) 4. ; STATE OF FLORIDA _ 2007 Apa) 5 DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION 113 DIVISION OF HOTELS AND RESTAURANTS Bie I: 4a ant Slsion DEPARTMENT OF BUSINESS AND 7 AU i if di Shah PROFESSIONAL REGULATION - | | HEADS VE Petitioner, 0 / O AR Ines vs, License No. 2650805 HOT DOGGIN rq dent. License Type 2014 spon , . Case No. 2006046417 ADMINISTRATIVE COMPLAINT The DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION, DIVISION OF HOTELS AND RESTAURANTS, ("Patitioner’), files this Administrative Complaint against HOT DOGGIN IT, (‘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 1750 DUVAL ST, JACKSONVILLE, FLORIDA 32202.The mailing address of record Is HOT DOGGIN IT,.at 4560 MISTY DAWN CT S, JACKSONVILLE, FLORIDA 32277. 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 dacuments are attached as Exhibit “B”, Incorporated herein by reference, WHEREFORE, Petitioner respectfully requests entry of an Order imposing ons 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 August 25, 2006 : : Steve Plies 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 1940 North Monroe Street Tallahassee, Florida 32399-1007 CERTIFICATE OF SERVIGE BY CERTIFIED U.S. MAIL, ARTICLE NUMBER: 7160 3901 9849 3577 6555 : {HEREBY CERTIFY that a true and correct copy of the foregoing ADMINISTRATIVE COMPLAINT has been hand served by me on this day of . 2006 ee Received by: Inspector's Signature Operator's Signature Title . Title. Case Number: 2006048417 District Number: 05 License Number: 2660805 2014 . Form revised 07.17.06 HOT DOGGIN IT . Exhibit A License Number: 2650805 License. Type: 2014 MOBILE FOOD DISPENSING VEHICLE . Case Number: 2006046417 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. . [tis alleged that on February 27, 2006 and July 12, 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. * 1.03B-03-1 3-501.16 (A)(1) FC:: (A) EXCEPT DURING PREPARATION, COOKING, OR COOLING, OR'WHEN TIME 1S USED AS THE PUBLIC HEALTH CONTROL AS SPECIFIED UNDER SECTION 3- 501.19, AND EXCEPT AS SPECIFIED IN PARAGRAPH (B) OF THIS SECTION, POTENTIALLY HAZARDOUS FOOD SHALL BE MAINTAINED: (1) AT 135 DEGREES FAHRENHEIT OR ABOVE, EXCEPT THAT ROASTS COOKED TO A TEMPERATURE AND FOR A TIME SPEGIFIED IN PARAGRAPH 3- 401.11(B) OR REHEATED AS SPECIFIED IN PARAGRAPH 3-403.11(E) MAY BE HELD AT A TEMPERATURE OF 130 DEGREES FAHRENHEIT OR ABOVE;. . , ’ . OBSERVED POTENTIALLY HAZARDOUS FOOD NOT HELD AT 135°F OR ABOVE - HOT DOGS AT 88F IN HOT HOLDING UNIT, * 2,12A-17-1 2-301.12 FC:: CLEANING PROCEDURE. (A) EXCEPT AS SPECIFIED IN PARAGRAPH (B) OF THIS SECTION, FOOD EMPLOYEES’ SHALL GLEAN THEIR HANDS AND EXPOSED PORTIONS OF THEIR ARMS (OR SURROGATE PROSTHETIC DEVICES FOR HANDS OR ARMS) FOR AT LEAST 20 SECONDS, USING A CLEANING COMPOUND IN A LAVATORY THAT.IS EQUIPPED AS SPECIFIED UNDER SECTION 5-202.12; (B) FOOD EMPLOYEES’ SHALL USE THE FOLLOWING CLEANING PROCEDURE: (1) VIGOROUS FRICTION ON THE SURFACES OF THE LATHERED FINGERS, FINGER TIPS, AREAS BETWEEN THE FINGERS, HANDS AND ARMS (OR BY VIGOROUSLY RUBBING THE SURROGATE PROSTHETIC DEVICES FOR HANDS OR ARMS) FOR AT LEAST 10 TO 15 SECONDS, FOLLOWED BY; (2) THOROUGH RINSING UNDER CLEAN, RUNNING WARM WATER; AND (3) IMMEDIATELY FOLLOW THE CLEANING PROCEDURE WITH THOROUGH DRYING OF CLEANED HANDS AND ARMS (OR SURROGATE PROSTHETIC DEVICES) USING A METHOD AS SPECIFIED _ UNDER SECTION 6-301,12, (C) FOOD EMPLOYEES’ SHALL PAY PARTICULAR ATTENTION TO THE AREAS UNDERNEATH THE FINGERNAILS DURING THE CLEANING PROCEDURE. (D) (F APPROVED AND CAPABLE OF REMOVING THE TYPES OF SOILS ENCOUNTERED IN THE FOOD OPERATIONS INVOLVED, AN AUTOMATIC HANDWASHING FACILITY MAY BE USED BY FOOD EMPLOYEES TO CLEAN THEIR HANDS. . . OBSERVED EMPLOYEE IMPROPERLY WASHING HANDS - USING A JUG OF WATER FOR HANDWASHING, : * 3,27-04-1 5-103,12 FG:: PRESSURE. WATER UNDER PRESSURE SHALL BE PROVIDED TO ALL FIXTURES, EQUIPMENT, AND NONFOOD EQUIPMENT THAT ARE REQUIRED TO USE WATER EXCEPT THAT WATER SUPPLIED AS SPECIFIED UNDER PARAGRAPHS 5-1 04.12(A) AND (B) TO A TEMPORARY FOOD ESTABLISHMENT OR IN RESPONSE TO A TEMPORARY INTERRUPTION OF A WATER SUPPLY NEED NOT BE UNDER PRESSURE. OBSERVED COLD WATER NOT PROVIDED/SHUT OFF AT EMPLOYEE HANDWASH SINK. * denotes critical violation , : Case Number: 2006046417 District: 05 License Number: 2650805 License Type: 2014 HOT DOGGIN IT Exhibit A *. 27-16-1 5-202.12(A) AND (B) FC:: HANDWASHING FACILITY, INSTALLATION. (A) A HANDWASHING LAVATORY SHALL BE EQUIPPED TO PROVIDE WATER AT A TEMPERATURE OF AT LEAST 100 DEGREES FAHRENHEIT THROUGH A MIXING VALVE OR COMBINATION FAUCET. (B)A STEAM MIXING VALVE MAY NOT BE USED AT A HANDWASHING LAVATORY. OBSERVED HOT WATER NOT PROVIDED/SHUT OFF AT EMPLOYEE HANDWASH SINK. * denotes critical viclation Case Number: 2006046417 : District: 05 Licanse Number: 2650805 : Jt License Type: 2014 HOT DOGGIN IT D ags R te } Division of Hotels and Restaurante ; j Dull LEGAL NOTICE Food Service Inspection Re (1 2010 Permanent Food Servica (21 2012 Theme Park Food Cart 11 2013 Catering : Epa Mobile Food Dispensing Vehicle 20 (7 Licensing (LIC) 15 Vending Machine (1 Complaint Ful (COMP) (1) 2054 Unlosnsed Food i Complaint Partial (CPAR) - . (1 Disaster Response (DSTR) — . 12 Epideiciogicl EPI) 26 Sofas CJ Sarvice Request (SERV) REMINDER: Your Boonse mies Gj 7 ) O77 CJ Quality Assurance (QA) : C1) Trainiig (TRNG) ‘Tha circled Jetters fn the ieftof each item Indicate that ttam's status at the time of Inspection ; Mark °X" in appropriate box for COS andor IN = In complianoa_QUT = not compliance _N/O = ‘not obsarved N/A =not apnilcable : COS = corrected on-alte during Inspaction R= repeat violation . COMPLIANCE STATUS 2 ; [cos] R lap OUT [|__| [tita | Food obtained trom approved source Approved Soures = [IN [€QUTA No [| bth [ Wholesome, sound condition : ee ee Ps, ; eo NO a Original contalner; properfy labeled, deta marking, shall stock tags, : ‘OUT | CREA [02-17 | Conaumer advisory on rew/undercookad ovsters Consumer Adviony TiN-LOUT || CWB_1_ 09-13" Consumer aisony on tawiuiderosoked ot be aredadi wv | Gud] | wa | Cold food at proper tamperaturas during storage, display, service, transport, Potentially : s AV HazardousFood § = |_ IN [(OUT>| NiO] NIA | 03b | Hot food at proper temperatura -_ ne, Time/Temperature LN | OUT Ime NA 5 : : yo *|" NiA_| “RST OUT 07. | Unwrapped or potentially hazardous food not re-served Protection from IND] OUT 08a__| Food protaction during storage, preparation, dleplay, sendce, trenapartalfo Contamination IN| OUT [|_| 08b _{ Gross-contamination, equipment, perso nel, storage : choy our 22 __| Food contact surfaces clean and sanitized 2 | Lan Jour | Personal with infections restricted Ci Coup ‘Personnel VN | a KE) —_ y with self-cloaing do " supplied with hand soap, dlaposable towels or hand drying devicas, Ussua, 2 covered waste receptacias . Chemical [fae [our [7 iy sored | ouT [| 41b Toxic substances property labeled, used : Demonstration of © IND] OUT [ [| 63a Food management certiication valld ; ° CT Kenn oT | ||| Eo Tg etn LterVLOcatON ppt Mitel eitieem |” temmocaton Temp | Nae Dt ha fai ee ce BH Blon oe0 oa owes (ao ~ Admin, laratve in = Order Calbback ~ Ti GS 0 ge ee ots Is - de ~ Not Caw onsonne ra agg ERIE | aa OTS Osteen PT Berrich — Sstm ama Pr) 7 Pri: ; hoes) PF7-3 PRIA po PIVHL DS BIL — ba Teophona: tnepecte’e Signature , Inspectors Teleghona DBPR Form HR 5022-015 wow. MyFlorida.com/dbpr 2006 May 2 . ) Diviston of Hotels and Restaurants - ~ DBP R., LEGAL NOTICE ala Food Service Inspection Repo COMPLIANCE STATUS eo ——_ 34 _Outekte storage area clean; enolosuna proper a [J 05 Thermometers provided and conepicuously placed |) *36a Presence on Insacts/odents, Animals prohibited Pd [_} 06 Potentially hazardous foads properly thawed | LJ *35b Outer openings protected from Ingects, rodent proc [ | siti a tc segragal () 10 Inuse food dispensing utensils properly stored |_| (1 97 Physical faciiticewaite, Ceilings and attached equipment, (| 13 Clean cothes, hair restraints [| constructed, clean LJ] 14 Food contact surfaces designed, constructed, maintained, | [J 38 Lighting provided as required, Fixtures atlelded Inetallad, located HES Reon deca opaume tied —_t . 23 18 Non-food contact surfaces designed, constructed, maiaed, | | IT 40 Employes lockers provided end used, clean | Installed, located . C0 42 Premises maintained, no unnecessery artictes, Cleaning & OD te Oiewashing faites dasined, constructed, operated melntenance exulpment property stored, Kitchen restricted, 1.Wash 2, Rinsa 3, Sanitize | 143 Completa se , : t_} 17 Thermometers, gauges, fast kits provided cre 90 [18 Pre-flushed, scraped, soaked bl "45 Fire entingulshers =p prope: andufident [} 18” Wash, rings water clean, proper temperatura {| | FIREEXTINGUISHERS: Daiofy) ———|”_CBUPPREAGION GYUTEME: Dalat L_}*20a Sanitizing concentration ppm Py : [| *20b Sanitizing temperature *Falrenhet ||] [bq ol wh : ~-—, . : [.} 21 Wiping cloths claan, uead properly, stored [| 23 Non-food contact surfaces clean LI} 24 Storageyhandling of clean equipment, utenalls [| Et 25. Service tame propeiy stored, handled, dispensed 2} | | |_| 26 Single service articles not re-used a) 49 Flammablaloombustioo mataiale - pi | 8 *27 Water sourca safe, hot and cold under pressure *60_ Current licansa, properly display [| { |*28 Sewage and waste waler disposed prope Te 51_Other conditions sanitary and wale on [ ty i ] | [J 30 Cross-connection, back siphonage, backflow ood/baveraga [1°31 Tollet and hand washing eal, umber, convenient, designed, re 54 Florida Clean Indoor Alr Act Compliance |_| Installed | Te) 55 Automatio Grat Notica” | Ta lt 68 Copy of Chapter 509, Florida Statutes avallabla | | [33 Garbage containers covered, adequate aumber, Trsecl and rodent | proof , empflad at pepe intervals, clean Hem No. Violations cited In this se of es stated on page 1. sah BLL fbohes aL tao! — Foot pg | A 0 Oven Clones | igh age Fil as MLE Bally atl DIE 57 Hosp tal Education Program Information provided L} Additional Comments on Attached Ted Person In Charge (Signature My lp [2S : Data /- "Ols Inspector (Signature) _ aA, Cre 4 Date HL - I ¢ DBPR'Form HR 5022-015 - : www. MyFlorida.com/dbpr 2008 May 2 . } ' Page 1 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION DIVISION SoC eae TAURANTS . . EXHI BIT B CALLBACK INSPECTION REPORT _ LEGAL NOTICE ‘ Fellura to comply with this Notice may inidate an administrative complaint that may reauitt in suspension or revocation of your lIcenee and fines. 4/4106 11:45:23 AM Waming ” MFD2660805_ 0 MFDV Callback Inspaction Date and Time Inspection Reason Lleense Number o NEIL-WIGGINS MELIA —— Complied 7432424 . Owner Name Area Code/Telephone Number Business Name Inspaction Result a cna : 02/28/2006 Numbar of Units Requested Caljback Date/Time “Initial Waming Date 1024 UNIVERSITY BLVD JACKSONVILLE FL 92214 Address / City / State /Zip / etc. : Comments Not same cart, 8 follawing Hams) have bean submitted for a Time Extension: Hon: 81-13-41 lo Halmitch maneuver sign posted. i 56-01-1 py of Florida Statute 509 not avaliable in the astablishmant, Jaton: 56-01-] . of Florida Statute 609 not available In the establishment. 4/4108 Date Signature of Reciptent Inspactor Signature Recipient: Nikki OUT For further information plaase contact: Title . ; Derrick Young empl aye ‘ Sanitation and Safety Spectallst-7960 Arlington Phone: 9044773353 - ‘ . Expressway Sulla 610 Jacksonville, FL. 32211 ah * 850-487-1395/Fax 727-5558 DBPR Form HR 6022-005 Ps . Page 2 STATE OF FLORIDA ExHl BIT Bere Number DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION MFDV MFD2650805 DIVISION OF HOTELS AND RESTAURANTS Business Name www. myflorida.convdbpr HOT DOGGIN IT CALLBACK INSPECTION REPORT Inspection Date LEGAL NOTICE ‘ ; 4/4/08 11:45:23 AM Fallure to comply with this Notice may Initiate an administrative complaint that may resuit In suspension or revocallon of your lleanae ‘end fines, ‘a follawing itent(s) are In compllance: lation: 53A-02-1 artified Food Manager falted to verify employes health, exclusions or restrictions, lailon: B3B-08-1 : . : ' proof of required employes training provided, All public food service estsblishments must provide the division with proof of employes training upon request, Including, but t Timited to, at the time of sny division inspection of the establishment. This violation must be coracted by 3-28-06, DBPR Form HR 5022-005 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION DIVISION OF HOTELS AND RESTAURANTS www. myflorida.com/dbpr EXHIBIT B CALLBACK INSPECTION REPORT LEGAL NOTICE Fallure to comply with this Notica may inllate an administrative complaint that may result In suspension or revocation of your license and fines. 2IZBIOG 12:02:23 PM Waming . Mep2geos5 FBV Callback Inspection Date and Time Inspectlon Reason License Number NEIL-WIGGINS MELIA "rime Extinded 7432424 Owner Nama : Area Code/Telaphone Number HOT OOGGIN IT. Business Name inspection Rasult . a. 03/28/2006 08:00 AM 02/27/2006 Number of Units Requested Callback Date/Time Initial Warning Data 1024 UNIVERSITY BLVD JACKSONVILLE FL 32214 Address / City / State / Zip / atc, Comments 16 following ilem(s) have bean submitted for a Tima Extension: lofation: 5{-13-4 lo Helmlich manguvor sign postad, tolation: 53A-02-1 artified Food Manager fallad to verify employes health, exclusions of restricilons, lotalion; S3B-08-1 2/28/06 Date Recipient: Title ° Phone: OBPR Form HR 8022-005 Signature of Reciplent . Sherry Smith employees 9047052580 nae Inspactor Signature For further information please contact; Darrick Young Sanitation and Safety Specialist 7960 Aringtan Expressway Suite 610 Jacksonville, FL. 92211 850-487-1395/Fax 727-5558 a LAHIBIT B nase STATE OF FLORIDA License Number DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION MFOV MPDZ650805 DIVISION OF HOTELS AND RESTAURANTS Business Name wow. mytionda.com/dbpr HOT DO! GGIN IT CALLBACK INSPECTION REPORT Inspection Dete LEGAL NOTICE : 2/28/08 12:02:23 PM Fallure to comply with this Notica may Iniate an admintetretive complaint that may result In suspension or revocation of your license and fines, jo prof of required employee training provided, Ail public food service establishments must provide the division with proof of employee taining upon request, Including, but 101 (Imiied to, al the time ofany division lnspactlon of the establishment. This violation mUst be corrected by : 3-28-06, folation: 56-01-1 ‘opy of Florida Statute 509 not avaliable In the esta billshment. jotation: 56-01-1 . . , , ‘apy of Florida Statute 509 nat avallable in the establishment. 8 following Item(s) are in compliance: latton: O3A-07-1 bsarved potentially hazardous food cold held at greater than 41 degrees Fahrenhelt I eat food letlon: 03B-03-1 lentially hazardous food not held at 135 dagrees Fahrenheit or above, 1 dogs olation: 08A-31-1 served food, othar then frankfurtara, prepared on a hot dog cart, . . Holation: 1286174 Oo served employes Improparly washing hands. th 8 cold water jug lofation: 21-11-1 ping cloth chorine sanitizing solution not at proper minimum strength, ver 200 ppm: lolatton; 24-12-4 fet wiping cloth not stored In sanitizing solution between Uses. lolation: 27-04-1 boat id wator not provided/shut off at ompigyan handwash alnk, holation: 27-16-1 lot water not provided/shut off at employee hand wash sink, lotation: 31-03-1 DBPR Form HR 5022-006 Page 3 . i) STATE OF FLORIDA License Number DEPARTMENT OF BUSINESS AND PROFESSIONAL REG Hf B i} T MFDV = MFD2650805 DIVISION OF HOTELS AND RESTAURANTS De iness Name worwmmfforie.combpr HOT DOGGIN IT - Inspection Date CALLBACK INSPECTION REPORT LEGAL NOTICE . 2/28/06 12:02:23 PM Fallure to comply with this Notice may Initiate an administrative complaint that may result In suspension of ravocation of your license and fines. land wash sink missing or inadequate on mobile food dispensing vehicle, jot connacted DBPR Form HR 6022-005 ) . ‘y STATE OF FLORIDA : Page 1 DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION DIVISION OF HOTELS AND RESTAURANTS www myflorda.comydbpr EXH | B IT B FOOD SERVICE INSPECTION REPORT J LEGAL NOTICE : Failure to comply with this Notice may Initiate an administrative complaint that may resutt in suspension or revocation of your lIcense and fines. 2/27/06 1:25:04 PM Routine 2650805 MEDV. Inspection Date and Time . Inspection Reason License Number NEIL WIGGINS MELIA Owner Name 904 HOT DOGGIN IT establis S Area Code/Telephone Number Business Name : Inspection Result : 0 _ i 02/28/2006 08:00 AM 06-01-08 Number of Units : Callback Date/Time License Expiration 1024 UNVERSITY BLVD. JACKSONVILLE FL 32211 . Address / City / State / Zip / etc, : . ltam 03; Food Temperatures (tem 53a; Cart, Food Managers “hot dog, cooler, 47 Degrees F. Manager Nama: Mella WMogins Certification Sanltizer Type: Not Set Up found at “sausage , Cooler, 46 Degmes F, Date: 96-01 Cartiled by: Florida Raataurant concentration of O PPM, cart hoa a certification date of August 0S ‘cole slaw, cooler, 64 Degrees F. Association . "hot dogs, sisam tables/bain marie, 84 Degrees: Ro: NOTE: Items marked above.with an asterisk (*) indicate a violation Inspector's Comments Provided Web Sile: www.myflorida.com/dbpr lecknowledge recelpt of this Inspection form and comments, Pharary Dab pea 227106 a ; 4 Signature of Recipient Inspector Signature Date 4 P : Recipient: Sherry Smith For furthar information please contact: . Derrick ‘Young Tile Employee ; Sanitation and Sstety Specallst 7860 Arlington Expressway Sutte 610 Phone: 9044773353 Serer aaron 727 88 [statis [ SOURCE STATUS PHF TEMPERATURE CONTROL Yes [Ola Approvedsourca NG 03b Ht ford ot proper temperature eo | *03a Cold food et proper tamperatures during storage, [Yes | display, service, transport, and cold holding "06 Potantially hazardous foods properly thawed Violations marked with an estarisk are critical violalions, hamdyiered YES are in compliance, Iams Marked NO are violations. Specific detalls of violation gra listed on subsequent pages, Items merked N/A are Not Applicable. {tems Marked as N/O ara Not Observed, and were not belng conducted at tha time of inspection. OBPR Form HR 5022-015 Sp ) STATE OF FLORIDA , Page 2 DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION — icensa Numba -. DIVISION OF HOTELS AND RESTAURANTS MEOV EX BIT B www. myflorida.comydbpr : inspection Date FOOD SERVICE INSPECTION REPORT 2/2706 1:25:04 PM . : LEGAL NOTICE . . Fallure to comply with this Notice may Inidate an administrative complalnt that may result in suspension or revocation of your {lcertse and fines. GARBAGE AND REFUSE DISPOSAL 33 Containers covered, adequate number,.insact and rodent ye eee Food protection during storage, preparation, display, proof, emptied at proper intervals, clean service, transportation Yes 34 Outside storage area clean, enclosure praperly [Yes 0b Cross-contamination, equipment, personnel, stage _| ponstructed Yes "35b Quier openings protected from insects, rodent proof [Yes [10 In use food dispensing utensils properly stored STATUS _ PERSONNEL Yes *11 Personnel with infections restricted 37 Walls, cellings, and attached equipment, constructed, clean sot Yes eS 13 Glesin clothes, halr restraints 40 Employes lockers provided and used, claan STATUS FOOD EQUIPMENT AND UTENSILS Yes ____ [44a Toxic Hams properly stored Yes 14 Food contact surfaces designed, constructed, '41b Toxlo tems iabeled and used proper! maintained, installed, located Yes 42 Premises maintained, free of liter, unnecessary articles. Yes 16 Non-food contact surfaces designed, constructed, | (maintained, installed, located . Cleaning and maintenance equipment property stored, Yes *46 Dishwashing facilities designed, constructed, operated 43 Complate saparation from fiving/sleaping area, laun Kitchen restricted to authorized personnal 4.Wash 2. Rinse 3, Sanitize Yas “17 Thermometers, gauges, test bits provided 18 Pre-flushed, scraped, soaked Yes Yes | "20a Sanitizing concentration Yas g q a *20b Sanitizing temperature [Yes eas Gas appliances - praperly installed, maintalned INo___|21. Wiping cloths clean, used properly, stored . Yes Wes |z2Foodcantact surfaces ofequismantandutensiisclean | STATUS |. GENERAL [Ves-___|23 Non-food contact surfaces clean Yes 24 Storage/handling of clean equipment, utensils [No sd 61 Other conditions sanitary and safe operation Yes - 52 False/misleading statements published or advartisad 6 ansed relating to food/beverage . 26 Single service articles not re-used No *53a Food management certification valid Yes Yes o! =< 4 WATER AND SEWAGE/PLUMBING No _[*6ab Employes traning validation No *27 Water source safe, hot and cold under pressure as 54 Florida Clean Indoor Air Act . 28 Sewage and waste water disposed proper! \ves [55 Aulomatic Gratuity Notice. a p 29 Plumbing installed and maintained N "30 Crosé-connaction, back siphonage, backflaw s+ S Violations marked with an astarisk are critcal violations. ltame'marked YES are in compliance. Items Marked NO are violations, Specific detalls of viotation ara listed on subsaquent pages. Itams marked N/A are Not Applicable, ltams Marked as N/O are Not Observed, and ware.not being canductad al the tima of inspection. 56 Copy of Chapter 509, Florida Statutes, available STATUS TOILET AND HANDWASHING FACILITIES Yes 67 Hospitality Education Program Information provided STATUS re 31 Toilet and handwashing factilies, number, convenient, designed, installed “i 32 Restrooms with salf-closing doors, fixtursa operate proparly, faciiity clean, supplied with handsoap, disposable towels or hand drying davicas, Ussua, covered wasta receptacles Total Number of COS Violations: i) Total Number of Repeat Violations: 0 DEPR Form HR 5022-015 STATE OF FLORIDA ‘Pays EX {] BI T B DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION _ License Number DIVISION OF HOTELS AND RESTAURANTS _ _MFDV — 26-50805 www. myfioride.comvdbpr . Inspection Data 2727106 1:25:04 PM FOOD SERVICE INSPECTION REPORT — LEGAL NOTICE Fallure to comply with thle Notice may inilate an administrative complaint that may result In suspension of revocation of your license and fines. Waming(s): : 03A-07-1 - Observed potentially hazardous food cold held at greater than 41 dagraes Fahrenhalt. All cald food 03B-03-1 - Potentially hezardous food not held al 135 degrees Fahrenhett or above, Hot dogs 08A-31-1 - Observed food, other than frankfurtars, praparad on a hot dog cart, REFERENCE TEXT: 610-4.0161(3}(c} FAC: (3) Mobile food dispansing vehicles which Ilmil the preperalion of food to frankfurtare only shall comply with all uppilcable requirements sat forth In rules 610-4.010 and 81C-4,023, FAC, a6 wall as the additonal requirements sat forth in Paragraph (2){a) and subsections (8)-(10) of this rule; except that: (c) Potentielly hazardous foods such as chili, cooked onions and pappers, cheese, dnd cheese sauce may only be served In individually portioned and packaged or pre-packaged containers which are maintained at proper tamparaturas on tha unit, Non-polentlally hazardous fonds such ag relish, raw-onlons and peppars, and ather auch condimants may be served directly from the unit. 24-144 « Wiping cloth chlorine sanitizing solution not at proper minimum strangth, Over 200 ppm 21-12-1 » Wat wiping cloth not stored In saniilzing solution between uses, 31-03-1 - Hand wash sink misaing or inadequate on mobile fond dispanaing vehicla, Nol connected ' . ; 51+13-1 - No Halmlich maneuver sign pasted, 53A-02-1 - Certiied Food Managar fatled to, verify amployaa health, exclusions or restrictions. . 53B-08-1 - No proof of required employed ireining provided. Al! pubile food service establishmants must provide the diviskon with proof of employee tralning upon request, Including, but not limited to, st tha time of any division inspection of the establishmarit. This violation must be corractad by : 3-28-08, . . 56-01-1 - Copy of Florida Statute 609 not avaliable in the establishment, Viotatlon(s): 12A-17-1 - Observed employee improperly washing hands. ‘With a cold water jug 27-04-1 - Cold water nat provided/shut off at employee handwash sink, 27-16-1 ~ Hot water not providad/shut off at employee hand wash sink, _ 58-01-1~ Copy af Florida Statute B09 nor available In the establishment. are - DBPR Form HR 5022-015

Docket for Case No: 07-001701