, personnel, storage Food contact surfaces clean'and sanitized Wo} out | wo 42a Hands washed and clean, good hygienic practices (observed), altemative- ersonnel a ai | operating plan — IN| OUT | NO | “| 42b- "| Proper hygienic practices, eating/drinking/smoking (evidence) Restrooms with self-closing doors, fixtures operate properly, facility clean, supa with hand soa disposable towels or hand drying devices, tissue, [| _4ta | Toxic ee ope Sa aeel = Toxic substances pr p ope labeled, used [ 53a_| : (elena recut ce coe Waming Given (WARN) (1 Calback ~ Extension Given (CBEX) Co imnsvaive complet Cabeck - Contes oc peso al (SEAS) a ae Callvack - Admin, Complaint Recommended oO Sasin ACE) - Time oO Ere Os Sib Tire SEE 2 ees ~\ Charge Name (Please . Tile Inspacto’s Name (Piease Priph aA AJ iD ya tee Huby MWAuk WSO0- Uy7- ft son In Charpa Signature elephone ‘inspector's Slonatura\ 7 Inspectors Telephone SPR Form HR 5022-015 www, MyFlorida.com/dbpr 2006 May 2 Flrvidtt fituse... DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION DBPR Division of Hotels and Restaurants . _ LEGAL NOTICE Food Service Inspection Report TTT BF 38 Lighting provided as required, Fivtures shielded ——|--|—-foj. 39. Rooms and equipment — vented as required 1 T fy 40 Employee lockers provided and used, clean - food segregated oe coved : | 10 _in use food dispensing utensils properly stored = __ j’4) 37 Physical facliities-walls, cellings and attached equipment, an 13. Clean clothes, hair restraints constructed, clean _.. . ed ec (1 42 Premises maintained, no unnecessary articles, Cleaning & [J] 16 Dishwashing facilities designed, consiructed, operated maintenance equipment properly stored. Kitchen restricted. __ 1,Wash 2. Rinse_3, Sanitize . | “ET 43” Complete separation from Iving/sleeping area, laundry [J 17 Thermometers, gauges, test Kits provided | [J 44 Clean and soiled linen segregated and properly stored 18 _Pre-flushed, scraped, soaked .. . | [p01 *45 Fire extinguishers ~ proper and sufficient —|_19 Wash, rinse water clean, proper temperature [| +__ FIRE EXTINGUISHERS: Oate(s) SUPPRESSION SYSTEMS: Date(s) “20a Sanitizing concentrati anitizing coi ion _ ppm _ | O?-oS , ~ ne [__[ [1*46 “Exiting sysiem- adequate, good repalr _J 24” Storage/handiing of clean equipment, ulensils (1°47 Electrical witing — adequate, good repait 25 Service items properly stored, handled, dispensed 8 26 Single service articles not re-used *27 Water source safe, hol and cold under pressure *28_ Sewage and waste water disposed properly 29 Plumbing installed and maintained . _]_30_Cross-connection, back siphonage, backflow = ____tofoodibeverage . _ _] *31 Toilet and hand washing facilities, number, convenient, designed, 54 Florida Clean Indoor Air Act Compliance ne Installed 4 55 Automatic Gratuity Notice [ 4 od Sup 45510 Z of o7-0 Cola t iv dk “ " , if 4 uj ee 37 Light shield eo a : as} bo g Frowe on ¢ loos ( t-4 . td 4 py yy he: ee rs a tl : af aan; Additions! Comments on Atached SI Imes Gn acer Ll” erson in Charge (Signature = \ Date ispector (Signature fart ZAM . _ pale O7-) £- 04 IBPR Form HR 5022-015 : www. MyFlorida.com/dbpr 2006 May 2

Docket for Case No: 07-000638